U.S. Circumcision Rate Drops
Published: 6/18/07, 2:45 PM EDT
By RACHEL KONRAD

SAN FRANCISCO (AP) - On the eighth day of her son's life, Julia Query
welcomed friends and family to celebrate his birth and honor their
Jewish heritage.

But there was no crying, no scalpel, no blood, no "mohel" - the person
who traditionally performs ritual circumcisions in the Jewish faith.
In fact, Elijah Rose's "bris" differed markedly from the ceremony long
used to initiate Jewish boys into a covenant with God: There was no
circumcision.

"I knew before I was even pregnant that I would not circumcise," said
Query, 39, a San Francisco filmmaker whose son was born in 2002. "It's
not like you're just cutting a piece of paper off a pad - there's no
`cut here' line. It's not made to be cut off, and I would never, ever
do that to my baby."

Query is among a growing number of American parents refusing
circumcision, in which the foreskin is removed from the penis.

According to a study by the National Health and Social Life Survey,
the U.S. circumcision rate peaked at nearly 90 percent in the early
1960s but began dropping in the '70s. By 2004, the most recent year
for which government figures are available, about 57 percent of all
male newborns delivered in hospitals were circumcised. In some states,
the rate is well below 50 percent.

Experts say immigration patterns play the biggest role in the decline,
which is steepest in Western states with big populations from Asian
and Latin American countries where circumcision is uncommon. The trend
has also accompanied a change in Americans' attitudes toward medicine
and their bodies.

"The rates of drug-free labor and breast-feeding all rose during the
1980s, while the initial declines in male circumcision rates began
during the 1980s as well," said Katharine Barrett, an anthropology
lecturer at Stanford University. "It may have been part and parcel of
the wider effort to reclaim bodies - adult female and infant male -
from unnecessary and potentially harmful medical interventions."

Circumcision remains the nation's most common surgery, and the United
States is still one of the few developed countries where a majority of
baby boys are circumcised. But circumcision is a heated issue and the
subject of vehemently pro and anti Web sites.

"We were all circumcised when I was born," said R. Louis Schultz, a
79-year-old New Yorker and author of "Out in the Open: The Complete
Male Pelvis." "People thought it could ward off masturbation or
disease, and those funny attitudes have really changed. Now people are
saying, `Why do it?'"

Many doctors still recommend circumcision because of some evidence
that it reduces the risk of penile cancer, urinary tract infections,
HIV and perhaps other sexual transmitted diseases. Many major
insurance companies still cover it, and many hospitals offer it free
for newborns.

But circumcision opponents say the medical benefits are dubious.
Penile cancer, for example, is extremely rare. Since 1999, the
American Academy of Pediatrics has not endorsed routine circumcision.

The debate escalated in February, when studies found that heterosexual
men in Africa who were circumcised had HIV infection rates up to 60
percent lower than uncircumcised men. Because of those studies, the
American Academy of Pediatrics is taking another look at its policy.

About one in three males worldwide is circumcised. In the United
States, the rates vary widely by region.

It is most prevalent in the upper Midwest. In 2004, according to data
compiled by the federal Agency for Healthcare Research and Quality,
more than 79 percent of newborn boys in the Midwest were circumcised
before leaving the hospital. Michigan and Kentucky had the highest
rates, at 85 percent.

In the fast-growing West, the rate declined dramatically - from 64
percent in 1979 to just under 32 percent in 2004.

In California, the rate of hospital circumcisions among newborns was
21 percent. California - which has more immigrants than any other
state - had the lowest circumcision rate in the study, which had
comprehensive data on only 27 states.

The decline coincides with rising immigration from Asia and Latin America.

"If you have a solid Victorian, American background, routine
circumcision is not unusual," said Carol A. Miller, clinical professor
of pediatrics at University of California at San Francisco.

Circumcision was uncommon in 35-year-old Usha Toland's family, which
has roots in India, Sri Lanka and Malaysia. When her son, Reynick, was
born in 2005 in San Francisco, her husband, Chris, a white man from
Southern California, assumed his son would be circumcised. But after
the couple read Web sites and medical literature, they decided against
the surgery.

"Usha probably would have understood if I really wanted to have
Reynick circumcised," said Chris, a 42-year-old advertising executive.
"But ultimately I didn't want to bring pain to the child
unnecessarily. We wanted to do things the way God or the universe
meant them to be."

Many parents fear their boys would feel awkward in the locker room if
they were not circumcised.

"I like the idea of him looking like his dad - that's the most
important thing for me," said Denise Milito Stockwell, 40, an artist
in Chicago who had her 15-month-old son, Harlan, circumcised. "It
wasn't traumatic for him in any way. He came back from the event
sleeping."

Circumcision is still common in many Jewish and Muslim communities.

Ruth Katz, 38, of San Francisco had both her sons circumcised at
brises. She and her husband, Michael Rapaport, were astonished when
the teacher in their birthing class described circumcision as
"immoral" and "not consensual."

"The edict to have your son circumcised was the first covenant with
God - the first challenge to being Jewish," said Katz, pursuing a
master's degree in business administration. "I am a progressive person
and think a lot about human rights issues, but I have never questioned
this."