Making the Cut

By JENINNE LEE-ST. JOHN

Expectant parents have loads of decisions to make, from whether to find out the baby's gender beforehand to planning the birth. But recently some have taken up another debate, over a cut that used to be nearly as routine in the U.S. as that of the umbilical cord: circumcision. When Jessica Davis learned she was having a boy, she and her husband assumed that the baby's foreskin would be removed. But when asked why by her obstetrician, who is originally from South Africa, where circumcision is rare, Davis, 28, a college administrator, did research and decided that the risks trumped the benefits. She left her son Aiden, now 20 months, intact--though she says her spouse remains leery of the decision: "He's kind of like, 'Well, I work just fine.'"

On Davis' side are the small but vocal, and growing, forces against circumcision, so-called intactivists: young parents who don't want to alter their perfect babies, men who feel their circumcisions left them psychically scarred and sexually disadvantaged ("I always felt something was missing, not functioning properly," says David Wilson, whose Stop Infant Circumcision Society marches on Washington annually) and even some medical professionals who consider the procedure genital mutilation.

And at least in some parts of the country, opinion is shifting in their favor. According to the National Health and Social Life Survey, the total proportion of U.S.-born males who were circumcised peaked in 1965 at about 85%, dropping to 77% in 1971, the last year of the study. The National Hospital Discharge Survey, which began tallying newborn circumcisions in 1979, shows a downward trend, from 65% that year to 57% in 2005. Much of the decline is attributed to immigration from Latin America and Asia, where the procedure is rare. Additionally, in more than a dozen states, Medicaid no longer covers the surgery routinely, leaving many poor children without the option. But intactivism is also gaining traction among educated, middle-class whites. As University of Virginia sociologist Brad Wilcox observes, "It's these new parents that are unwilling to let kids suffer."

But circumcision partisans say a foreskin causes suffering too. Intact boys are at greater risk for kidney infection as infants, and for penile cancer, foreskin disorders, HIV and other STDs like human papillomavirus later in life, leaving female partners more likely to get cervical cancer. The cost of prevention, proponents say, is the brief trauma of the procedure. Says Edgar Schoen, former pediatrics chief at Kaiser Permanente, who led the 1989 American Association of Pediatrics circumcision task force, which came out neutral on cutting: "A newborn baby is programmed for stress and recovers quickly." Opponents, on the other hand, say foreskin-related afflictions are rare, condoms block STDs, and circumcision has its risks. Michelle Richardson, of Fort Worth, Texas, says her 5-year-old has two genital disorders due to his botched circumcision.

The debate has even extended to the religious practice of Jews. Instead of opting for a bris, the rite in which a boy's foreskin is removed at 8 days old, Theo Margaritov's family welcomed him in April with a brit shalom, a cut-free ceremony. "That's the way God made him," says his mom Deborah, 33, a raw-foods cooking teacher in Brooklyn, N.Y.

Still, religion and health aren't the only concerns parents weigh when making the decision to cut or not to cut; tradition is also a factor. Liz Arnaiz, 30, a Brooklyn architect whose son Lucas was circumcised when he was born last November, says her husband is circumcised, so it made sense for the boy to be like his dad. Besides, she adds, "to imagine your kid in the locker room the odd man out is tough."