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created from English and partly translated
[[File:Flag_of_USA.svg|thumb|150px|Flagge der Vereinigten Staaten von America (USA)]]
Die '''Vereinigten Staaten von Amerika''' sind auch bekannt als '''Vereinigte Staaten''' oder einfach als '''America''' oder durch Initialismen wie '''USA''' oder '''US''' oder '''U.S.A.''' oder '''U.S.''' (bitte beachten, dass ''Amerika'' auch der Name zweier geologischer Kontinente ist: ''Nordamerika'' und ''Südamerika'', die viel mehr Länder umfassen als nur die ''Vereinigten Staaten von Amerika'', die das Thema dieses Artikels sind. Siehe auch: [[:Kategorie:Amerikas]].)
{{NYT en}}
America is predominantly an English-speaking nation. As in other English-speaking nations, non-therapeutic [[circumcision]] of boys was popularized in the late nineteenth century. Due to the rates of infant circumcision that formerly approached 90 percent, the vast majority of [[Circumcised doctors| male doctors were neonatally circumcised]] and have no real knowledge of a normal body part. Such doctors frequently give poor advice to parents on the care of the [[intact]] [[penis]].<ref name="goldman2005">{{REFjournal
|last=Goldman
|first=Ronald
|init=R
|author-link=Ronald Goldman
|etal=no
|title=Circumcision policy: a psychosocial perspective
|trans-title=
|language=
|journal=Paediatrics & Child Health (Ottawa)
|location=
|date=2005-11
|volume=9
|issue=9
|pages=630-3
|url=https://academic.oup.com/pch/article/9/9/630/2648566?login=true
|quote=
|pubmedID=19675851
|pubmedCID=2724127
|DOI=10.1093/pch/9.9.630
|accessdate=2020-03-16
}}</ref> They are also much more likely to injure [[intact]] boys during office visits by premature [[Forced foreskin retraction| forcible foreskin retraction]] (PFFR).<ref>{{REFjournal
|last=Narvaez
|first=Darcia
|init=D
|author-link=
|last2=Geisheker
|first2=John V.
|init2=JV
|author2-link=John V. Geisheker
|url=https://www.psychologytoday.com/us/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy
|title=What Is the Greatest Danger for an Uncircumcised Boy?
|journal=Psychology Today
|date=2011-10-23
|volume=
|issue=
|pages=
|accessdate=2021-10-31
}}</ref>
The United States is unique in having a medical industry that aggressively promotes the practice of medically-unnecessary, non-therapeutic, harmful infant [[circumcision]]. The decline of the unnecessary practice has been slowed by continual encouragement and promotion of circumcision by the medical industry. However, the practice of non-therapeutic circumcision of boys is now in decline.
Despite the financially self-serving promotional efforts of the circumcision industry, the incidence of non-therapeutic [[circumcision]] of infant boys was reported to have continued its slow decline to 52.1 percent in 2016.<ref name="jacobson2021">{{REFjournal
|last=Jacobson
|first=Deborah L.
|init=
|author-link=
|last2=Balmert
|first2=Lauren C.
|init2=
|author2-link=
|last3=Holl
|first3=Jane L.
|init3=
|author3-link=
|last4=Rosoklija
|first4=Ilina
|init4=
|author4-link=
|last5=Davis
|first5=Matthew M.
|init5=
|author5-link=
|last6=Johnson
|first6Emilie K.
|init6=
|author6-link=
|etal=no
|title=Nationwide Circumcision Trends: 2003 to 2016
|trans-title=
|language=
|journal=J Urol
|location=
|date=2021-01
|volume=205
|issue=1
|article=
|pages=257-63
|url=https://www.auajournals.org/doi/abs/10.1097/JU.0000000000001316
|pubmedID=32716676
|pubmedCID=
|DOI=10.1097/JU.0000000000001316
|accessdate=2021-10-15
}}</ref>
== Geschichte ==
Jews have lived in America since before the Revolutionary War. They have always practiced [[Jewish circumcision| ritual circumcision]], ([[Brit Milah]]), of boys on the eighth day of life in accordance with the [[Abrahamic covenant]], however this was only for a very small percentage of the population.<ref name="self2016">{{REFjournal
|url=https://journals.troy.edu/index.php/test/article/view/386/302
|title=The Rise of Circumcision in Victorian America
|first=Eleanor
|last=Self
|author-link=Eleanor Self
|journal=The Alexandrian
|volume=5
|issue=1
|date=2016
|accessdate=2022-09-02
|format=PDF
}}
</ref>
One may be certain that the eighteenth century [https://www.nationalgeographic.org/article/founding-fathers/ Founding Fathers of the United States] of America were men with [[intact]] [[foreskin]]s as were the [[foreskinned]] men who fought the American Civil War (1861-1865).
Non-therapeutic [[circumcision]] of males for non-religious reasons originated with [[Claude François Lallemand]] in 1836 in France but soon spread to the [[United Kingdom]] in the early nineteenth century, from which it eventually spread to other English-speaking nations.
=== Spätes 19. Jahrhundert ===
The late nineteenth century was characterized by prominent medical doctors advancing all sorts of absurd reasons for the performance of non-therapeutic circumcision, including the prevention of venereal disease.<ref name="self2016" />
The first recorded non-religious circumcision of a boy in the United States occurred in 1870 when [[Lewis Albert Sayre]], a prominent New York City doctor, [[circumcised]] a boy of five years of age for paralysis.<ref name="gollaher1994">{{GollaherDL 1994}}</ref> [[Lewis Albert Sayre|Sayre]] then continued to advocate circumcision for numerous reasons until his death in 1900. According to [[Lewis Albert Sayre|Sayre]], circumcision was recommended for paralysis, epilepsy, hernia, lunacy, curvature of the spine, and clubfoot.
[[M. J. Moses]] (1871) advocated [[circumcision]] to prevent [[masturbation]].<ref name="moses1871">{{Moses1871}}</ref>
[[H. H. Kane]] (1879) 'discovers' that [[circumcision]] cures nocturnal emissions and abdominal neuralgia.<ref>{{Kane1879}}</ref>
Seventh-day Adventist [[John Harvey Kellogg]], {{MD}}, of Battle Creek, Michigan, was an important 19th century promoter of male circumcision. Although masturbation is never mentioned in the Bible, Dr. Kellogg believed that [[masturbation]] was immoral, sinful, and caused one to dream "impure dreams", which he believed was harmful to the mental faculties, resulting in mental disorders, such as feeblemindness.<ref name="kellogg1888">{{Kellogg1888}}</ref> He believed that the urge to masturbate could be prevented by eating bland foods, for which purpose, he and his brother invented corn flakes.
Dr. Kellogg (1879) also recommended [[circumcision]] in cases "in which irritation is produced by retained secretions".<ref name="kellogg1888"/>
Dr. Kellogg perhaps is most famous for his book, ''Plain facts for young and old'' (1879), in which he advocated circumcision of boys as punishment for masturbation.<ref name="kellogg1888"/>
[[William G. Eggleston]], {{MA}}, {{MD}}, from Chicaco, {{USSC|IL}}, (1886) stated that [[foreskin]] of minors and the natural "phimosis" in minors would cause crossed eyes.<ref name="eggleston1886">{{Eggleston1886}}
</ref>
Dr. [[William D. Gentry]] (1890) alleged that [[Retraction of the foreskin| phimosis in boys]] produces serious nervous derangements.<ref name="gentry1890">{{REFjournal
|last=Gentry
|first=William D.
|init=WD
|author-link=William D. Gentry
|title=Nervous Derangements Produced by Sexual Irregularities in Boys
|journal=Medical Current
|date=1890-07
|volume=6
|issue=7
|pages=268-74
}}</ref>
[[Elizabeth Blackwell]], {{MD}}, ({{LifeData|1821|1910}}), was born in England, but attended medical school in the United States. She was the first woman to become a medical doctor in the United States. Blackwell thought [[masturbation]] was immoral but that [[circumcision]] was not the way to correct it. She wrote against it in her 1894 book:
<blockquote>Appeals to the fears of uninstructed parents on the grounds of cleanliness or of hardening the part are entirely fallacious and unsupported by evidence. It is a physiological fact that the natural lubricating secretion of every healthy part is beneficial, not injurious to the part thus protected, and that no attempt to render a sensitive part insensitive is either practicable or justifiable. The protection which nature affords to these parts is an aid to physical purity by affording necessary protection against constant external contact of a part which necessarily remains keenly sensitive; and bad habits in boys and girls cannot by prevented by surgical operations. Where no malformation exists, bad habits can only be forestalled by healthy moral and physical education.<ref>{{REFbook
|last=Blackwell
|first=Elizabeth
|init=E
|author-link=Elizabeth Blackwell
|title=The Human Element in Sex; being a Medical Inquiry into the Relation of Sexual Physiology to Christian Morality
|url=https://archive.org/details/B20442622/page/n9/mode/2up
|edition=2
|year=1894
|pages=35-6
|location=London
|publisher=J.& A. Churchill
}}</ref></blockquote>
[[Peter Charles Remondino]], {{MD}},<ref name="gollaher1994" /> was a San Diego, California physician, who was born in Turin (''Torino'') in 1846, but migrated with his family to the United States at the age of eight. There is some reason to believe that he was of Sephardic Jewish descent and had been [[circumcised]] while still in Turin, however this is uncertain.
Remondino clearly was highly intelligent. He mastered English, started medical school at age 17, treated wounded soldiers during the Civil War, and later moved to San Diego for his health.
After moving to San Diego, he practiced medicine, served as an officer of several medical societies, and other regulatory agencies.
Remondino is famous for his 346 page book, ''The History of Circumcision'' (1891).<ref name="remondino1891">{{REFbook
|last=Remondino
|first=Peter Charles
|init=PC
|author-link=Peter Charles Remondino
|year=1891
|title=History of Circumcision
|url=https://www.gutenberg.org/files/23135/23135-h/23135-h.htm
|pages=
|location=Philadelphia
|publisher=F. A. Davis
|website=Welcome Collection
|accessdate=2021-09-29
}}</ref> <ref name="gollaher1994" />
When Remondino discussed the [[foreskin]], he used the most horrific, derogatory, and disparaging language. He devoted thirteen chapters to the alleged evils and faults of the foreskin. It is not clear why he had such an extreme dislike for a natural and functional body part. His recommendation, of course, was for [[Adolescent and adult circumcision| circumcision]].
[[H. L. Rosenberry]], {{MD}}, (1894) published a paper "proving" that circumcision cures urinary and rectal incontinence.<ref name="rosenberry1894">{{Rosenberry1894}}</ref>
Dr. [[E. J. Spratling]] (1895) provided information for other doctors.<ref>{{REFjournal
|last=Spratling
|init=EJ
|title=Masturbation in the Adult
|journal=Medical Record
|volume=24
|issue=
|pages=442-443
|url=https://www.proquest.com/openview/9a247c3410d34390e418dc970faa3b87/1?pq-origsite=gscholar&cbl=40146
|quote=
|date=1895
|accessdate=2022-08-30
}}</ref>
By the end of the nineteenth century, America had at least one prominent physician and surgeon on the east coast promoting circumcision and another prominent physician and surgeon on the west coast promoting circumcision. There was no real medical science with which to dispute and discredit their false claims. Non-therapeutic circumcision of males was now well-established in the United States.
=== Frühes 20. Jahrhundert ===
The early twentieth century is characterized by advocacy of circumcision based on false claims to prevent cancer and sexually transmitted (venereal) disease; and by the involvement of the United States military services in the promotion of circumcision.
[[Ernest G. Mark]] (1901) noted that the "pleasurable sensations that are elicited from the extremely sensitive" [[Ridged band|inner lining]] of the [[foreskin]] may encourage a child to [[Masturbation|masturbate]], which is why he recommended circumcision since it "lessens the sensitiveness of the organ".<ref>{{Mark1901}}</ref>
Brimhall (1902) reported an [[amputation]] of a penis after circumcision.<ref name="brimhall1902">{{REFjournal
|last=Brimhall
|init=JB
|author-link=
|last2=
|init2=
|author2-link=
|url=
|title=Amputation of the penis following a unique method of preventing hemorrhage after circumcision
|journal=St. Paul Med J.
|date=1902
|volume=4
|issue=
|page=490
|accessdate=2021-10-05
}}</ref>
[[Roswell Park]] (1902) published a paper 'proving' that foreskin causes epilepsy and that circumcision cures it.<ref>{{Park1902}}</ref>
[[L. Emmett Holt]] (1913) reported that tubercular [[mohel]]s were infecting infant Jewish boys with tuberculosis during [[Brit Milah| ritual circumcision]].<ref>{{REFjournal
|last=Holt
|init=LE
|author-link=L. Emmett Holt
|url=http://www.cirp.org/library/complications/holt1/
|title=Tuberculosis acquired through ritual circumcision
|journal=JAMA
|date=1913-07-12
|volume=LXI
|issue=2
|pages=99-102
|accessdate=2021-10-04
}}</ref>
[[Abraham L. Wolbarst]], {{MD}}, a Jewish New York doctor, apparently considered [[L. Emmett Holt|Holt]]'s paper to be an attack on ritual circumcision or perhaps Judaism itself. He collected ''opinions'' from other doctors of the alleged value of circumcision for health and published those ''opinions'' as ''scientific fact'' in a 1914 ''JAMA'' article.<ref name="wolbarst1914">{{REFjournal
|last=Wolbarst
|first=Abraham L.
|init=AL
|author-link=Abraham L. Wolbarst
|title=Universal circumcision as a sanitary measure
|journal=JAMA
|date=1914-1-10
|volume=62
|issue=2
|pages=92-7
|url=https://jamanetwork.com/journals/jama/article-abstract/453164
|accessdate=2021-10-04
}}</ref> Wolbarst's paper appeared shortly before the start of World War I. It is thought that Wolbarst's false claims inspired some military commanders to require men under their command to be circumcised so as to reduce venereal disease (VD).
M. S. Reuben (1916) (1917) reported additional cases of tuberculosis after ritual circumcision.<ref name="reuben1916">{{REFjournal
|last=Reuben
|init=MS
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/reuben1/
|title=Tuberculosis from ritual circumcision
|journal=Proceedings of the New York Academy of Medicine
|date=1916-12-15
|volume=
|issue=
|pages=333-4
|accessdate=2021-10-04
}}</ref><ref name="ruben1917">{{REFjournal
|last=Reuben
|init=MS
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/reuben2/
|title=Tuberculosis following ritual circumcision
|journal=Arch Pediatr
|date=1917-03
|volume=XXXIV
|issue=
|pages=186-90
|accessdate=2021-10-04
}}</ref>
J. Brennermann (1921) reported that [[Meatal stenosis| meatal disease]] occurs only in circumcised boys who lack the protection of the [[foreskin]].<ref name="brennermann2021>{{REFjournal
|last=Brennermann
|init=J
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/brennemann1/
|title=The ulcerated meatus in the circumcised child
|journal=Am J Dis Child
|date=1921
|volume=21
|issue=
|pages=38-47
|accessdate=2021-10-04
}}</ref>
[[Abraham L. Wolbarst|Wolbarst]] (1926) made his claim for the first time that male circumcision prevents [[penile cancer]].<ref name="wolbarst1926!>{{REFjournal
|last=Wolbarst
|first=Abraham L.
|init=AL
|author-link=Abraham L. Wolbarst
|title=Is circumcision a prophylactic against penis cancer?
|journal=Cancer
|date=1926-07
|volume=3
|issue=4
|pages=301-10
}}</ref>
[[Abraham L. Wolbarst|Wolbarst]] (1932) put forward his claim again that [[circumcision]] would prevent [[penile cancer]] in the British journal, ''The Lancet''.<ref name="Wolbarst 1932">{{Wolbarst1932}}</ref> In those long ago days, the true causes of cancer were unknown so it was impossible to disprove Wolbarst's falsehoods.
