Circumcision’s decline pinned on immigration

Rates vary
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.

Arguing for tradition
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.”

MORE FROM KIDS AND PARENTING

Kids and parenting Section Front

CPSC chief: Agency moved too slowly on crib safety Largest crib recall in U.S. history announced Kids watching hours of TV at home daycare Biggest child-killers: pneumonia and diarrhea 1 formerly conjoined twin talking after surgery FDA panel OKs new kids’ pneumococcal shot Toxic toys? Health group finds high lead levels Sex infections still rising, especially in teens FDA weighs updated kids’ pneumococcal shot Twins joined at head successfully separated Kids and parenting Section Front   Add Kids and parenting headlines to your news reader: