Normal versus Circumcised: U.S. Neonatal Male Genital Ratio - 2001

p("Normal versus Circumcised: U.S. Neonatal Male Genital Ratio
By Dan Bollinger, © 2003 Revised: April, 22, 2003"); p("Interest in the genital integrity issue continues to grow and trustworthy statistics are necessary for an informed debate. The American Academy of Pediatrics complained that statistics being cited are outdated and inaccurate." . sup(1);?> The goal of this paper is to provide recent, accurate and consistent statistics for that discussion. This white paper addresses United States neonatal male circumcisions performed in hospitals.");
p("Source Data: According to the " . elink("http://www.census.gov/population/www/socdemo/birth.html","U.S. Census Bureau") . " the most accurate figures for live births is the " . elink("http://www.cdc.gov/nchswww/","National Center for Health Statistics") . " (NCHS)." . sup(2);?> Live births and male births from 1990-2001 are from the annual NCHS reports including the recent Births: Final Data for 2000 (100% samplings). The NCHS tracks the sex ratio; in recent years it has been 1047 males for every 1000 females born live, or 51.15%." . sup(3);?> This figure has changed little in the past 50 years and is used to calculate male births for years 1990-1997. The number of circumcisions is from health care analysts " . elink("http://www.solucient.com/","Solucient") . " who compiled an Inpatient View report (33% samplings) on annual male" . sup(4);?> neonate" . sup(5);?> circumcisions" . sup(6);?> performed in hospitals between 1990 and 2001.");
p("The only known historical compilation of circumcision rates is in Edward Wallerstein’s Circumcision: An American Health Fallacy." . sup(7);?> His statistics are estimates for the years 1870 (the year circumcision was introduced to the United States" . sup(8);?>) through 1979. In 1979 popularity of circumcision reached a record high in the United States at 85%. Since then the rate has been decreasing. In comparison, the United Kingdom’s circumcision rate is 0.41% for one-year-olds." . sup(9));
Year Circumcisions % Change Live Births Male Births % Intact % Circumcised
2001 1,137,654 -6.3% 4,040,121 2066522* 44.9% 55.1%
2000 1,214,312 1.9% 4,058,814 2076969 41.5% 58.5%
1999 1,191,733 -1.1% N/A 2,026,854 41.2% 58.8%
1998 1,204,431 +5.0% N/A 2,106,205 42.8% 57.2%
1997 1,146,839 -12.9% 3,880,894 1,985,077 42.2% 57.8%
1996 1,317,422 +9.5% 3,891,494 1,990,499 33.8% 66.2%
1995 1,203,223 -3.0% 3,899,589 1,994,640 39.7% 60.3%
1994 1,240,572 -1.3% 3,952,767 2,021,840 38.6% 61.4%
1993 1,257,461 -5.8% 4,000,240 2,046,123 38.5% 61.5%
1992 1,334,742 +0.9% 4,065,014 2,079,255 35.8% 64.2%
1991 1,323,189 -2.6% 4,110,907 2,102,729 37.1% 62.9%
1990 1,358,218 N/A 4,158,212 2,126,925 36.1% 63.9%
p(" "); p("image"); p("The intact rate for 2001 is 44.9%." . sup(10);?> The last time the rate was this high was around 1930, 64 years ago. In 1979 an estimated 15% of boys retained their normal penis." . sup(11);?> The intact rate has increased almost three-fold since then. The number of circumcisions in 2001 decreased 6.3% from the previous year."); p("Neonatal circumcisions account for 99.3% of U.S. circumcisions. It is the most often performed surgery in the U.S.A." . sup(12);?> Hospital circumcisions account for an estimated 99% of U.S. circumcisions." . sup(13)); p("image"); p("Circumcision in the neonatal period is contraindicated." . sup(14);?> The American Academy of Pediatricians concluded: There is no absolute medical indication for routine circumcision of the newborn." . sup(15);?> The American Medical Association concurs." . sup(16)); p("There are conflicting reports of the true cost of neonatal circumcisions. Medicaid paid at least $35 million for circumcision in 1999." . sup(17);?> The AAP estimates that circumcision costs $150-270 million annually." . sup(18);?> The additional cost of complications and extra hospital stay (averages ½ day) has not been estimated."); p("Deaths from circumcision and related causes are estimated at 229 per year." . sup(19)); p("The number of circumcisions varies by region." . sup(20);?> Over the past ten years numbers in the Northeast and North Central regions have dropped while those in the South region have risen, while circumcisions in the West have remained about the same."); p("Racial make-up of patients changed over the past ten years. The number of circumcisions to White infants is down 38%. Black circumcisions are down 34%. Asian circumcisions are up 30%. American Indian circumcisions are up 263% and Hispanic circumcisions are down 21%." . sup(21)); p("image"); p("No female circumcision has been performed in U.S. hospitals since 1991 when 8 surgeries were performed. It is illegal to circumcise females in the U.S. except for diagnosed medical conditions." . sup(22)); p("This report will be updated annually as data becomes available. Dan Bollinger is an independent men’s studies researcher and instructor for men’s workshops. He resides in West Lafayette, Indiana. danbollinger@insightbb.com"));