Laumann et al., writing in 1997, reported an incidence of circumcision of 31 percent in 1933.<ref name="laumann1997">{{REFjournal
|last=Laumann
|first=Edward O.
|init=
|author-link=
|last2=Masi
|first2=christopher M.
|init2=
|author2-link=
|last3=Zuckerman
|first3=Ezra W.
|init3=
|author3-link=
|etal=no
|title=Circumcision in the United States
|journal=JAMA
|location=
|date=1997-04-02
|volume=277
|issue=13
|article=
|pages=1052-7
|url=http://www.cirp.org/library/general/laumann/
|pubmedID=9091693
|pubmedCID=
|DOI=
|accessdate=2021-10-05
}}</ref>
[[Hiram S. Yellen]] and [[Aaron Goldstein]] invented the [[Gomco]] clamp in 1934-1935. The clamp, by crushing the foreskin in an intensely painful procedure, reduced the risk of hemorrhage,<ref name="yellen1935">{{GoldsteinYellen1935}}</ref> but increased the [[pain]].<ref name="sinkey2015">{{REFjournal
|url=https://www.ncbi.nlm.nih.gov/pubmed/25794628?dopt=Abstract
|title=The GoMo study: a randomized clinical trial assessing neonatal pain with Gomco vs Mogen clamp circumcision
|last=Sinkey
|init=RG
|last2=Eschenbacher
|init2=MA
|last3=Walsh
|init3=PM
|last4=Doerger
|init4=RG
|last5=Lambers
|init5=DS
|last6=Sibai
|init6=BM
|last7=Habli
|init7=MA
|journal=Am J Obstet Gynecol
|date=2015-05
|volume=212
|issue=5
|pages=664.e1-8
|pubmedID=25794628
|DOI=10.1016/j.ajog.2015.03.029
|accessdate=2021-10-05
}}</ref> The availability of the Gomco clamp increased the popularity of non-therapeutic infant circumcision.
Brown (1937) reported restoration of the [[skin]] of the [[penis]] after a denudation complication of circumcision.<ref name="brown1837">{{REFjournal
|last=Brown
|init=JB
|author-link=
|url=
|title=Restoration of the entire skin of the penis
|journal=Surg Gynecol Obstetr
|date=1937
|volume=65
|issue=362-5
|pages=
|accessdate=2021-10-05
}}</ref>
Laumann et al. (1997) reported an incidence of circumcision of 53 percent in 1941.<ref name="laumann1997" />
<b>World War II.</b> America entered the war after the Empire of Japan attacked the American naval base at Pearl Harbor, Hawaii on 7 December 1941. This was followed by Germany declaring war on the United States.
The information on military circumcision in WWII is sketchy and anecdotal. It appears that many [[foreskinned]] American men were encouraged and, in some cases, forced to be circumcised. It seems that the American military's foreskin-phobia and circumcision policy persisted through the Korean War (1950-52) but was discontinued by a change in policy thereafter.
The "Sand Myth" circulated among English-speaking armies. According to the [http://www.circumstitions.com/sand.htm Sand Myth], [[foreskinned]] men who fought in the Saharan desert had medical issues due to sand collecting under the [[foreskin]]. [[Intact]] Italian and German men who fought in the same desert had no such problems.<ref>{{REFjournal
|last=Darby
|first=Robert
|init=
|author-link=Robert Darby
|etal=no
|title=The riddle of the sands: circumcision, history, and myth
|journal=NZ Med J
|location=
|date=2005-07-15
|volume=118
|issue=1218
|article=
|page=U1564
|url=https://www.academia.edu/9899840/The_riddle_of_the_sands_Circumcision_history_and_myth
|pubmedID=16027753
|pubmedCID=
|DOI=
|accessdate=2021-10-05
}}</ref>
[[Abraham Ravich]] (1942) falsely claimed that circumcision prevents [[prostate cancer]].<ref name="ravich1942">{{Ravich1942}}</ref>
'''Post-war era.''' In the post-war era after WWII, the popularity of non-therapeutic circumcision, driven by medical promotion by doctors seeking a nice [[Financial incentive| surgical fee]] as an alleged preventive of penile cancer and by the [[Adamant father syndrome| adamant request of circumcised men home from the war who became fathers]].
Non-therapeutic, medically-unnecessary circumcision of boys had become a "routine" surgical operation that usually was performed automatically on newborn boys even without consent from anyone.
Laumann et al. (1997) reported an incidence of non-therapeutic circumcision of boys of 85 percent in 1948.<ref name="laumann1997" />
[[Eugene H. Hand]], {{MD}}, (1949) falsely claimed that circumcision would prevent cancer of the tongue and [[Circumcision and STDs| venereal disease]].<ref name="HandEH1949">{{REFjournal
|last=Hand
|first=Eugene H.
|init=EH
|author-link=Eugene H. Hand
|url=https://pubmed.ncbi.nlm.nih.gov/18135844/
|title=Circumcision and venereal disease
|journal=Archives of Dermatology and Syphilology
|date=1949-09
|volume=60
|issue=3
|pages341-6
|pubmedID=18135844
|DOI=10.1001/archderm.1949.01530030037004
|accessdate=2021-10-08
}}</ref>
The publication of a landmark article by [[Douglas Gairdner]] (1949) in the [[United Kingdom]] showing that infant circumcision is non-therapeutic, unnecessary, causes deaths, and which called for preservation of the [[foreskin]]<ref name="gairdner1949">{{GairdnerDM 1949}}</ref> was totally ignored by the circumcision industry in the United States.
=== Spätes 20. Jahrhundert ===
The late twentieth century was characterized by increasing opposition to non-therapeutic circumcision of boys by [[intactivists]] and increasing efforts by the circumcision industry to protect [[third-party payment]] for performance of non-therapeutic circumcision of non-consenting boys; and by increasing recognition that newborn boys intensely feel [[pain]] and that non-therapeutic male [[circumcision]] is a horribly traumatic experience.
[[Abraham Ravich]] (1951) falsely claimed that [[circumcision]] prevents [[cervical cancer]] in women.<ref name="ravitch1951">{{Ravich1951}}</ref>
Hollister, Inc. formally introduced the [[Plastibell]] circumcision device in 1953.<ref name=MillerSnyder1953>{{MillerSnyder1953}}</ref>
[[Ernest L. Wynder]] (1954) promoted male circumcision to prevent cervical cancer in women.<ref name="wynder1954">{{Wynder1954}}</ref>
The Congress of the United States created the [https://www.medicaid.gov/ Medicaid program] in 1965. Medicaid is a joint federal/state program that pays the medical expenses of low-income Americans. Medicaid covers about 45 percent of births in the United States. Medicaid pays for medically-unnecessary, non-therapeutic circumcision in 32 states, although it appears to be a violation of law to do so.<ref name="adler2011">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|title=It is lawful to use Medicaid to pay for circumcision?
|journal=Journal of Law and Medicine
|date=2011
|volume=19
|issue=
|pages=335-53
|url=https://www.arclaw.org/wp-content/uploads/2019/04/is-it-lawful-to-use-medicaid-to-pay-for-circumcision.pdf
|quote=
|accessdate=2021-10-05
}}</ref>
W. K. C. Morgan, a Canadian medical doctor, then on the faculty of the {{UNI|University of Maryland|UMD}} [https://www.medschool.umaryland.edu/ School of Medicine], in a highly critcal letter pubished by ''JAMA'' (1965), slammed the practice of non-therapeutic circumcision of boys as it had developed in the United States.<ref>{{REFjournal
|last=Morgan
|first=
|init=WKC
|author-link=
|etal=no
|title=The rape of the phallus
|journal=JAMA
|location=
|date=1965-07-19
|volume=193
|issue=
|article=
|pages=223-4
|url=http://www.cirp.org/library/general/morgan/
|pubmedID=14310332
|pubmedCID=
|DOI=jama.1965.03090030045013
|accessdate=2021-10-05
}}</ref>
Preston (1970) considered the matter of infant [[circumcision]]. He examined and debunked claims that male circumcision could prevent cancer of the cervix in women, cancer of the penis and cancer of the prostate in men. Preston concluded:
<blockquote>Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine.<ref>{{REFjournal
|last=Preston
|first=E. Noel
|init=
|author-link=
||etal=no
|title=Whither the foreskin? A consideration of routine neonatal circumcision.
|journal=JAMA
|location=
|date=1970-09-14
|volume=213
|issue=11
|article=
|pages=1853-8
|url=http://www.cirp.org/library/general/preston/
|pubmedID=5468911
|pubmedCID=
|DOI=10.1001/jama.213.11.1853
|accessdate=2021-10-05
}}</ref></blockquote>
Preston's paper elicited a response from C. J. Falliers, {{MD}}, (1970) who cited the "sensory pleasure induced by tactile stimulation of the foreskin."<ref name="falliers1970">{{REFjournal
|last=Falliers
|first=
|init=CJ
|author-link=
|etal=
|title=Circumcision (letter)
|journal=JAMA
|location=
|date=1970-12-21
|volume=214
|issue=12
|article=
|page=2194
|url=http://www.cirp.org/library/general/falliers1/
|accessdate=2021-10-05
}}</ref>
[[Abraham Ravich]] (1971) falsely claims that circumcision prevents cancer of the bladder and the rectum.<ref name="ravich1971">{{Ravich1971}}</ref>
Laumann et al. reported an incidence of newborn circumcision of 78 percent in 1971.
The [[American Academy of Pediatrics]] (AAP) is not an "academy" at all. It is a medical trade association that protects and advances the business and financial interests of its pediatrician "fellows". Influenced by Preston's paper, the AAP published a manual on the hospital care of newborn infants in 1971. The manual included the statement:
<blockquote>
There are no valid medical indications for circumcision in the neonatal period.<ref>{{REFbook
|year=1971
|title=Standards and Recommendation for Hospital Care of Newborn infants
|url=http://www.cirp.org/library/statements/aap/#a1971
|page=110
|location=Evanston, {{USSC|IL}}
|publisher=American Academy of Pediatrics
|isbn=
|accessdate=2021-10-05
}}</ref>
</blockquote>
The statement in the 1971 manual was good medical science, then and now, but it did not sit well with the membership of the AAP because it provided no basis on which to promote non-therapeutic circumcision for profit. A four-member "ad hoc" task force was formed to produce a new statement to fit the desires of the membership, which was published in ''Pediatrics'' in 1975.<ref name="aap1975">{{REFjournal
|last=Thompson
|first=
|init=HC
|author-link=
|last2=King
|first2=
|init2=LR
|author2-link=
|last3=Knox
|first3=
|init3=E
|author3-link=
|last4=Korones
|first4=
|init4=SH
|author4-link=
|etal=no
|title=Report of the Ad Hoc Task Force on Circumcision
|journal=Pediatrics
|location=
|date=1975-10
|volume=56
|issue=3
|article=
|page=
|pages=610-11
|url=http://www.cirp.org/library/statements/aap/#a1975
|pubmedID=1174384
|pubmedCID=
|DOI=
|accessdate=2021-10-06
}}</ref> The new statement had not a single citation of any other document. While it recognized the validity of the 1971 statement, It claimed without any basis that parents had a right to circumcise a newborn infant boy for "traditional, cultural, and religious factors".<ref name="aap1975" />
The statement falsely claimed facilitation of hygiene, prevention of [[phimosis]], and prevention of [[penile cancer]] as reasons that parents may elect non-therapeutic infant circumcision.<ref name="aap1975" />
The statement expressed no concern for the [[pain]] of circumcision, nor did it provide information on the functions and value of the [[foreskin]] nor did it recognize the child as a person with domestic and international rights to self-determination and physical integrity. The statement carefully avoided recommending [[circumcision]] and placed the responsibility for the certain [[amputation]] injury on the parents rather than on the attending physician.<ref name="aap1975" />
The 1975 statement served as the AAP's position statement until 1989.
The AAP supplemented the 1975 statement in 1977 by stating:
<blockquote>There are no medical indications for routine circumcisions, and the procedure cannot be considered an essential component of health care. If an infant is circumcised, the procedure must be delayed until the infant is at least 24 hours old and stable, without [[bleeding]] tendency or any other illness. Circumcision must never be done at time of delivery.<ref>{{REFbook
|year=1977
|title=Standards and Recommendations for Hospital Care of Newborn Infants. Sixth Edition
|url=http://www.cirp.org/library/statements/aap/#a1977
|pages=66-7
|location=Evanston, {{USSC|IL}}
|publisher=American Academy of Pediatrics
|isbn=
|accessdate=2021-10-05
}}</ref>
</blockquote>
Infant circumcision traditionally had been carried out without any kind of anesthesia or analgesia because of the false belief that infants could not feel [[pain]]. Researchers started to investigate the [[Pain| pain of circumcision]] in the 1970s.
The American Cancer Society estimated that there are about 460 deaths per year in the United States from penile cancer.<ref>{{REFweb
|url=https://www.cancer.org/cancer/penile-cancer/about/key-statistics.html
|title=Key Statistics for Penile Cancer
|last=
|first=
|date=2021-01-12
|accessdate=2021-10-17
}}</ref> Sidney S. Gellis, {{MD}} (1978) estimated that the number of deaths from infant circumcision exceeded the number of deaths from [[penile cancer]].<ref name="gellis1978">{{REFjournal
|last=Gellis
|first=
|init=
|author-link=
|etal=no
|title=Circumcision
|trans-title=
|language=
|journal=Am J Dis Child
|location=
|date=1978-12
|volume=132
|issue=
|article=
|page=
|pages=1168-9
|url=http://www.cirp.org/library/general/gellis1/
|pubmedID=717329
|pubmedCID=
|DOI=10.1001/archpedi.1978.02120370016003
|accessdate=2021-10-17
}}</ref>
David Grimes, {{MD}}, (1978), recognized the increasing controversy regarding the practice of non-therapeutic infant [[circumcision]]. Grimes discussed several concerns including:
* Irrational patient selection.
* Lack of information prior to consent.
* Pain and anesthesia management.
* Improper surgical objectives.
* Lack of cost-effectiveness.<ref name="grimes1978">{{REFjournal
|last=Grimes
|first=David
|init=
|author-link=
|etal=no
|title=Routine circumcision of the newborn: a reappraisal
|journal=Am J Obstet Gynecol
|location=
|date=1978-01-15
|volume=130
|issue=2
|article=
|pages=125-9
|url=http://www.cirp.org/library/general/grimes/
|pubmedID=413435
|pubmedCID=
|DOI=10.1016/0002-9378(78)90353-8
|accessdate=2021-10-05
}}</ref>
Grimes concluded:
<blockquote> However, until the benefits of routine circumcision of the neonate can be proved worth the risk and cost, medical resources probably should be allocated to measures of demonstrated value.<ref name="grimes1978" />
</blockquote>
The American circumcision industry appears to have totally ignored Grimes' concerns.
