The United States had no tradition of circumcision. So how did it become the norm?
For the vast majority of its history, the United States — a predominantly Protestant nation of Northern European descent — had no cultural or religious tradition of circumcision. As recently as 1870, the practice was almost exclusively limited to Jewish and Muslim communities.
What happened over the next hundred years is a story of moral panic, pseudoscience, wartime policy, and the quiet machinery of health insurance — each playing a role in turning a niche religious practice into one of the most common surgeries in American history.
Understanding how this happened is not about assigning blame. It is about understanding why America arrived at a place the rest of the developed world never went — and why, now that we know what we know, the trajectory is slowly reversing.
How it spread — one justification at a time
Each generation produced a new reason to continue the practice. When the old reasons were disproven, new ones appeared. The procedure outlasted every argument used to justify it.
A religious practice — not a medical one
Before 1870, circumcision in the United States was practiced almost exclusively within Jewish and Muslim communities as a religious rite. The broader American Protestant population had no tradition of it whatsoever. Most American men of this era were intact, and the idea of surgically altering a newborn for non-religious reasons would have seemed unusual at best.
The story of how that changed begins not with medicine, but with morality.
The Victorian moral panic — masturbation as disease
The late 19th century saw a widespread Victorian-era belief that masturbation caused a staggering range of physical and mental illnesses — including epilepsy, insanity, tuberculosis, blindness, paralysis, and early death. This was not fringe thinking; it was mainstream American medicine.
In 1870, Dr. Lewis Sayre — a prominent orthopedist and Vice President of the American Medical Association — began promoting circumcision as a medical cure, claiming it resolved conditions from hip disease to paralysis by eliminating the "reflex irritation" caused by the foreskin. His influence was enormous, and his advocacy marked the moment circumcision crossed from religious ritual into American medicine.
In the years that followed, the procedure was claimed to prevent or cure masturbation, insanity, epilepsy, hernia, tuberculosis, cancer, venereal disease, and headaches — a list that tells you everything about the quality of the science behind it.
The "hygiene" pivot — when moral arguments got a medical costume
As the anti-masturbation arguments became harder to defend scientifically, the medical justification shifted. "Hygiene" became the new rationale. Circumcision was now said to prevent infections, make cleanliness easier, and reduce disease risk — arguments that sounded more scientific but were similarly lacking in evidence.
This period also saw the rise of the "sanatorium movement" — health institutions promoting sweeping lifestyle interventions in the name of moral and physical purity. Circumcision fit neatly into this framework. The procedure was promoted not just as medicine, but as a marker of a modern, educated, health-conscious family.
The people who shaped — and distorted — American medicine
These are not villains. They were products of their era, operating within the beliefs of their time. But their influence was enormous — and understanding it explains a great deal about how America ended up where it did.
Sayre is widely credited as the man who medicalized circumcision in America. In 1870 he published claims that he had cured a paralyzed boy by circumcising him, arguing that "reflex neurosis" from the foreskin was responsible for conditions ranging from hip disease to epilepsy. His prominence in the AMA gave these claims enormous reach.
His theories were never supported by controlled evidence, but they launched an era in which circumcision was promoted as a cure for an ever-expanding list of ailments. The procedure had entered American medicine — and it would prove very difficult to remove.
Medicalized the practiceYes — the man behind Corn Flakes. John Harvey Kellogg was one of the most influential health figures in early 20th-century America. He directed the famous Battle Creek Sanitarium in Michigan, which attracted thousands of patients and enormous media attention. He is often cited as a major force behind the spread of circumcision in the U.S.
Kellogg was terrified of masturbation, which he believed caused epilepsy, cancer, heart disease, and insanity. He explicitly advocated circumcision as a punishment and deterrent — performed without anesthesia, so that the pain would serve as a psychological deterrent. He applied carbolic acid to the clitorises of girls for the same reason.
It is worth noting that historians debate his precise role in normalizing infant circumcision specifically — he advocated it as punishment for older boys caught masturbating, rather than routinely for newborns. But his enormous public influence helped establish the idea that the foreskin was a medical problem requiring surgical correction, laying cultural groundwork that others extended to infants.
Cultural influencerIn 1914, Wolbarst made one of the first explicit calls for universal circumcision of all male infants in the United States — not as punishment, not as religious ritual, but as routine preventive medicine. He argued it would prevent venereal disease and cancer. His position was decades ahead of mainstream medical consensus — but it planted a seed.
His proposal was embraced over time by obstetricians and gynecologists who became, paradoxically, the most influential advocates for a procedure on male anatomy. From the 1930s onward, it was largely these specialists — who knew relatively little about the male foreskin — who drove the push toward making circumcision a hospital routine for every newborn boy.
Universalization advocateHow World War I and II turned circumcision into a national standard
The wars did not just shape military policy — they reshaped what an entire generation of American fathers believed about their sons' bodies.
The military orders circumcision — men have no say
During World War I, U.S. military doctors promoted circumcision among servicemen as a preventive measure against venereal disease. Thousands of soldiers and sailors — many of whom would never have chosen the procedure voluntarily — were circumcised in boot camps and field hospitals. Military discipline left them little choice.