References

  1. Circumcision Policy Statement (RE9850), Amer. Acad. Ped. Volume 103, Number 3, March 1999, pp. 686-693
  2.  External link http://www.census.gov/population/www/socdemo/birth.html
  3. Births: Final Data for 1998, NCHS,  External link http://www.cdc.gov/nchs/data/nvs48_3.pdf PDF link; see Sex Ratio, p. 8
  4. HCIA reported 8 female circumcisions performed as a secondary procedure in 1991, but none elsewhere in the 1990-99 findings.
  5. Less than 28 days old
  6. ICD-9 64.0 Circumcision
  7. Edward Wallerstein, Circumcision: An American Health Fallacy, Springer Publ., New York, 1980
  8. David Gollaher, Circumcision: A History of the World’s Most Controversial Surgery, Basic Books, New York, 2000, Chapter 4
  9. British Department of Health and Social Security 1972 National Census, from records of 400,000 males under the age of one year old the circumcision frequency rate was 0.41%
  10. Based on preliminary data from the NCHS. Their Final Birth Data is not yet released.
  11. Edward Wallerstein, Circumcision: An American Health Fallacy, Springer Publ., New York, 1980 see appendix ‘B’
  12. J. M. Appleby, Top 25 inpatient procedures, Managed Healthcare, Oct, 2000
  13. http://www.hcia.com/findings/990513_circum.htm#1993
  14. Committee on Fetus and Newborn: Standards and Recommendations for Hospital Care of Newborn Infants. Sixth Edition. American Academy of Pediatrics; Evanston, IL 60204, 1978:p. 66-7
  15. Thompson HC, King LR, Knox E, et al. Report of the ad hoc task force on circumcision, Pediatrics, Vol. 56 No. 4: Pages 610-611, October 1975.
  16. Report 10 of the Council on Scientific Affairs (I-99), Neonatal Circumcision, American Medical Association, Chicago, 1999.
  17. J. W. Travis, G. Denniston, R. Cruz, J. S. Svoboda, A. Craig,  External link Tax Dollar Funding of Medically Unnecessary Circumcisions Through Medicaid PDF link, International Coalition for Genital Integrity, Santa Cruz, 2001
  18. AAP Circumcision Policy Statement (1999) Pediatrics.
  19. Estimated circumcision related deaths are 229 per year. Baker RL. Newborn male circumcision: needless and dangerous. Sexual MedicineToday 1979;3(11):35-36
  20. Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT
    North Central: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI
    South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV
    West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY
  21. Note: These rates are derived from recorded data, but may not represent accurate results since the percentage of unrecorded patient’s race is such a large portion of the whole.
  22. Federal Prohibition Against Female Genital Mutilation Act, 1996
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