It was at about this time that several small organizations that opposed non-therapeutic circumcision of boys started to appear. They were the first [[intactivists]], although that word had not yet been coined. One such organization was the Remain Intact Organization of Larchwood, Iowa, which was lead by Rev. [[George Zangger| Russell George Zangger]]. From the 1970s to the 1990s Zangger sent out cards with New Testament quotations that said the outward sign of circumcision is of no value. [[Jeffrey R. Wood]] formed [[INTACT Educational Foundation| INTACT]] (Infants Need to Avoid Circumcision Trauma), founded in 1976 as a local resource serving Western Massachusetts, and "Dedicated to Preserving Freedom of Choice." The organization gained recognition and had members across the nation.
Boczko & Freed (1979) collected cases of penile cancer in circucised men and by so doing, disproved the false belief propagated since 1932 by [[Abraham L. Wolbarst]] that circumcision was protective against penile cancer.<ref name="boczko1979">{{REFjournal
|last=Boczo
|first=Stanley
|init=
|author-link=
|last2=Freed
|first2=Selwyn
|init2=
|author2-link=
|etal=no
|title=Penile carcinoma in circumcised males
|journal=N Y State J Med
|location=
|date=1979-11
|volume=79
|issue=12
|article=
|pages=1903-4
|url=http://www.cirp.org/library/disease/cancer/boczko/
|pubmedID=292845
|pubmedCID=
|DOI=
|accessdate=2021-10-07
}}</ref>
Robert Leon Baker, {{MD}} (1979) estimated 229 [[Death| deaths]] per year in the United States from circumcision complications.<ref name="baker1979">{{REFjournal
|last=Baker
|first=Robert L.
|init=
|author-link=
|etal=no
|title=Newborn male circumcision: needless and dangerous
|trans-title=
|language=
|journal=Sexual Medicine Today
|location=
|date=1979
|volume=3
|issue=11
|article=
|pages=35-6
|url=http://www.cirp.org/library/general/baker1/
|accessdate=2021-10-17
}}</ref>
[[Edward Wallerstein]] (1980) published his book, ''[[Circumcision: An American Health Fallacy]]''.<ref name="wallerstein1980">{{WallersteinE 1980}}</ref>
Bollinger (2017) reported the incidence of infant non-therapeutic circumcision peaked at about 85 percent of all infant boys in 1982.<ref name="bollinger2017">{{REFweb
|url=https://www.academia.edu/23494197/Infant_Male_Genital_Cutting_Incidence_Worldwide
|title=Infant male genital cutting incidence worldwide
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|website=
|date=2017-05-19
|accessdate=2021-10-27
|format=PDF
|quote=
}}</ref>
[[John A. Erickson]] (1982) started to work individually to advance [[genital integrity]].
Professor Lowell R. King (1982), who had been a member of the "ad hoc" task force on circumcision of the AAP, felt compelled to defend the reasoning of the task force.<ref name="king1982">{{REFjournal
|last=King
|first=Lowell R.
|init=
|author-link=
|etal=no
|title=Neonatal circumcision in the United States in 1982
|journal=J Urol
|location=
|date=1982-11
|volume=128
|issue=5
|article=
|pages=1135-6
|url=http://www.cirp.org/library/general/king1982/
|pubmedID=7176044
|pubmedCID=
|DOI=10.1016/s0022-5347(17)53361-3
|accessdate=2021-10-11
}}</ref>
[[Marilyn Fayre Milos]], {{RN}}, while a nursing student at [https://www.mymarinhealth.org/locations/medical-center/ Marin General Hospital], witnessed an unanesthetized circumcision of a newborn boy in 1979. Shocked by the extreme [[pain]] and horror of it, she became an opponent of infant circumcision and was forced to resign in 1985 from her nursing position at Marin General Hospital where infant non-therapeutic circumcision is a profit center and promoted to parents. She immediately created the National Organization of Circumcision Information Resource Centers ([[NOCIRC]]) in 1985.
[[Rosemary Romberg]] (1985) published <i>Circumcision: The Painful Dilemma</i>.
[[Edward Wallerstein]] (1985) pointed out that the American way of practicing non-religious circumcision of boys is without parallel anywhere else in the world.<ref>{{REFjournal
|last=Wallerstein
|first=Edward
|init=
|author-link=Edward Wallerstein
|etal=no
|title=Is Nonreligious Circumcision Necessary?
|journal=Urol Clin North Am
|location=
|date=1985-05
|volume=12
|issue=1
|pages=123-32
|url=http://www.cirp.org/library/general/wallerstein/
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|accessdate=2021-10-06
}}</ref>
American lawyer William E. Brigman (1985) used new medical evidence to argue that circumcision is child abuse, and discussed possible legal remedies. Recent medical articles have documented the actual injury of circumcision, to make it possible for an attorney to win damages for wrongful circumcision, he said. Brigman suggested civil rights class action suits against hospitals.<ref name="brigman1985">{{REFjournal
|last=Brigman
|first=William E.
|init=WE
|author-link=
|title=Circumcision as Child Abuse: The Legal and Constitutional Issues
|journal=J Fam Law
|date=1985
|volume=23
|issue=3
|page=337
|url=http://www.cirp.org/library/legal/brigman/
|accessdate=2021-10-07
}}</ref>
Anand & Hickey (1987) published a paper in the ''New England Journal of Medicine'' that conclusively proved that newborn infants are capable of feeling [[pain]]. After publication of this landmark paper, no doubt about pain sensation in infants remained. The article stated:
<blockquote>
<i>Numerous lines of evidence suggest that even in the human [[fetus]], pain pathways as well as cortical and subcortical centers necessary for pain perception are well developed late in gestation, and the neurochemical systems now known to be associated with pain transmission and modulation are intact and functional. Physiologic responses to painful stimuli have been well documented in neonates of various gestational ages and are reflected in hormonal, metabolic, and cardiorespiratory changes similar to but greater than those observed in adult subjects. Other responses in newborn infants are suggestive of integrated emotional and behavioral responses to pain and are retained in memory long enough to modify subsequent behavior patterns.</i><ref name="anand1987">{{REFjournal
|last=Anand
|init=KJS
|author-link=
|last2=Hickey
|init2=PR
|author2-link=
|etal=yes
|title=Pain and its effects in the human neonate and fetus
|journal=N Engl J Med
|location=
|date=1987-11-19
|volume=317
|issue=21
|pages=1321-9
|url=http://www.cirp.org/library/pain/anand/
|pubmedID=3317037
|pubmedCID=
|DOI=10.1056/NEJM198711193172105
|accessdate=2021-10-07
}}</ref>
</blockquote></i>
[[NOCIRC]] sponsored the [[First International Symposium]] on Circumcision which was held in Anaheim, California, USA on 1-3 March 1989.
The July/August 1989 edition of <i>[[The Truth Seeker]]</i> was dedicated to circumcision. It featured the core proceedings from the First International Symposium.
The [[American Academy of Pediatrics]]' 1975 circumcision promotional statement<ref name="aap1975" /> was now getting long in the tooth so a newer statement was desired. The AAP appointed the late [[Edgar J. Schoen]], {{MD}}, of Oakland, California, who had written a humorous poem about circumcision as the chairman of a new task force on circumcision. The task force had six members of whom five (83%), including Schoen, were believed to be Jewish, although Jews constitute only 1.9 percent of the population.
Schoen's task force produced the AAP's [[American_Academy_of_Pediatrics#Third_policy_.281989.29| third circumcision policy statement]] which was published in ''Pediatrics'' in November 1979.<ref name="aap1989">{{REFjournal
|last=Schoen
|first=Edgar J.
|init=EJ
|author-link=Edgar J. Schoen
|last2=Anderson
|first2=Glenn
|init2=G
|author2-link=
|last3=Bohon
|first3=Constance
|init3=C
|author3-link=
|last4=Hinman
|first4=Frank
|init4=F
|author4-link=
|last5=Poland
|first5=Ronald
|init5=R
|author5-link=
|last6=Wakeman
|first6=E. Maurice
|init6=EM
|author6-link=
|etal=no
|title=Report of the Task Force of Circumcision.
|journal=Pediatrics
|location=
|date=1989-11
|volume=84
|issue=4
|pages=388-91
|url=http://www.cirp.org/library/statements/aap/#a1989
|pubmedID=2664697
|pubmedCID=
|DOI=
|accessdate=2021-10-10
}}</ref>
The statement, which was intended to promote the practice of non-therapeutic circumcision for the benefit of the fellows of the AAP, had a high degree of [[bias]] and had many serious deficiences. Some more notable deficiences included:
* failure to recognize the child as a person with legal rights to bodily integrity.
* failure to provide information on the nature and functions of the human [[foreskin]].
* failure to call for analgesia to ease the intense [[pain]] of the [[amputation]].
* inclusion of [[Thomas E. Wiswell]]'s methodologically-flawed papers on [[urinary tract infection]] (UTI).
* failure to inform parents that UTI is properly treated with antibiotics.
* use of the misleading word ''potential'' to describe speculative medical benefits that do not actually exist.
* attempting to shift responsibility for the performance of an injurious and harmful [[amputation]] from the medical operator to the parents.
The advocacy of [[circumcision]] to prevent UTI spurred a debate in the medical literature until the AAP published a new statement in 1999 that softened the claims.
[[Charles A. Bonner|Bonner]] & Kinane (1989) discussed the legal and constitutional issues of non-therapeutic male circumcision under United States and California law.<ref name="bonner1989">{{REFjournal
|last=Bonner
|first=Charles
|init=C
|author-link=Charles A. Bonner
|last2=Kinane
|first2=Michael
|init2=M
|author2-link=
|title=The Legal and Constitutional Issues
|journal=The Truth Seeker
|date=1989-07
|url=http://www.noharmm.org/bonner.htm
|accessdate=2021-10-10
}}</ref>
Professor Ronald Poland (1990), who had served on the task force with [[Edgar J. Schoen]] that produced the 1989 AAP Circumcision Policy Statement, strongly objected to the use of methodologically flawed UTI studies. Professor Poland concluded that infant non-therapeutic circumcision should not be "a part of routine medical care."<ref name="poland1990">{{REFjournal
|last=Poland
|first=Ronald L.
|init=
|author-link=
|etal=no
|title=The question of routine neonatal circumcision
|journal=N Eng J Med
|location=
|date=1990-05-03
|volume=322
|issue=18
|article=
|pages=1312-5
|url=http://www.cirp.org/library/general/poland/
|pubmedID=2183058
|pubmedCID=
|DOI=10.1056/NEJM199005033221811
|accessdate=2021-10-11
}}</ref>
The [[Second International Symposium]] on Circumcision convened at the Hotel Kabuki in San Francisco, California, USA on April 30 through May 3, 1991.
[[Ronald Goldman]], {{PhD}}, founded the [[Circumcision Resource Center]] in 1991.
[[Tim Hammond]] organized the [http://www.noharmm.org/ National Organization to Halt the Abuse and Routine Mutilation of Males] in 1992.
[[John A. Erickson]] (1992) self-published ''Making America Safe for Foreskins''<ref> {{REFbook
|last=Erickson
|first=John A.
|init=JA
|author-link=John A. Erickson
|title=Making America Safe for Foreskins
|publisher=Self-published (42 page pamphlet)
|location=Biloxi, Mississippi
|date=1992-01
}}</ref>
Lynn E. Lebit (1992) discussed issues with the substituted judgment doctrine.<ref name="lebit1992">{{REFjournal
|last=Lebit
|first=Lynn E.
|init=LE
|author-link=
|etal=no
|title=Compelled Medical Procedures Involving Minors and Incompetents and Misapplication of the Substituted Judgment Doctrine
|journal=Journal of Law and Medicine
|location=
|date=1992
|volume=7
|issue=
|page=107
|url=http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1304&context=jlh
|pubmedID=11659623
|pubmedCID=
|DOI=
|accessdate=2021-10-10
}}</ref>
Professor [[George C. Denniston]], {{MD}}, {{MPH}}, explained some [[Foreskin#Physiological_functions| functions of the foreskin]], said circumcision was both unnecessary and harmful because of the deprivation of functions, so should not be performed.<ref name-"denniston1992">
{{REFjournal
|last=Denniston
|first=George C.
|init=
|author-link=George C. Denniston
|etal=no
|title=Unnecessary Circumcision
|trans-title=
|language=
|journal=Female Patient
|location=
|date=1992-07
|volume=17
|issue=
|article=
|pages=13-4
|url=
|accessdate=
}}</ref>
The [[Third International Symposium]] on Circumcision convened at the {{UNI|University of Maryland|UMD}}, College Park, {{USSC|MD}}, USA on 23-25 May 1994.
Professor [[George C. Denniston]], {{MD}}, {{MPH}}, organized [[Doctors Opposing Circumcision (D.O.C.)]] in 1995.
Three registered nurses in Santa Fe, {{USSC|NM}}, who conscientiously objected to assisting with foreskin [[amputation]] operations, formed [[Nurses for the Rights of the Child]] in 1995.
A group of [[intactivist]]s assembled at Evanston, {{USSC|IL}} in 1996 for a meeting and then protested and demonstrated before the AAP convention in nearby Chicago.
[[John A. Erickson]] (1996) self-published ''Deeper into Circumcision: A Invitation to Awareness'' (196 pages).<ref name="erickson1996">{{REFbook
|last=Erickson
|first=John A.
|init=JA
|author-link=John A. Erickson
|year=1996
|title=Deeper into Circumcision: An Invitation to Awareness
|url=http://www.foreskin.org/je-dic.htm
|publisher=Self-published (196 page pamphlet)
|location=Biloxi, Mississippi
}}</ref>
[[Geoffrey T. Falk]] created the [http://www.cirp.org/ Circumcision Information and Resources Pages] in 1996 to take advantage of the newly-available Internet.