These men came home with something no previous generation of American fathers had: a personal experience of adult circumcision, often remembered as painful and difficult. When they later became fathers, doctors began asking whether they wanted their newborn sons circumcised. Many said yes — reasoning that a "quick snip" in infancy was far better than the ordeal they remembered from adulthood.
Desert warfare, hygiene, and a generation's lasting belief
World War II reinforced and expanded this trend. In the harsh conditions of the North African desert campaign — extreme heat, sand, and limited water for washing — some military physicians reported higher rates of infection among uncircumcised soldiers and pushed for circumcision as a wartime medical policy. The military's embrace of the procedure as sound preventive medicine gave it a new level of institutional authority.
When the war ended and the baby boom began, returning fathers — hundreds of thousands of them with a personal or military connection to circumcision — entered hospital maternity wards as new parents. The procedure was offered routinely. Most said yes. By the late 1940s and into the 1950s, hospital circumcision of newborns had become standard American practice for the first time in history.
The pattern that kept repeating: Every time the medical justification for circumcision was disproven, a new one appeared to take its place. Masturbation cure → hygiene → disease prevention → wartime medicine → cancer prevention → STD reduction. The arguments changed every generation. The procedure never did. This pattern — a solution in search of a problem — is one of the most distinctive features of American circumcision history.
Insurance, hospitals, and the routine that became invisible
By mid-century, circumcision had stopped being a decision and become a default — reinforced by the two most powerful forces in American medicine: hospital protocol and insurance coverage.
Insurance coverage makes circumcision invisible — it becomes the unquestioned default
As postwar prosperity expanded employer-provided health insurance, and as childbirth moved overwhelmingly into hospitals, circumcision was quietly added to the standard package of newborn care. Most private insurance plans covered it. Hospitals performed it as a matter of routine. It appeared on the bill alongside cord clamping and the vitamin K shot.
Parents were rarely asked whether they wanted it — they were asked how they wanted it done, or informed it had already been completed. For millions of American families, circumcision stopped being a decision and became something that simply happened, as natural and unquestioned as any other part of giving birth in an American hospital.
By the peak years of the 1960s and early 1970s, approximately 85% of American newborn boys were circumcised. The U.S. had become the only country in the world where the majority of non-Jewish, non-Muslim men were circumcised — and almost no one thought to ask why.
How the tide began — slowly — to change
The decline was not driven by a single moment. It was driven by scrutiny — as medicine became more evidence-based and parents began asking questions that earlier generations had not.
The American Academy of Pediatrics issues its first statement concluding there is no valid medical indication for routine neonatal circumcision. For the first time, the country's leading pediatric body officially said the procedure was not medically necessary. The statement received little mainstream attention.
A new AAP task force found some potential benefits — including reduced urinary tract infections in infancy — and softened its position. This brief reversal was widely covered and contributed to continued high rates. Subsequent reviews found the UTI benefit modest and easily managed without surgery.
The AAP revises its position again: the potential benefits are not sufficient to recommend routine circumcision. They leave the decision to parents. This is essentially where the official U.S. position still rests today — "up to you" rather than "yes" or "no."
A growing number of U.S. states stopped covering routine circumcision through Medicaid — meaning lower-income families were less likely to choose it, simply because it was no longer automatically included. Rates dropped significantly in western states. Today, circumcision rates in California and the Pacific Northwest are below 30% — already below the national average and still falling.
A uniquely American practice, reconsidering itself
For the first time in a century, the question of why America does this differently from the rest of the world is being asked openly — in hospitals, in medical journals, and in living rooms.
No major medical organization recommends it. Rates are falling. The conversation is changing.
The AAP's last formal policy statement on circumcision was issued in 2012 and expired in 2017 without renewal — leaving American medicine without a current official position. The Canadian, British, Australian, and Dutch pediatric equivalents all actively advise against routine circumcision. No major world health organization recommends it as a standard practice.
Meanwhile, circumcision rates in the U.S. continue their decades-long decline. In western states, intact boys are now the majority. The generation of Americans currently becoming parents grew up in a country where the question had already begun to shift — and many are choosing differently from their own parents.
The practice that was built on moral panic, wartime policy, and insurance defaults is meeting, for the first time, an informed generation of parents who know they have a choice. That is exactly the change we are working to support.
The American exception: The United States remains the only wealthy, predominantly non-Muslim, non-Jewish country in the world where routine infant circumcision is common. Every other comparable nation abandoned the practice decades ago — not because of a cultural shift alone, but because the evidence never supported continuing it. America is simply the last to catch up.
This history doesn't make anyone a villain. It makes us better informed.
Every parent who consented to circumcision over the past century did so within the context of what they knew and were told. The practice was normalized by medicine, by insurance, by wartime policy, and by cultural inheritance. Understanding that history is not about blame — it is about recognizing that the foundation was always shakier than it appeared, and that the future can look different.
- The practice began with anti-masturbation moral panic, not medicine
- Wars normalized it for an entire generation of American fathers
- Insurance coverage made it invisible — a default rather than a choice
- No major medical org currently recommends it as routine
- Rates have been falling for 40 years and continue to fall
- America is the last developed nation where this remains common