Ross Povenmire (1998) questioned the authority of parents to grant consent for non-therapeutic circumcision of children.<ref name="povenmire1998">{{REFjournal
|last=Povenmire
|init=R
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/legal/povenmire/
|title=Do Parents Have the Legal Authority to Consent to the Surgical Amputation of Normal, Healthy Tissue From Their Infant Children?: The Practice of Circumcision in the United States
|journal=Journal of Gender, Social Policy & the Law
|date=1998
|volume=7
|issue=
|page=87
|accessdate=2021-10-14
}}</ref>
[[Christopher Fletcher]], M.D., (1998) conducted a survey of doctors in the United States who perform non-therapeutic circumcision of boys. Dr. Fletcher concluded his report in part:
<blockquote>
This study reveals that, across the country, American specialties that perform circumcisions are ignorant of the medical facts regarding the penile foreskin and in conjunction with hospitals and misinformed patients, attempt to justify and rationalise newborn male circumcision. In many cases, despite personal beliefs that circumcision is more harmful than beneficial, some physicians are unwilling to give up their participation in this almost uniquely American custom which many of them have personally experienced as infants.<ref name="fletcher1998!>{{REFbook
|last=Fletcher
|first=Christopher R.
|init=CR
|url=https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19
|chapter=[https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19 Circumcision in America in 1998: Attitudes, Beliefs and Charges of American Physicians]
|publisher=Kluwer/Plenum
|title=Male and Female Circumcision
|pages=259-71
|editors=George C. Denniston, Frederick Mansfield Hodges, Marilyn Fayre Milos
|year=1998
|accessdate=2021-10-21
}}</ref>
</blockquote>
The American Academy of Pediatrics had been acutely embarrassed by the faults of [[Edgar J. Schoen]]'s [http://www.cirp.org/library/statements/aap/#a1989 horrific circumcision policy statement], so a new task force was convened under the direction of Carole Marie Lannon, {{MD}}, {{MPH}}, to produce a new, more appropriate, and less embarrassing policy statement on non-therapeutic child circumcision. The new task force produced the [[American_Academy_of_Pediatrics#Fourth_policy_.281999.29|Fourth Circumcision Policy Statement]].<ref name="aap1999">{{REFjournal
|last=Lannon
|first=Carole Marie
|init=CM
|author-link=
|last2=Bailey
|first2=Ann Geryl Doll
|init2=AGD
|author2-link=
|last3=Fleishman
|first3=Alan R.
|init3=AR
|author3-link=
|last4=Kaplan
|first4=George W.
|init4=GW
|author4-link=George W. Kaplan
|last5=Shoemaker
|first5=Craig T.
|init5=CT
|author5-link=
|last6=Swanson
|first6=Jack T.
|init6=JT
|author6-link=
|last7=Coustan
|first7=Donald
|init7=D
|author7-link=
|etal=no
|title=Circumcision Policy Statement
|journal=Pediatrics
|location=
|date=1999-09
|volume=103
|issue=3
|article=
|pages=686-93
|url=http://www.cirp.org/library/statements/aap1999/
|pubmedID= 22926180
|pubmedCID=
|DOI=10.1542/peds.2012-1989
|accessdate=2021-10-10
}}</ref> The 1999 circumcision statement advocated analgesia for pain relief of the extreme circumcision [pain], admitted that the [[foreskin]] contains [[Ridged band| nerves]], softened the claims made for [[UTI]] prevention, recognized the effectiveness of breastfeeding at reducing UTI in infants and declared non-therapeutic infant circumcision to be an ''elective'' surgical procedure. Other than that, it shared the much the same faults as the 1989 statement.
Rhinehart (1999) was a practicing psychiatrist who described his patients later-life problems stemming from their neonatal circumcision.<ref name="rhinehart1999">{{REFjournal
|last=Rhinehart
|first=John W.
|init=JW
|author-link=
|etal=no
|title=Neonatal Circumcision Reconsidered
|journal=Transactional Analysis Journal
|location=
|date=1999-07
|volume=29
|issue=3
|pages=215-21
|url=http://www.cirp.org/library/psych/rhinehart1/
|quote=
|pubmedID=
|pubmedCID=
|DOI=10.
|accessdate=2021-10-14
}}</ref>
===Late twentieth century history video===
<youtube>o25MjZsmvGY</youtube>
=== Frühes 21. Jahrhundert ===
The twenty-first century has been characterized by greater opposition to non-therapeutic circumcision of boys in the general population, the utter failure of the circumcision industry's vaunted new circumcision policy, and much more attention to legal and ethical issues relating to non-therapeutic circumcision of boys.
Giannetti (2000) argued that scientific misconduct in the [[American Academy of Pediatrics]] circumcision policy statements should expose the AAP to trade association liability.<ref name="gianetti2000">{{REFjournal
|last=Giannetti
|first=Matthew
|init=M
|author-link=
|title=Circumcision and the American Academy of Pediatrics: Should Scientific Misconduct Result in Trade Association Liability
|journal=Iowa Law Rev
|date=2000
|volume=85
|issue=4
|pages=1507-68
|url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2018/01/Gianetti-AAP-Misconduct-Trade-Assn-Iowa-Law-Rev-2000.pdf
|accessdate=2020-05-09
}}</ref>
[[J. Steven Svoboda|Svoboda]], [[Robert S. Van Howe|Van Howe]] & [[James G. Dwyer|Dwyer]] (2000) discussed legal issues inherent with consent for non-therapeutic circumcision of boys.<ref name="svoboda2000">{{REFjournal
|last=Svoboda
|first=J. Steven
|init=JS
|author-link=J. Steven Svoboda
|last2=Van Howe
|first2=Robert S.
|init2=RS
|author2-link=Robert S. Van Howe
|last3=Dwyer
|first3=James G.
|init3=JG
|author3-link=James G. Dwyer
|etal=no
|title=Informed Consent for Neonatal Circumcision: An Ethical and Legal Conundrum
|journal=J Contemporary Health Law Policy
|location=
|date=2000-09
|volume=17
|issue=1
|pages=61-133
|url=https://scholarship.law.edu/cgi/viewcontent.cgi?article=1255&context=jchlp
|pubmedID=11216345
|pubmedCID=
|DOI=
|accessdate=2021-10-11
}}</ref>
[[J. Steven Svoboda]] (2001) discussed the limits of the law.<ref name="svoboda2001">{{REFbook
|last=Svoboda
|first=J. Steven
|init=JS
|author-link=J. Steven Svoboda
|year=2001
|title=Limits of the law: Comparative analysis of legal and extralegal methods.
|url=https://www.arclaw.org/wp-content/uploads/Limits-of-the-Law-Comparative-Analysis-of-Legal-and-Extralegal-Methods.pdf
|work=Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem
|editor=[[George C. Denniston]], [[Frederick M. Hodges]], and [[Marilyn Fayre Milos]]
|edition=
|volume=
|chapter=
|pages=297-365
|location=
|publisher=Springer
|isbn=978-1-4419-3375-1.
|quote=
|accessdate=2021-10-11
|note=
}}</ref>
Geoffrey P. Miller (2002) discussed the impact of American culture on the law of circumcision.<ref name="miller2002">{{REFjournal
|last=Miller
|first=Geoffrey P.
|init=GP
|author-link=
|title=Circumcision: Cultural-Legal Analysis
|journal=Virginia Journal of Social Policy & the Law.
|date=2002-3
|volume=9
|issue=
|pages=497-585
|url=http://www.cirp.org/library/legal/miller1/
|accessdate=2020-07-29
}}</ref>
[[George Hill]] (2003) questioned the authority of anyone to grant consent for the non-therapeutic alteration of a child's body.<ref name="hill2010">{{REFjournal
|last=Hill
|first=George
|init=
|author-link=George Hill
|etal=no
|title=Can Anyone Authorize the Nontherapeutic Permanent Alteration of a Child's Body?
|trans-title=
|language=
|journal=Am J Bioeth
|location=
|date=2003-03
|volume=3
|issue=2
|article=
|page=W6
|url=https://www.tandfonline.com/doi/abs/10.1162/152651603766436342
|pubmedID=14635628
|pubmedCID=
|DOI=10.1162/152651603766436342
|accessdate=2021-10-14
}}</ref>
[[Petrina Fadel]] founded [[Catholics Against Circumcision]].
Thomas et al. (2004) studied the incidence of [[HIV]] in circumcision and intact men in a United States Navy population. A slightly higher incidence of [[HIV]] infection was found in circumcised men (84.9%) as compared with intact men (81.8%). The authors concluded:
<blockquote>
Although there may be other medical or cultural reasons for male circumcision, it is not associated with [[HIV]] or STI prevention in this U.S. military population.<ref name="thomas2004">Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. [http://www.cirp.org/library/disease/HIV/thomas1/ Prevalence of male circumcision and its association with [[HIV]] and sexually transmitted infections in a U.S. Navy population]. Abstract no. TuPeC4861. Presented at the XV International [[AIDS]] Conference, Bangkok, Thailand, July 11-16, 2004.</ref>
</blockquote>
[[Saving Our Sons (SoS)]], an [[intactivist]] organization, commenced operations online in 2007.
[[Dr. Momma - peaceful parenting]], an [[intactivist]] organization, started in 2007.
[[Doctors Opposing Circumcision (D.O.C.)]] included this commentary on the law of circumcision of boys in their June 2008 Genital Integrity Statement. It has since been later amended by another party to include a reference to Adler (2013) that was not available at the time of writing.<ref>{{REFbook
|last=Hill
|first=George
|init=G
|author-link=George Hill
|year=2008
|title=Ch. 10: American Law and the Circumcision of Children
|url=https://www.i2researchhub.org/articles/ch-10-american-law-and-the-circumcision-of-children-doc-genital-integrity-statement/
|work=Genital Integrity Policy
|editor=
|edition=
|volume=
|chapter=
|pages=
|location=Seattle
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|isbn=
|quote=
|accessdate=2021-10-11
|note=
}}</ref>
[[Doctors Opposing Circumcision (D.O.C.)]] issued a Genital Integrity Policy in June 2008.<ref name-"doc2008">{{REFdocument
|title=Genital Integrity Policy
|url=https://www.i2researchhub.org/wp-content/uploads/2015/05/GenitalIntegrityStatement.pdf
|contribution=
|last=Hill
|first=George
|author-link=George Hill
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|format=PDF
|date=2008-06
|accessdate=2021-10-11
}}</ref>
[[Georganne Chapin]] founded [[Intact America]] in 2008.
[[Robert S. Van Howe|Van Howe]] & Svoboda (2008) said of the American practice of medically-unnecessary, non-therapeutic infant circumcision:
<blockquote>
Once all factors are revealed, it
is impossible to consider circumcision a minor issue,
but rather circumcision comes to symbolize one of the
greatest ongoing systemic ethical violations for which
modern medicine has been responsible.<ref name="vanhowe2008">{{REFjournal
|last=Van Howe
|first=Robert S.
|init=RS
|author-link=Robert S. Van Howe
|last2=Svoboda
|first2=J. Steven
|init2=JS
|author2-link=J. Steven Svoboda
|etal=no
|title=Neonatal pain relief and the Helsinki Declaration
|journal=Journal of Law, Medicine, and Ethics
|location=
|date=2008-12
|volume=36
|issue=4
|article=
|pages=803-23
|url=https://www.academia.edu/download/33981944/27_Van_Howe.pdf
|pubmedID=19094008
|pubmedCID=
|DOI=10.1111/j.1748-720X.2008.00339.x
|accessdate=2021-10-31
}}</ref>
</blockquote>
The British journal, ''The Lancet'', published reports of two randomized controlled trials (RCTs) that were carried out in sub-Saharan Africa which purported to prove that male circumcision was protective against infection with [[HIV]]. The American Academy of Pediatrics consulted with the American College of Obstetricians and Gynecologists ([[ACOG]]) and the American College of Family Physicians ([[AAFP]]) (those being the medical trade associations that represent the specialties that perform most non-therapeutic infant circumcisions and make most of the money from the performance of the non-therapeutic [[amputation]]). The three associations determined to make common cause to produce a position statement that would promote male circumcision based on its alleged protection against [[HIV]] infection. The AAP was to take the lead, but ACOG and AAFP provided representatives to the new [[AAP Circumcision Task Force 2012| AAP task force]], of which New York Jewess [[Susan Blank]], {{MD}}, {{MPH}}, was the chairwoman. This new task force did not publish a statement until 2012. The AAP declined to re-affirm the statement so it expired in August 2017.
[[Dan Bollinger|Bollinger]] (2010) estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States.<ref name="bollinger2010">{{BollingerD 2010}}</ref>
[[Anthony Losquadro]] formed [[Intaction]], an [[intactivist]] organization in 2010.
The Centers for Disease Control and Prevention ([[CDC]]) reported an incidence of newborn circumcision of 58.3 percent in 2010.<ref name="cdc2015">{{REFweb
|url=https://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.htm
|title=Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010
|publisher=Centers for Disease Control and Prevention
|website=cdc.gov
|date=2015-11-06
|accessdate=2021-10-16
}}</ref>
Professor [[Peter W. Adler]], J. D., (2011) argued that it is unlawful for United States Medicaid to pay for non-therapeutic circumcision.<ref name="adler2011" />
[[Brother K]] formed the [[Bloodstained Men]] in 2012.
The AAP, lead by the [[AAP Circumcision Task Force 2012]], finally published the [[American_Academy_of_Pediatrics#Fifth_policy_.282012.29| fifth circumcision policy statement]] in the September 2012 issue of ''Pediatrics''. The [[American_Academy_of_Pediatrics#Criticism| adverse criticism]] was overwhelming.
[[Dan Bollinger|Bollinger]] (2012) estimated that the total cost of non-therapeutic male circumcision, including hospital costs, repair of botched circumcisions, treatment of complications, and so on is more than $3 billion per year,<ref name="bollinger2012">{{REFweb
|url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually
|title=High Cost of Circumcision: $3.6 Billion Annually
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|date=2012
|accessdate=2020-11-25
}}</ref> of which the beneficiary is the American circumcision industry.
[[Doctors Opposing Circumcision (D.O.C.)]] (2013) provided evidence that the purpose of the 2012 AAP Circumcision Policy Statement was to get more money for doctors,<ref name="doc2013">{{REFdocument
|title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statemeni
|url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf
|contribution=
|last=
|first=
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|format=PDF
|date=2013-04-01
|accessdate=2021-10-21
}}</ref>
Professor [[Peter W. Adler]], {{JD}}, (2013) argued that non-therapeutic circumcision of boys is unlawful.<ref name="adler2013">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|title=Is circumcision legal?
|journal=Richmond Journal of Law and the Public Interest
|date=2013
|volume=16
|issue=3
|pages=439-86
|url=https://scholarship.richmond.edu/cgi/viewcontent.cgi?article=1265&context=jolpi
|accessdate=2020-05-08
}}</ref>
[[Robert S. Van Howe|Van Howe]] & [[J. Steven Svoboda|Svoboda]] (2013) criticized the 2012 AAP statement because it failed to include important points, inaccurately analyzed and interpreted current medical literature, and made unsupported conclusions.<ref name="vanhowe2013">{{REFjournal
|last=Van Howe
|first=Robert S.
|init=RS
|author-link=Robert S. Van Howe
|last2=Svoboda
|first2=J. Steven
|init2=JS
|author2-link=J. Steven Svoboda
|date=2013-07-01
|title=Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision
|url=https://jme.bmj.com/content/39/7/434
|journal=Journal of Medical Ethics
|language=en
|volume=39
|issue=7
|pages=434-41
|DOI=10.1136/medethics-2013-101346
|issn=0306-6800
|pubmedID=23508208
}}</ref>
[[Jen Williams]] organized [[Your Whole Baby]] in 2014.
[[Doctors Opposing Circumcision (D.O.C.)]] commissioned a [https://www,doctorsopposingcircumcision.org new website] in 2016.
[[J. Steven Svoboda]] argued against non-therapeutic circumcision.<ref name="svoboda2017">{{REFjournal
|date=2017-08-01
|title=Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury
|journal=AMA Journal of Ethics
|language=en
|volume=19
|issue=8
|pages=815-24
|DOI=10.1001/journalofethics.2017.19.8.msoc2-1708
|pubmedID=28846521
|issn=2376-6980
|last1=Svoboda
|first1=J.S.
}}</ref> He stated that this decision should be considered in the context of benefit vs risk of harm, rather than simply risk-benefit due to the non-therapeutic nature of the procedure.<ref name="svoboda2017"/> He states that benefits do not outweigh the risks, and also claims that foreskin removal should be considered a sexual harm.<ref name="svoboda2017"/> He also went on to conclude that non-therapeutic circumcision largely violates the physician's duty to respect a patient's autonomy since many procedures take place before a patient is able to freely give consent himself.<ref name="svoboda2017"/>
Reis-Dennis & Reis (2017) asked if physicians should be blamed for harm resulting from unnecessary genital surgeries, including infant circumcision.<ref name="reis-dennis2017">{{REFjournal
|last=Reis-Dennis
|first=
|init=
|author-link=
|last2=Reis
|first2=
|init2=
|author2-link=
|etal=no
|title=Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries?
|trans-title=
|language=
|journal=AMA Journal of Ethics
|location=
|date=2017
|volume=19
|issue=8
|article=
|pages=825-33
|url=
|pubmedID=28846522
|pubmedCID=
|DOI=10.1001/journalofethics.2017.19.8.msoc3-1708
|accessdate=2021-10-14
}}</ref>
The ill-fated 2012 AAP Circumcision Policy Statement expired on August 31, 2017 in accordance with AAP policy, because it was not reaffirmed. The AAP has had ''no'' official circumcision policy since that time.
[[Dan Bollinger|Bollinger]] (2019) discussed circumcision as an adverse childhood experience,<ref name-"bollinger2019">{{REFdocument
|title=Child genital cutting as an adverse childhood experience
|url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|last2=Chapin
|first2=Georganne
|author2-link=Georganne Chapin
|publisher=Intact America
|location=Tarrytown
|format=PDF
|date=2019-08
|accessdate=2021-04-02
}}</ref>
[[Peter W. Adler|Adler]], [[Robert S. Van Howe|Van Howe]], Wisdom & Daase (2020) examined male non-therapeutic circumcision as fraud.<ref name="adler2020">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|last2=Van Howe
|first2=Robert S.
|init2=RS
|author2-link=Robert S. Van Howe
|last3=Wisdom
|first3=Travis
|init3=T
|author3-link=
|last4=Daase
|first4=Felix
|init4=F
|author4-link=Felix Daase
|etal=no
|title=Is circumcision a fraud?
|journal=Cornell Journal of Law and Public Policy
|location=
|date=2020-11
|volume=30
|issue=1
|pages=45-107
|url=https://www.lawschool.cornell.edu/research/JLPP/upload/Adler-et-al-final.pdf
}}
</ref>
Adler & Daase (2020) reviewed the American debate on non-therapeutic child circumcision for a French-speaking audience.<ref name="adlerB2020>{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|last2=Daase
|first2=Felix
|init2=F
|author2-link=Felix Daase
|etal=no
|title=Actualié du débat sur la circoncision aux États-Unis: Is the Circumcision Debate Over?
|journal=Droit et Cultures
|location=
|date=2020
|volume=79
|issue=1
|pages=207-22
|url=https://journals.openedition.org/droitcultures/6276?lang=en
|accessdate=2021-06-19
}}</ref>
[[Ronald Goldman]] led a group of Massachusetts taxpayers who filed a suit against [https://www.mass.gov/topics/masshealth MassHealth] (Massachusetts Medicaid), which is unlawfully paying for non-therapeutic circumcisions with public funds.<ref>{{REFweb
|url=https://circumcision.org/taxpayers-sue-massachusetts-medicaid-about-circumcisions/
|title=Taxpayers Sue Massachusetts Medicaid About Circumcisions
|first=Ronald
|last=Goldman
|author-link=Ronald Goldman
|publisher=[[Circumcision Resource Center]]
|date=2020-07-22
|accessdate=2021-10-13
}}</ref>
Navia et al. (2020) surveyed the incidence of non-therapeutic neonatal circumcision in four states. The incidence of circumcision in 2016 was found to have declined to 54.5 percent, which translates to an increase in [[genital integrity]] and wholeness rate to 45.5 percent.<ref>{{REFjournal
|last=Navia
|first=Mateo Zambrano
|init=
|author-link=
|last2=Jacobson
|first2=Deborah L.
|init2=
|author2-link=
|last3=Balmert
|first3=Lauren C.
|init3=
|author3-link=
|last4=Rosoklija
|first4=Ilina
|init4=
|author4-link=
|last5=Holl
|first5=Jane L.
|init5=
|author5-link=
|last6=Davis
|first6=Matthew M.
|init6=
|author6-link=
|last7=Johnson
|first7=Emilie K
|init7=
|author7-link=
|etal=no
|title=State-Level Public Insurance Coverage and Neonatal Circumcision Rates
|trans-title=
|language=
|journal=Pediatrics
|location=
|date=2020-11
|volume=146
|issue=5
|article=
|page=e20201475
|url=https://pediatrics.aappublications.org/content/146/5/e20201475
|pubmedID=33055226
|pubmedCID=
|DOI=10.1542/peds.2020-1475
|accessdate=2021-10-13
}}</ref>
The Lavine family of New Jersey has brought a lawsuit against a New Jersey practitioner and the [[American Academy of Pediatrics]] that alleges fraud.<ref>{{REFweb
|url=https://www.circumcisionisafraud.com/docket-mer-l-000272-21
|title=Circumcision is a Fraud
|last=
|first=
|accessdate=2021-10-13
}}</ref>
A study by [[Intact America]] (2020) reveals how hospitals pressure mothers into granting consent for unneeded and unwanted injurious non-therapeutic [[circumcision]] of a newborn boy.<ref>{{REFweb
|url=https://www.prweb.com/printer/17552844.htm
|title=Having a Baby Boy? Intact America Warns, ‘Get Ready for the Circumcision Sellers!
|last=Chapin
|first=Georganne
|author-link=Georganne Chapin
|publisher=Intact America
|website=prweb
|date=2020-11-18
|accessdate=2021-10-13
|format=
|quote=
}}</ref> Infant circumcision is a profit center for many American hospitals so parents are pushed to circumcise.
== Staatliche finanzielle Unterstützung für nicht-therapeutische Beschneidung ==
The United States government provides [[financial incentive]] for medically-unnecessary, non-therapeutic [[circumcision]] by [[third-party payment]] through numerous government health insurance programs:
* [https://www.medicaid.gov/ Medicaid] — About 45 percent of births are under Medicaid.
* [https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/ Child Health Insurance Program (CHIP)] — Covers children whose family income is higher.
* [https://www.ihs.gov/ Indian Health Service] — Covers the indigenous population.
* [https://www.tricare.mil/ Tricare] — Covers military dependents.
* [https://www.benefits.gov/benefit/4440 Federal Employees Health Benefits (FEHB) Program] — Covers federal employees and families.
* [https://www.medicare.gov/ Medicare] − Covers persons who have reached 65 years of age.
== Einige statistische Daten ==
=== Verbreitung der Beschneidung ===
Peter Moore (2015) reported that 62 percent of all American males reported being ]]circumcised]],<ref name="moore2015">{{REFweb
|url=https://today.yougov.com/topics/lifestyle/articles-reports/2015/02/03/younger-americans-circumcision
|title=Young Americans less supportive of circumcision at birth
|last=Moore
|first=Peter
|date=2015-02-03
|accessdate=2022-02-07
}}</ref> which increases the prevalence of [[intact]] [[foreskin]] to 38 percent of living American males of all ages. This percentage is expected to gradually but constantly decline, while the percentage of males who are intact due to the declining incidence of newborn boys receiving medically-unnecessary, non-therapeutic [[circumcision]] is expected to increase. The percentage of males with [[intact]] [[foreskin]] is highest in the youngest age groups.
=== Häufigkeit der Beschneidung ===
The incidence of non-therapeutic neonatal circumcision hit its peak at 85-90 percent in 1980. It has been slowly declining ever since.
Peter Moore (2015) reported that the incidence of circumcision was 55 percent.<ref name="moore2015"/>
Jacobson et al. (2021) collected circumcision statistics from the Kids' Inpatient Database from 2002 to 2016. They reported that the incidence of non-therapeutic neonatal circumcision has "decreased significantly over time" with 55 percent being circumcised, which translates to a [[genital integrity]] (intact) rate of 45 percent. The previous intact rate for the nation had been reported to be 41.7 percent in 2010, so this represents an improvement of 7.9 percent in the number of intact boys. The incidence of circumcision for the entire United States had declined to 52.1 percent at the end of the study period (2016), which indicates that 47.9 percent of boys born in that year are intact.<ref name="jacobson2021" />
In the Midwest, the incidence of circumcision had declined to 75 percent, which translates to a [[genital integrity]] rate increase to 25 percent or 1 in 4 boys having an [[intact]] foreskin.<ref name="jacobson2021" /> The previous report from 2010 was one boy in five being intact,<ref name="bollinger2017" /> and before that it was 1 in 10 boys being intact, so this in an increase of 250 percent (0.25/0.10 X 100 = 250%) in the rate of [[Intact| intactness]] for the Midwest. The populularity of non-circumcision of boys has increased to the point that non-circumcision has become the NORM in many sections of the United States.
== Gleichstellung ==
The percentage of American boys being [[circumcised]] has been slowly declining for a long time, while the number of boys with [[intact]] [[foreskin]] has correspondingly increased.<ref name="jacobson2021" /> A state of parity has now been reached where the percentage of [[intact]] boys is about equal to the percentage of [[circumcised]] boys.
As the present trend continues, it is expected that being [[intact]] will shortly become the more usual, normal condition for young boys in America, if it has not already done so.
== Amerikanische [[genitale Integrität]]-Organisationen ==
The United States of America now have numerous [[genital integrity]] ([[intactivist]]) organizations working to promote and encourage the protection of the [[physical integrity]] of American boys.
{{SEEALSO}}
* [[Financial incentive]]
* [[Intakt-freundlich]]
{{LINKS}}
These documents by [[Dan Bollinger]] are included here because they contain significant information about the United States:
* {{REFweb
|url=https://www.academia.edu/23494197/Infant_Male_Genital_Cutting_Incidence_Worldwide
|title=Infant Male Genital Cutting Incidence Worldwide
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|date=2017-05-19
|accessdate=2021-10-21
|format=PDF
}}
* {{REFjournal
|last=Bollinger
|init=D
|author-link=Dan Bollinger
|url=https://www.researchgate.net/publication/321837170_Origins_of_the_Intactivist_Movement_A_Masculine_Foundation
|title=Origins of the intactivist movement: A masculine foundation
|journal=
|date=2017-11-17
|accessdate=2021-10-14
}}
{{ABBR}}
{{REF}}
[[Kategorie:BSM]]
[[Kategorie:USA]]
[[Kategorie:Männliche Beschneidung]]
[[Kategorie:Geschichte]]
[[en:United States of America]]
Die '''Vereinigten Staaten von Amerika''' sind auch bekannt als '''Vereinigte Staaten''' oder einfach als '''America''' oder durch Initialismen wie '''USA''' oder '''US''' oder '''U.S.A.''' oder '''U.S.''' (bitte beachten, dass ''Amerika'' auch der Name zweier geologischer Kontinente ist: ''Nordamerika'' und ''Südamerika'', die viel mehr Länder umfassen als nur die ''Vereinigten Staaten von Amerika'', die das Thema dieses Artikels sind. Siehe auch: [[:Kategorie:Amerikas]].)
{{NYT en}}
America is predominantly an English-speaking nation. As in other English-speaking nations, non-therapeutic [[circumcision]] of boys was popularized in the late nineteenth century. Due to the rates of infant circumcision that formerly approached 90 percent, the vast majority of [[Circumcised doctors| male doctors were neonatally circumcised]] and have no real knowledge of a normal body part. Such doctors frequently give poor advice to parents on the care of the [[intact]] [[penis]].<ref name="goldman2005">{{REFjournal
|last=Goldman
|first=Ronald
|init=R
|author-link=Ronald Goldman
|etal=no
|title=Circumcision policy: a psychosocial perspective
|trans-title=
|language=
|journal=Paediatrics & Child Health (Ottawa)
|location=
|date=2005-11
|volume=9
|issue=9
|pages=630-3
|url=https://academic.oup.com/pch/article/9/9/630/2648566?login=true
|quote=
|pubmedID=19675851
|pubmedCID=2724127
|DOI=10.1093/pch/9.9.630
|accessdate=2020-03-16
}}</ref> They are also much more likely to injure [[intact]] boys during office visits by premature [[Forced foreskin retraction| forcible foreskin retraction]] (PFFR).<ref>{{REFjournal
|last=Narvaez
|first=Darcia
|init=D
|author-link=
|last2=Geisheker
|first2=John V.
|init2=JV
|author2-link=John V. Geisheker
|url=https://www.psychologytoday.com/us/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy
|title=What Is the Greatest Danger for an Uncircumcised Boy?
|journal=Psychology Today
|date=2011-10-23
|volume=
|issue=
|pages=
|accessdate=2021-10-31
}}</ref>
The United States is unique in having a medical industry that aggressively promotes the practice of medically-unnecessary, non-therapeutic, harmful infant [[circumcision]]. The decline of the unnecessary practice has been slowed by continual encouragement and promotion of circumcision by the medical industry. However, the practice of non-therapeutic circumcision of boys is now in decline.
Despite the financially self-serving promotional efforts of the circumcision industry, the incidence of non-therapeutic [[circumcision]] of infant boys was reported to have continued its slow decline to 52.1 percent in 2016.<ref name="jacobson2021">{{REFjournal
|last=Jacobson
|first=Deborah L.
|init=
|author-link=
|last2=Balmert
|first2=Lauren C.
|init2=
|author2-link=
|last3=Holl
|first3=Jane L.
|init3=
|author3-link=
|last4=Rosoklija
|first4=Ilina
|init4=
|author4-link=
|last5=Davis
|first5=Matthew M.
|init5=
|author5-link=
|last6=Johnson
|first6Emilie K.
|init6=
|author6-link=
|etal=no
|title=Nationwide Circumcision Trends: 2003 to 2016
|trans-title=
|language=
|journal=J Urol
|location=
|date=2021-01
|volume=205
|issue=1
|article=
|pages=257-63
|url=https://www.auajournals.org/doi/abs/10.1097/JU.0000000000001316
|pubmedID=32716676
|pubmedCID=
|DOI=10.1097/JU.0000000000001316
|accessdate=2021-10-15
}}</ref>
== Geschichte ==
Jews have lived in America since before the Revolutionary War. They have always practiced [[Jewish circumcision| ritual circumcision]], ([[Brit Milah]]), of boys on the eighth day of life in accordance with the [[Abrahamic covenant]], however this was only for a very small percentage of the population.<ref name="self2016">{{REFjournal
|url=https://journals.troy.edu/index.php/test/article/view/386/302
|title=The Rise of Circumcision in Victorian America
|first=Eleanor
|last=Self
|author-link=Eleanor Self
|journal=The Alexandrian
|volume=5
|issue=1
|date=2016
|accessdate=2022-09-02
|format=PDF
}}
</ref>
One may be certain that the eighteenth century [https://www.nationalgeographic.org/article/founding-fathers/ Founding Fathers of the United States] of America were men with [[intact]] [[foreskin]]s as were the [[foreskinned]] men who fought the American Civil War (1861-1865).
Non-therapeutic [[circumcision]] of males for non-religious reasons originated with [[Claude François Lallemand]] in 1836 in France but soon spread to the [[United Kingdom]] in the early nineteenth century, from which it eventually spread to other English-speaking nations.
=== Spätes 19. Jahrhundert ===
The late nineteenth century was characterized by prominent medical doctors advancing all sorts of absurd reasons for the performance of non-therapeutic circumcision, including the prevention of venereal disease.<ref name="self2016" />
The first recorded non-religious circumcision of a boy in the United States occurred in 1870 when [[Lewis Albert Sayre]], a prominent New York City doctor, [[circumcised]] a boy of five years of age for paralysis.<ref name="gollaher1994">{{GollaherDL 1994}}</ref> [[Lewis Albert Sayre|Sayre]] then continued to advocate circumcision for numerous reasons until his death in 1900. According to [[Lewis Albert Sayre|Sayre]], circumcision was recommended for paralysis, epilepsy, hernia, lunacy, curvature of the spine, and clubfoot.
[[M. J. Moses]] (1871) advocated [[circumcision]] to prevent [[masturbation]].<ref name="moses1871">{{Moses1871}}</ref>
[[H. H. Kane]] (1879) 'discovers' that [[circumcision]] cures nocturnal emissions and abdominal neuralgia.<ref>{{Kane1879}}</ref>
Seventh-day Adventist [[John Harvey Kellogg]], {{MD}}, of Battle Creek, Michigan, was an important 19th century promoter of male circumcision. Although masturbation is never mentioned in the Bible, Dr. Kellogg believed that [[masturbation]] was immoral, sinful, and caused one to dream "impure dreams", which he believed was harmful to the mental faculties, resulting in mental disorders, such as feeblemindness.<ref name="kellogg1888">{{Kellogg1888}}</ref> He believed that the urge to masturbate could be prevented by eating bland foods, for which purpose, he and his brother invented corn flakes.
Dr. Kellogg (1879) also recommended [[circumcision]] in cases "in which irritation is produced by retained secretions".<ref name="kellogg1888"/>
Dr. Kellogg perhaps is most famous for his book, ''Plain facts for young and old'' (1879), in which he advocated circumcision of boys as punishment for masturbation.<ref name="kellogg1888"/>
[[William G. Eggleston]], {{MA}}, {{MD}}, from Chicaco, {{USSC|IL}}, (1886) stated that [[foreskin]] of minors and the natural "phimosis" in minors would cause crossed eyes.<ref name="eggleston1886">{{Eggleston1886}}
</ref>
Dr. [[William D. Gentry]] (1890) alleged that [[Retraction of the foreskin| phimosis in boys]] produces serious nervous derangements.<ref name="gentry1890">{{REFjournal
|last=Gentry
|first=William D.
|init=WD
|author-link=William D. Gentry
|title=Nervous Derangements Produced by Sexual Irregularities in Boys
|journal=Medical Current
|date=1890-07
|volume=6
|issue=7
|pages=268-74
}}</ref>
[[Elizabeth Blackwell]], {{MD}}, ({{LifeData|1821|1910}}), was born in England, but attended medical school in the United States. She was the first woman to become a medical doctor in the United States. Blackwell thought [[masturbation]] was immoral but that [[circumcision]] was not the way to correct it. She wrote against it in her 1894 book:
<blockquote>Appeals to the fears of uninstructed parents on the grounds of cleanliness or of hardening the part are entirely fallacious and unsupported by evidence. It is a physiological fact that the natural lubricating secretion of every healthy part is beneficial, not injurious to the part thus protected, and that no attempt to render a sensitive part insensitive is either practicable or justifiable. The protection which nature affords to these parts is an aid to physical purity by affording necessary protection against constant external contact of a part which necessarily remains keenly sensitive; and bad habits in boys and girls cannot by prevented by surgical operations. Where no malformation exists, bad habits can only be forestalled by healthy moral and physical education.<ref>{{REFbook
|last=Blackwell
|first=Elizabeth
|init=E
|author-link=Elizabeth Blackwell
|title=The Human Element in Sex; being a Medical Inquiry into the Relation of Sexual Physiology to Christian Morality
|url=https://archive.org/details/B20442622/page/n9/mode/2up
|edition=2
|year=1894
|pages=35-6
|location=London
|publisher=J.& A. Churchill
}}</ref></blockquote>
[[Peter Charles Remondino]], {{MD}},<ref name="gollaher1994" /> was a San Diego, California physician, who was born in Turin (''Torino'') in 1846, but migrated with his family to the United States at the age of eight. There is some reason to believe that he was of Sephardic Jewish descent and had been [[circumcised]] while still in Turin, however this is uncertain.
Remondino clearly was highly intelligent. He mastered English, started medical school at age 17, treated wounded soldiers during the Civil War, and later moved to San Diego for his health.
After moving to San Diego, he practiced medicine, served as an officer of several medical societies, and other regulatory agencies.
Remondino is famous for his 346 page book, ''The History of Circumcision'' (1891).<ref name="remondino1891">{{REFbook
|last=Remondino
|first=Peter Charles
|init=PC
|author-link=Peter Charles Remondino
|year=1891
|title=History of Circumcision
|url=https://www.gutenberg.org/files/23135/23135-h/23135-h.htm
|pages=
|location=Philadelphia
|publisher=F. A. Davis
|website=Welcome Collection
|accessdate=2021-09-29
}}</ref> <ref name="gollaher1994" />
When Remondino discussed the [[foreskin]], he used the most horrific, derogatory, and disparaging language. He devoted thirteen chapters to the alleged evils and faults of the foreskin. It is not clear why he had such an extreme dislike for a natural and functional body part. His recommendation, of course, was for [[Adolescent and adult circumcision| circumcision]].
[[H. L. Rosenberry]], {{MD}}, (1894) published a paper "proving" that circumcision cures urinary and rectal incontinence.<ref name="rosenberry1894">{{Rosenberry1894}}</ref>
Dr. [[E. J. Spratling]] (1895) provided information for other doctors.<ref>{{REFjournal
|last=Spratling
|init=EJ
|title=Masturbation in the Adult
|journal=Medical Record
|volume=24
|issue=
|pages=442-443
|url=https://www.proquest.com/openview/9a247c3410d34390e418dc970faa3b87/1?pq-origsite=gscholar&cbl=40146
|quote=
|date=1895
|accessdate=2022-08-30
}}</ref>
By the end of the nineteenth century, America had at least one prominent physician and surgeon on the east coast promoting circumcision and another prominent physician and surgeon on the west coast promoting circumcision. There was no real medical science with which to dispute and discredit their false claims. Non-therapeutic circumcision of males was now well-established in the United States.
=== Frühes 20. Jahrhundert ===
The early twentieth century is characterized by advocacy of circumcision based on false claims to prevent cancer and sexually transmitted (venereal) disease; and by the involvement of the United States military services in the promotion of circumcision.
[[Ernest G. Mark]] (1901) noted that the "pleasurable sensations that are elicited from the extremely sensitive" [[Ridged band|inner lining]] of the [[foreskin]] may encourage a child to [[Masturbation|masturbate]], which is why he recommended circumcision since it "lessens the sensitiveness of the organ".<ref>{{Mark1901}}</ref>
Brimhall (1902) reported an [[amputation]] of a penis after circumcision.<ref name="brimhall1902">{{REFjournal
|last=Brimhall
|init=JB
|author-link=
|last2=
|init2=
|author2-link=
|url=
|title=Amputation of the penis following a unique method of preventing hemorrhage after circumcision
|journal=St. Paul Med J.
|date=1902
|volume=4
|issue=
|page=490
|accessdate=2021-10-05
}}</ref>
[[Roswell Park]] (1902) published a paper 'proving' that foreskin causes epilepsy and that circumcision cures it.<ref>{{Park1902}}</ref>
[[L. Emmett Holt]] (1913) reported that tubercular [[mohel]]s were infecting infant Jewish boys with tuberculosis during [[Brit Milah| ritual circumcision]].<ref>{{REFjournal
|last=Holt
|init=LE
|author-link=L. Emmett Holt
|url=http://www.cirp.org/library/complications/holt1/
|title=Tuberculosis acquired through ritual circumcision
|journal=JAMA
|date=1913-07-12
|volume=LXI
|issue=2
|pages=99-102
|accessdate=2021-10-04
}}</ref>
[[Abraham L. Wolbarst]], {{MD}}, a Jewish New York doctor, apparently considered [[L. Emmett Holt|Holt]]'s paper to be an attack on ritual circumcision or perhaps Judaism itself. He collected ''opinions'' from other doctors of the alleged value of circumcision for health and published those ''opinions'' as ''scientific fact'' in a 1914 ''JAMA'' article.<ref name="wolbarst1914">{{REFjournal
|last=Wolbarst
|first=Abraham L.
|init=AL
|author-link=Abraham L. Wolbarst
|title=Universal circumcision as a sanitary measure
|journal=JAMA
|date=1914-1-10
|volume=62
|issue=2
|pages=92-7
|url=https://jamanetwork.com/journals/jama/article-abstract/453164
|accessdate=2021-10-04
}}</ref> Wolbarst's paper appeared shortly before the start of World War I. It is thought that Wolbarst's false claims inspired some military commanders to require men under their command to be circumcised so as to reduce venereal disease (VD).
M. S. Reuben (1916) (1917) reported additional cases of tuberculosis after ritual circumcision.<ref name="reuben1916">{{REFjournal
|last=Reuben
|init=MS
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/reuben1/
|title=Tuberculosis from ritual circumcision
|journal=Proceedings of the New York Academy of Medicine
|date=1916-12-15
|volume=
|issue=
|pages=333-4
|accessdate=2021-10-04
}}</ref><ref name="ruben1917">{{REFjournal
|last=Reuben
|init=MS
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/reuben2/
|title=Tuberculosis following ritual circumcision
|journal=Arch Pediatr
|date=1917-03
|volume=XXXIV
|issue=
|pages=186-90
|accessdate=2021-10-04
}}</ref>
J. Brennermann (1921) reported that [[Meatal stenosis| meatal disease]] occurs only in circumcised boys who lack the protection of the [[foreskin]].<ref name="brennermann2021>{{REFjournal
|last=Brennermann
|init=J
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/complications/brennemann1/
|title=The ulcerated meatus in the circumcised child
|journal=Am J Dis Child
|date=1921
|volume=21
|issue=
|pages=38-47
|accessdate=2021-10-04
}}</ref>
[[Abraham L. Wolbarst|Wolbarst]] (1926) made his claim for the first time that male circumcision prevents [[penile cancer]].<ref name="wolbarst1926!>{{REFjournal
|last=Wolbarst
|first=Abraham L.
|init=AL
|author-link=Abraham L. Wolbarst
|title=Is circumcision a prophylactic against penis cancer?
|journal=Cancer
|date=1926-07
|volume=3
|issue=4
|pages=301-10
}}</ref>
[[Abraham L. Wolbarst|Wolbarst]] (1932) put forward his claim again that [[circumcision]] would prevent [[penile cancer]] in the British journal, ''The Lancet''.<ref name="Wolbarst 1932">{{Wolbarst1932}}</ref> In those long ago days, the true causes of cancer were unknown so it was impossible to disprove Wolbarst's falsehoods.
Laumann et al., writing in 1997, reported an incidence of circumcision of 31 percent in 1933.<ref name="laumann1997">{{REFjournal
|last=Laumann
|first=Edward O.
|init=
|author-link=
|last2=Masi
|first2=christopher M.
|init2=
|author2-link=
|last3=Zuckerman
|first3=Ezra W.
|init3=
|author3-link=
|etal=no
|title=Circumcision in the United States
|journal=JAMA
|location=
|date=1997-04-02
|volume=277
|issue=13
|article=
|pages=1052-7
|url=http://www.cirp.org/library/general/laumann/
|pubmedID=9091693
|pubmedCID=
|DOI=
|accessdate=2021-10-05
}}</ref>
[[Hiram S. Yellen]] and [[Aaron Goldstein]] invented the [[Gomco]] clamp in 1934-1935. The clamp, by crushing the foreskin in an intensely painful procedure, reduced the risk of hemorrhage,<ref name="yellen1935">{{GoldsteinYellen1935}}</ref> but increased the [[pain]].<ref name="sinkey2015">{{REFjournal
|url=https://www.ncbi.nlm.nih.gov/pubmed/25794628?dopt=Abstract
|title=The GoMo study: a randomized clinical trial assessing neonatal pain with Gomco vs Mogen clamp circumcision
|last=Sinkey
|init=RG
|last2=Eschenbacher
|init2=MA
|last3=Walsh
|init3=PM
|last4=Doerger
|init4=RG
|last5=Lambers
|init5=DS
|last6=Sibai
|init6=BM
|last7=Habli
|init7=MA
|journal=Am J Obstet Gynecol
|date=2015-05
|volume=212
|issue=5
|pages=664.e1-8
|pubmedID=25794628
|DOI=10.1016/j.ajog.2015.03.029
|accessdate=2021-10-05
}}</ref> The availability of the Gomco clamp increased the popularity of non-therapeutic infant circumcision.
Brown (1937) reported restoration of the [[skin]] of the [[penis]] after a denudation complication of circumcision.<ref name="brown1837">{{REFjournal
|last=Brown
|init=JB
|author-link=
|url=
|title=Restoration of the entire skin of the penis
|journal=Surg Gynecol Obstetr
|date=1937
|volume=65
|issue=362-5
|pages=
|accessdate=2021-10-05
}}</ref>
Laumann et al. (1997) reported an incidence of circumcision of 53 percent in 1941.<ref name="laumann1997" />
<b>World War II.</b> America entered the war after the Empire of Japan attacked the American naval base at Pearl Harbor, Hawaii on 7 December 1941. This was followed by Germany declaring war on the United States.
The information on military circumcision in WWII is sketchy and anecdotal. It appears that many [[foreskinned]] American men were encouraged and, in some cases, forced to be circumcised. It seems that the American military's foreskin-phobia and circumcision policy persisted through the Korean War (1950-52) but was discontinued by a change in policy thereafter.
The "Sand Myth" circulated among English-speaking armies. According to the [http://www.circumstitions.com/sand.htm Sand Myth], [[foreskinned]] men who fought in the Saharan desert had medical issues due to sand collecting under the [[foreskin]]. [[Intact]] Italian and German men who fought in the same desert had no such problems.<ref>{{REFjournal
|last=Darby
|first=Robert
|init=
|author-link=Robert Darby
|etal=no
|title=The riddle of the sands: circumcision, history, and myth
|journal=NZ Med J
|location=
|date=2005-07-15
|volume=118
|issue=1218
|article=
|page=U1564
|url=https://www.academia.edu/9899840/The_riddle_of_the_sands_Circumcision_history_and_myth
|pubmedID=16027753
|pubmedCID=
|DOI=
|accessdate=2021-10-05
}}</ref>
[[Abraham Ravich]] (1942) falsely claimed that circumcision prevents [[prostate cancer]].<ref name="ravich1942">{{Ravich1942}}</ref>
'''Post-war era.''' In the post-war era after WWII, the popularity of non-therapeutic circumcision, driven by medical promotion by doctors seeking a nice [[Financial incentive| surgical fee]] as an alleged preventive of penile cancer and by the [[Adamant father syndrome| adamant request of circumcised men home from the war who became fathers]].
Non-therapeutic, medically-unnecessary circumcision of boys had become a "routine" surgical operation that usually was performed automatically on newborn boys even without consent from anyone.
Laumann et al. (1997) reported an incidence of non-therapeutic circumcision of boys of 85 percent in 1948.<ref name="laumann1997" />
[[Eugene H. Hand]], {{MD}}, (1949) falsely claimed that circumcision would prevent cancer of the tongue and [[Circumcision and STDs| venereal disease]].<ref name="HandEH1949">{{REFjournal
|last=Hand
|first=Eugene H.
|init=EH
|author-link=Eugene H. Hand
|url=https://pubmed.ncbi.nlm.nih.gov/18135844/
|title=Circumcision and venereal disease
|journal=Archives of Dermatology and Syphilology
|date=1949-09
|volume=60
|issue=3
|pages341-6
|pubmedID=18135844
|DOI=10.1001/archderm.1949.01530030037004
|accessdate=2021-10-08
}}</ref>
The publication of a landmark article by [[Douglas Gairdner]] (1949) in the [[United Kingdom]] showing that infant circumcision is non-therapeutic, unnecessary, causes deaths, and which called for preservation of the [[foreskin]]<ref name="gairdner1949">{{GairdnerDM 1949}}</ref> was totally ignored by the circumcision industry in the United States.
=== Spätes 20. Jahrhundert ===
The late twentieth century was characterized by increasing opposition to non-therapeutic circumcision of boys by [[intactivists]] and increasing efforts by the circumcision industry to protect [[third-party payment]] for performance of non-therapeutic circumcision of non-consenting boys; and by increasing recognition that newborn boys intensely feel [[pain]] and that non-therapeutic male [[circumcision]] is a horribly traumatic experience.
[[Abraham Ravich]] (1951) falsely claimed that [[circumcision]] prevents [[cervical cancer]] in women.<ref name="ravitch1951">{{Ravich1951}}</ref>
Hollister, Inc. formally introduced the [[Plastibell]] circumcision device in 1953.<ref name=MillerSnyder1953>{{MillerSnyder1953}}</ref>
[[Ernest L. Wynder]] (1954) promoted male circumcision to prevent cervical cancer in women.<ref name="wynder1954">{{Wynder1954}}</ref>
The Congress of the United States created the [https://www.medicaid.gov/ Medicaid program] in 1965. Medicaid is a joint federal/state program that pays the medical expenses of low-income Americans. Medicaid covers about 45 percent of births in the United States. Medicaid pays for medically-unnecessary, non-therapeutic circumcision in 32 states, although it appears to be a violation of law to do so.<ref name="adler2011">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|title=It is lawful to use Medicaid to pay for circumcision?
|journal=Journal of Law and Medicine
|date=2011
|volume=19
|issue=
|pages=335-53
|url=https://www.arclaw.org/wp-content/uploads/2019/04/is-it-lawful-to-use-medicaid-to-pay-for-circumcision.pdf
|quote=
|accessdate=2021-10-05
}}</ref>
W. K. C. Morgan, a Canadian medical doctor, then on the faculty of the {{UNI|University of Maryland|UMD}} [https://www.medschool.umaryland.edu/ School of Medicine], in a highly critcal letter pubished by ''JAMA'' (1965), slammed the practice of non-therapeutic circumcision of boys as it had developed in the United States.<ref>{{REFjournal
|last=Morgan
|first=
|init=WKC
|author-link=
|etal=no
|title=The rape of the phallus
|journal=JAMA
|location=
|date=1965-07-19
|volume=193
|issue=
|article=
|pages=223-4
|url=http://www.cirp.org/library/general/morgan/
|pubmedID=14310332
|pubmedCID=
|DOI=jama.1965.03090030045013
|accessdate=2021-10-05
}}</ref>
Preston (1970) considered the matter of infant [[circumcision]]. He examined and debunked claims that male circumcision could prevent cancer of the cervix in women, cancer of the penis and cancer of the prostate in men. Preston concluded:
<blockquote>Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine.<ref>{{REFjournal
|last=Preston
|first=E. Noel
|init=
|author-link=
||etal=no
|title=Whither the foreskin? A consideration of routine neonatal circumcision.
|journal=JAMA
|location=
|date=1970-09-14
|volume=213
|issue=11
|article=
|pages=1853-8
|url=http://www.cirp.org/library/general/preston/
|pubmedID=5468911
|pubmedCID=
|DOI=10.1001/jama.213.11.1853
|accessdate=2021-10-05
}}</ref></blockquote>
Preston's paper elicited a response from C. J. Falliers, {{MD}}, (1970) who cited the "sensory pleasure induced by tactile stimulation of the foreskin."<ref name="falliers1970">{{REFjournal
|last=Falliers
|first=
|init=CJ
|author-link=
|etal=
|title=Circumcision (letter)
|journal=JAMA
|location=
|date=1970-12-21
|volume=214
|issue=12
|article=
|page=2194
|url=http://www.cirp.org/library/general/falliers1/
|accessdate=2021-10-05
}}</ref>
[[Abraham Ravich]] (1971) falsely claims that circumcision prevents cancer of the bladder and the rectum.<ref name="ravich1971">{{Ravich1971}}</ref>
Laumann et al. reported an incidence of newborn circumcision of 78 percent in 1971.
The [[American Academy of Pediatrics]] (AAP) is not an "academy" at all. It is a medical trade association that protects and advances the business and financial interests of its pediatrician "fellows". Influenced by Preston's paper, the AAP published a manual on the hospital care of newborn infants in 1971. The manual included the statement:
<blockquote>
There are no valid medical indications for circumcision in the neonatal period.<ref>{{REFbook
|year=1971
|title=Standards and Recommendation for Hospital Care of Newborn infants
|url=http://www.cirp.org/library/statements/aap/#a1971
|page=110
|location=Evanston, {{USSC|IL}}
|publisher=American Academy of Pediatrics
|isbn=
|accessdate=2021-10-05
}}</ref>
</blockquote>
The statement in the 1971 manual was good medical science, then and now, but it did not sit well with the membership of the AAP because it provided no basis on which to promote non-therapeutic circumcision for profit. A four-member "ad hoc" task force was formed to produce a new statement to fit the desires of the membership, which was published in ''Pediatrics'' in 1975.<ref name="aap1975">{{REFjournal
|last=Thompson
|first=
|init=HC
|author-link=
|last2=King
|first2=
|init2=LR
|author2-link=
|last3=Knox
|first3=
|init3=E
|author3-link=
|last4=Korones
|first4=
|init4=SH
|author4-link=
|etal=no
|title=Report of the Ad Hoc Task Force on Circumcision
|journal=Pediatrics
|location=
|date=1975-10
|volume=56
|issue=3
|article=
|page=
|pages=610-11
|url=http://www.cirp.org/library/statements/aap/#a1975
|pubmedID=1174384
|pubmedCID=
|DOI=
|accessdate=2021-10-06
}}</ref> The new statement had not a single citation of any other document. While it recognized the validity of the 1971 statement, It claimed without any basis that parents had a right to circumcise a newborn infant boy for "traditional, cultural, and religious factors".<ref name="aap1975" />
The statement falsely claimed facilitation of hygiene, prevention of [[phimosis]], and prevention of [[penile cancer]] as reasons that parents may elect non-therapeutic infant circumcision.<ref name="aap1975" />
The statement expressed no concern for the [[pain]] of circumcision, nor did it provide information on the functions and value of the [[foreskin]] nor did it recognize the child as a person with domestic and international rights to self-determination and physical integrity. The statement carefully avoided recommending [[circumcision]] and placed the responsibility for the certain [[amputation]] injury on the parents rather than on the attending physician.<ref name="aap1975" />
The 1975 statement served as the AAP's position statement until 1989.
The AAP supplemented the 1975 statement in 1977 by stating:
<blockquote>There are no medical indications for routine circumcisions, and the procedure cannot be considered an essential component of health care. If an infant is circumcised, the procedure must be delayed until the infant is at least 24 hours old and stable, without [[bleeding]] tendency or any other illness. Circumcision must never be done at time of delivery.<ref>{{REFbook
|year=1977
|title=Standards and Recommendations for Hospital Care of Newborn Infants. Sixth Edition
|url=http://www.cirp.org/library/statements/aap/#a1977
|pages=66-7
|location=Evanston, {{USSC|IL}}
|publisher=American Academy of Pediatrics
|isbn=
|accessdate=2021-10-05
}}</ref>
</blockquote>
Infant circumcision traditionally had been carried out without any kind of anesthesia or analgesia because of the false belief that infants could not feel [[pain]]. Researchers started to investigate the [[Pain| pain of circumcision]] in the 1970s.
The American Cancer Society estimated that there are about 460 deaths per year in the United States from penile cancer.<ref>{{REFweb
|url=https://www.cancer.org/cancer/penile-cancer/about/key-statistics.html
|title=Key Statistics for Penile Cancer
|last=
|first=
|date=2021-01-12
|accessdate=2021-10-17
}}</ref> Sidney S. Gellis, {{MD}} (1978) estimated that the number of deaths from infant circumcision exceeded the number of deaths from [[penile cancer]].<ref name="gellis1978">{{REFjournal
|last=Gellis
|first=
|init=
|author-link=
|etal=no
|title=Circumcision
|trans-title=
|language=
|journal=Am J Dis Child
|location=
|date=1978-12
|volume=132
|issue=
|article=
|page=
|pages=1168-9
|url=http://www.cirp.org/library/general/gellis1/
|pubmedID=717329
|pubmedCID=
|DOI=10.1001/archpedi.1978.02120370016003
|accessdate=2021-10-17
}}</ref>
David Grimes, {{MD}}, (1978), recognized the increasing controversy regarding the practice of non-therapeutic infant [[circumcision]]. Grimes discussed several concerns including:
* Irrational patient selection.
* Lack of information prior to consent.
* Pain and anesthesia management.
* Improper surgical objectives.
* Lack of cost-effectiveness.<ref name="grimes1978">{{REFjournal
|last=Grimes
|first=David
|init=
|author-link=
|etal=no
|title=Routine circumcision of the newborn: a reappraisal
|journal=Am J Obstet Gynecol
|location=
|date=1978-01-15
|volume=130
|issue=2
|article=
|pages=125-9
|url=http://www.cirp.org/library/general/grimes/
|pubmedID=413435
|pubmedCID=
|DOI=10.1016/0002-9378(78)90353-8
|accessdate=2021-10-05
}}</ref>
Grimes concluded:
<blockquote> However, until the benefits of routine circumcision of the neonate can be proved worth the risk and cost, medical resources probably should be allocated to measures of demonstrated value.<ref name="grimes1978" />
</blockquote>
The American circumcision industry appears to have totally ignored Grimes' concerns.
It was at about this time that several small organizations that opposed non-therapeutic circumcision of boys started to appear. They were the first [[intactivists]], although that word had not yet been coined. One such organization was the Remain Intact Organization of Larchwood, Iowa, which was lead by Rev. [[George Zangger| Russell George Zangger]]. From the 1970s to the 1990s Zangger sent out cards with New Testament quotations that said the outward sign of circumcision is of no value. [[Jeffrey R. Wood]] formed [[INTACT Educational Foundation| INTACT]] (Infants Need to Avoid Circumcision Trauma), founded in 1976 as a local resource serving Western Massachusetts, and "Dedicated to Preserving Freedom of Choice." The organization gained recognition and had members across the nation.
Boczko & Freed (1979) collected cases of penile cancer in circucised men and by so doing, disproved the false belief propagated since 1932 by [[Abraham L. Wolbarst]] that circumcision was protective against penile cancer.<ref name="boczko1979">{{REFjournal
|last=Boczo
|first=Stanley
|init=
|author-link=
|last2=Freed
|first2=Selwyn
|init2=
|author2-link=
|etal=no
|title=Penile carcinoma in circumcised males
|journal=N Y State J Med
|location=
|date=1979-11
|volume=79
|issue=12
|article=
|pages=1903-4
|url=http://www.cirp.org/library/disease/cancer/boczko/
|pubmedID=292845
|pubmedCID=
|DOI=
|accessdate=2021-10-07
}}</ref>
Robert Leon Baker, {{MD}} (1979) estimated 229 [[Death| deaths]] per year in the United States from circumcision complications.<ref name="baker1979">{{REFjournal
|last=Baker
|first=Robert L.
|init=
|author-link=
|etal=no
|title=Newborn male circumcision: needless and dangerous
|trans-title=
|language=
|journal=Sexual Medicine Today
|location=
|date=1979
|volume=3
|issue=11
|article=
|pages=35-6
|url=http://www.cirp.org/library/general/baker1/
|accessdate=2021-10-17
}}</ref>
[[Edward Wallerstein]] (1980) published his book, ''[[Circumcision: An American Health Fallacy]]''.<ref name="wallerstein1980">{{WallersteinE 1980}}</ref>
Bollinger (2017) reported the incidence of infant non-therapeutic circumcision peaked at about 85 percent of all infant boys in 1982.<ref name="bollinger2017">{{REFweb
|url=https://www.academia.edu/23494197/Infant_Male_Genital_Cutting_Incidence_Worldwide
|title=Infant male genital cutting incidence worldwide
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|website=
|date=2017-05-19
|accessdate=2021-10-27
|format=PDF
|quote=
}}</ref>
[[John A. Erickson]] (1982) started to work individually to advance [[genital integrity]].
Professor Lowell R. King (1982), who had been a member of the "ad hoc" task force on circumcision of the AAP, felt compelled to defend the reasoning of the task force.<ref name="king1982">{{REFjournal
|last=King
|first=Lowell R.
|init=
|author-link=
|etal=no
|title=Neonatal circumcision in the United States in 1982
|journal=J Urol
|location=
|date=1982-11
|volume=128
|issue=5
|article=
|pages=1135-6
|url=http://www.cirp.org/library/general/king1982/
|pubmedID=7176044
|pubmedCID=
|DOI=10.1016/s0022-5347(17)53361-3
|accessdate=2021-10-11
}}</ref>
[[Marilyn Fayre Milos]], {{RN}}, while a nursing student at [https://www.mymarinhealth.org/locations/medical-center/ Marin General Hospital], witnessed an unanesthetized circumcision of a newborn boy in 1979. Shocked by the extreme [[pain]] and horror of it, she became an opponent of infant circumcision and was forced to resign in 1985 from her nursing position at Marin General Hospital where infant non-therapeutic circumcision is a profit center and promoted to parents. She immediately created the National Organization of Circumcision Information Resource Centers ([[NOCIRC]]) in 1985.
[[Rosemary Romberg]] (1985) published <i>Circumcision: The Painful Dilemma</i>.
[[Edward Wallerstein]] (1985) pointed out that the American way of practicing non-religious circumcision of boys is without parallel anywhere else in the world.<ref>{{REFjournal
|last=Wallerstein
|first=Edward
|init=
|author-link=Edward Wallerstein
|etal=no
|title=Is Nonreligious Circumcision Necessary?
|journal=Urol Clin North Am
|location=
|date=1985-05
|volume=12
|issue=1
|pages=123-32
|url=http://www.cirp.org/library/general/wallerstein/
|quote=
|pubmedID=
|pubmedCID=
|DOI=
|accessdate=2021-10-06
}}</ref>
American lawyer William E. Brigman (1985) used new medical evidence to argue that circumcision is child abuse, and discussed possible legal remedies. Recent medical articles have documented the actual injury of circumcision, to make it possible for an attorney to win damages for wrongful circumcision, he said. Brigman suggested civil rights class action suits against hospitals.<ref name="brigman1985">{{REFjournal
|last=Brigman
|first=William E.
|init=WE
|author-link=
|title=Circumcision as Child Abuse: The Legal and Constitutional Issues
|journal=J Fam Law
|date=1985
|volume=23
|issue=3
|page=337
|url=http://www.cirp.org/library/legal/brigman/
|accessdate=2021-10-07
}}</ref>
Anand & Hickey (1987) published a paper in the ''New England Journal of Medicine'' that conclusively proved that newborn infants are capable of feeling [[pain]]. After publication of this landmark paper, no doubt about pain sensation in infants remained. The article stated:
<blockquote>
<i>Numerous lines of evidence suggest that even in the human [[fetus]], pain pathways as well as cortical and subcortical centers necessary for pain perception are well developed late in gestation, and the neurochemical systems now known to be associated with pain transmission and modulation are intact and functional. Physiologic responses to painful stimuli have been well documented in neonates of various gestational ages and are reflected in hormonal, metabolic, and cardiorespiratory changes similar to but greater than those observed in adult subjects. Other responses in newborn infants are suggestive of integrated emotional and behavioral responses to pain and are retained in memory long enough to modify subsequent behavior patterns.</i><ref name="anand1987">{{REFjournal
|last=Anand
|init=KJS
|author-link=
|last2=Hickey
|init2=PR
|author2-link=
|etal=yes
|title=Pain and its effects in the human neonate and fetus
|journal=N Engl J Med
|location=
|date=1987-11-19
|volume=317
|issue=21
|pages=1321-9
|url=http://www.cirp.org/library/pain/anand/
|pubmedID=3317037
|pubmedCID=
|DOI=10.1056/NEJM198711193172105
|accessdate=2021-10-07
}}</ref>
</blockquote></i>
[[NOCIRC]] sponsored the [[First International Symposium]] on Circumcision which was held in Anaheim, California, USA on 1-3 March 1989.
The July/August 1989 edition of <i>[[The Truth Seeker]]</i> was dedicated to circumcision. It featured the core proceedings from the First International Symposium.
The [[American Academy of Pediatrics]]' 1975 circumcision promotional statement<ref name="aap1975" /> was now getting long in the tooth so a newer statement was desired. The AAP appointed the late [[Edgar J. Schoen]], {{MD}}, of Oakland, California, who had written a humorous poem about circumcision as the chairman of a new task force on circumcision. The task force had six members of whom five (83%), including Schoen, were believed to be Jewish, although Jews constitute only 1.9 percent of the population.
Schoen's task force produced the AAP's [[American_Academy_of_Pediatrics#Third_policy_.281989.29| third circumcision policy statement]] which was published in ''Pediatrics'' in November 1979.<ref name="aap1989">{{REFjournal
|last=Schoen
|first=Edgar J.
|init=EJ
|author-link=Edgar J. Schoen
|last2=Anderson
|first2=Glenn
|init2=G
|author2-link=
|last3=Bohon
|first3=Constance
|init3=C
|author3-link=
|last4=Hinman
|first4=Frank
|init4=F
|author4-link=
|last5=Poland
|first5=Ronald
|init5=R
|author5-link=
|last6=Wakeman
|first6=E. Maurice
|init6=EM
|author6-link=
|etal=no
|title=Report of the Task Force of Circumcision.
|journal=Pediatrics
|location=
|date=1989-11
|volume=84
|issue=4
|pages=388-91
|url=http://www.cirp.org/library/statements/aap/#a1989
|pubmedID=2664697
|pubmedCID=
|DOI=
|accessdate=2021-10-10
}}</ref>
The statement, which was intended to promote the practice of non-therapeutic circumcision for the benefit of the fellows of the AAP, had a high degree of [[bias]] and had many serious deficiences. Some more notable deficiences included:
* failure to recognize the child as a person with legal rights to bodily integrity.
* failure to provide information on the nature and functions of the human [[foreskin]].
* failure to call for analgesia to ease the intense [[pain]] of the [[amputation]].
* inclusion of [[Thomas E. Wiswell]]'s methodologically-flawed papers on [[urinary tract infection]] (UTI).
* failure to inform parents that UTI is properly treated with antibiotics.
* use of the misleading word ''potential'' to describe speculative medical benefits that do not actually exist.
* attempting to shift responsibility for the performance of an injurious and harmful [[amputation]] from the medical operator to the parents.
The advocacy of [[circumcision]] to prevent UTI spurred a debate in the medical literature until the AAP published a new statement in 1999 that softened the claims.
[[Charles A. Bonner|Bonner]] & Kinane (1989) discussed the legal and constitutional issues of non-therapeutic male circumcision under United States and California law.<ref name="bonner1989">{{REFjournal
|last=Bonner
|first=Charles
|init=C
|author-link=Charles A. Bonner
|last2=Kinane
|first2=Michael
|init2=M
|author2-link=
|title=The Legal and Constitutional Issues
|journal=The Truth Seeker
|date=1989-07
|url=http://www.noharmm.org/bonner.htm
|accessdate=2021-10-10
}}</ref>
Professor Ronald Poland (1990), who had served on the task force with [[Edgar J. Schoen]] that produced the 1989 AAP Circumcision Policy Statement, strongly objected to the use of methodologically flawed UTI studies. Professor Poland concluded that infant non-therapeutic circumcision should not be "a part of routine medical care."<ref name="poland1990">{{REFjournal
|last=Poland
|first=Ronald L.
|init=
|author-link=
|etal=no
|title=The question of routine neonatal circumcision
|journal=N Eng J Med
|location=
|date=1990-05-03
|volume=322
|issue=18
|article=
|pages=1312-5
|url=http://www.cirp.org/library/general/poland/
|pubmedID=2183058
|pubmedCID=
|DOI=10.1056/NEJM199005033221811
|accessdate=2021-10-11
}}</ref>
The [[Second International Symposium]] on Circumcision convened at the Hotel Kabuki in San Francisco, California, USA on April 30 through May 3, 1991.
[[Ronald Goldman]], {{PhD}}, founded the [[Circumcision Resource Center]] in 1991.
[[Tim Hammond]] organized the [http://www.noharmm.org/ National Organization to Halt the Abuse and Routine Mutilation of Males] in 1992.
[[John A. Erickson]] (1992) self-published ''Making America Safe for Foreskins''<ref> {{REFbook
|last=Erickson
|first=John A.
|init=JA
|author-link=John A. Erickson
|title=Making America Safe for Foreskins
|publisher=Self-published (42 page pamphlet)
|location=Biloxi, Mississippi
|date=1992-01
}}</ref>
Lynn E. Lebit (1992) discussed issues with the substituted judgment doctrine.<ref name="lebit1992">{{REFjournal
|last=Lebit
|first=Lynn E.
|init=LE
|author-link=
|etal=no
|title=Compelled Medical Procedures Involving Minors and Incompetents and Misapplication of the Substituted Judgment Doctrine
|journal=Journal of Law and Medicine
|location=
|date=1992
|volume=7
|issue=
|page=107
|url=http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1304&context=jlh
|pubmedID=11659623
|pubmedCID=
|DOI=
|accessdate=2021-10-10
}}</ref>
Professor [[George C. Denniston]], {{MD}}, {{MPH}}, explained some [[Foreskin#Physiological_functions| functions of the foreskin]], said circumcision was both unnecessary and harmful because of the deprivation of functions, so should not be performed.<ref name-"denniston1992">
{{REFjournal
|last=Denniston
|first=George C.
|init=
|author-link=George C. Denniston
|etal=no
|title=Unnecessary Circumcision
|trans-title=
|language=
|journal=Female Patient
|location=
|date=1992-07
|volume=17
|issue=
|article=
|pages=13-4
|url=
|accessdate=
}}</ref>
The [[Third International Symposium]] on Circumcision convened at the {{UNI|University of Maryland|UMD}}, College Park, {{USSC|MD}}, USA on 23-25 May 1994.
Professor [[George C. Denniston]], {{MD}}, {{MPH}}, organized [[Doctors Opposing Circumcision (D.O.C.)]] in 1995.
Three registered nurses in Santa Fe, {{USSC|NM}}, who conscientiously objected to assisting with foreskin [[amputation]] operations, formed [[Nurses for the Rights of the Child]] in 1995.
A group of [[intactivist]]s assembled at Evanston, {{USSC|IL}} in 1996 for a meeting and then protested and demonstrated before the AAP convention in nearby Chicago.
[[John A. Erickson]] (1996) self-published ''Deeper into Circumcision: A Invitation to Awareness'' (196 pages).<ref name="erickson1996">{{REFbook
|last=Erickson
|first=John A.
|init=JA
|author-link=John A. Erickson
|year=1996
|title=Deeper into Circumcision: An Invitation to Awareness
|url=http://www.foreskin.org/je-dic.htm
|publisher=Self-published (196 page pamphlet)
|location=Biloxi, Mississippi
}}</ref>
[[Geoffrey T. Falk]] created the [http://www.cirp.org/ Circumcision Information and Resources Pages] in 1996 to take advantage of the newly-available Internet.
Ross Povenmire (1998) questioned the authority of parents to grant consent for non-therapeutic circumcision of children.<ref name="povenmire1998">{{REFjournal
|last=Povenmire
|init=R
|author-link=
|last2=
|init2=
|author2-link=
|url=http://www.cirp.org/library/legal/povenmire/
|title=Do Parents Have the Legal Authority to Consent to the Surgical Amputation of Normal, Healthy Tissue From Their Infant Children?: The Practice of Circumcision in the United States
|journal=Journal of Gender, Social Policy & the Law
|date=1998
|volume=7
|issue=
|page=87
|accessdate=2021-10-14
}}</ref>
[[Christopher Fletcher]], M.D., (1998) conducted a survey of doctors in the United States who perform non-therapeutic circumcision of boys. Dr. Fletcher concluded his report in part:
<blockquote>
This study reveals that, across the country, American specialties that perform circumcisions are ignorant of the medical facts regarding the penile foreskin and in conjunction with hospitals and misinformed patients, attempt to justify and rationalise newborn male circumcision. In many cases, despite personal beliefs that circumcision is more harmful than beneficial, some physicians are unwilling to give up their participation in this almost uniquely American custom which many of them have personally experienced as infants.<ref name="fletcher1998!>{{REFbook
|last=Fletcher
|first=Christopher R.
|init=CR
|url=https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19
|chapter=[https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19 Circumcision in America in 1998: Attitudes, Beliefs and Charges of American Physicians]
|publisher=Kluwer/Plenum
|title=Male and Female Circumcision
|pages=259-71
|editors=George C. Denniston, Frederick Mansfield Hodges, Marilyn Fayre Milos
|year=1998
|accessdate=2021-10-21
}}</ref>
</blockquote>
The American Academy of Pediatrics had been acutely embarrassed by the faults of [[Edgar J. Schoen]]'s [http://www.cirp.org/library/statements/aap/#a1989 horrific circumcision policy statement], so a new task force was convened under the direction of Carole Marie Lannon, {{MD}}, {{MPH}}, to produce a new, more appropriate, and less embarrassing policy statement on non-therapeutic child circumcision. The new task force produced the [[American_Academy_of_Pediatrics#Fourth_policy_.281999.29|Fourth Circumcision Policy Statement]].<ref name="aap1999">{{REFjournal
|last=Lannon
|first=Carole Marie
|init=CM
|author-link=
|last2=Bailey
|first2=Ann Geryl Doll
|init2=AGD
|author2-link=
|last3=Fleishman
|first3=Alan R.
|init3=AR
|author3-link=
|last4=Kaplan
|first4=George W.
|init4=GW
|author4-link=George W. Kaplan
|last5=Shoemaker
|first5=Craig T.
|init5=CT
|author5-link=
|last6=Swanson
|first6=Jack T.
|init6=JT
|author6-link=
|last7=Coustan
|first7=Donald
|init7=D
|author7-link=
|etal=no
|title=Circumcision Policy Statement
|journal=Pediatrics
|location=
|date=1999-09
|volume=103
|issue=3
|article=
|pages=686-93
|url=http://www.cirp.org/library/statements/aap1999/
|pubmedID= 22926180
|pubmedCID=
|DOI=10.1542/peds.2012-1989
|accessdate=2021-10-10
}}</ref> The 1999 circumcision statement advocated analgesia for pain relief of the extreme circumcision [pain], admitted that the [[foreskin]] contains [[Ridged band| nerves]], softened the claims made for [[UTI]] prevention, recognized the effectiveness of breastfeeding at reducing UTI in infants and declared non-therapeutic infant circumcision to be an ''elective'' surgical procedure. Other than that, it shared the much the same faults as the 1989 statement.
Rhinehart (1999) was a practicing psychiatrist who described his patients later-life problems stemming from their neonatal circumcision.<ref name="rhinehart1999">{{REFjournal
|last=Rhinehart
|first=John W.
|init=JW
|author-link=
|etal=no
|title=Neonatal Circumcision Reconsidered
|journal=Transactional Analysis Journal
|location=
|date=1999-07
|volume=29
|issue=3
|pages=215-21
|url=http://www.cirp.org/library/psych/rhinehart1/
|quote=
|pubmedID=
|pubmedCID=
|DOI=10.
|accessdate=2021-10-14
}}</ref>
===Late twentieth century history video===
<youtube>o25MjZsmvGY</youtube>
=== Frühes 21. Jahrhundert ===
The twenty-first century has been characterized by greater opposition to non-therapeutic circumcision of boys in the general population, the utter failure of the circumcision industry's vaunted new circumcision policy, and much more attention to legal and ethical issues relating to non-therapeutic circumcision of boys.
Giannetti (2000) argued that scientific misconduct in the [[American Academy of Pediatrics]] circumcision policy statements should expose the AAP to trade association liability.<ref name="gianetti2000">{{REFjournal
|last=Giannetti
|first=Matthew
|init=M
|author-link=
|title=Circumcision and the American Academy of Pediatrics: Should Scientific Misconduct Result in Trade Association Liability
|journal=Iowa Law Rev
|date=2000
|volume=85
|issue=4
|pages=1507-68
|url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2018/01/Gianetti-AAP-Misconduct-Trade-Assn-Iowa-Law-Rev-2000.pdf
|accessdate=2020-05-09
}}</ref>
[[J. Steven Svoboda|Svoboda]], [[Robert S. Van Howe|Van Howe]] & [[James G. Dwyer|Dwyer]] (2000) discussed legal issues inherent with consent for non-therapeutic circumcision of boys.<ref name="svoboda2000">{{REFjournal
|last=Svoboda
|first=J. Steven
|init=JS
|author-link=J. Steven Svoboda
|last2=Van Howe
|first2=Robert S.
|init2=RS
|author2-link=Robert S. Van Howe
|last3=Dwyer
|first3=James G.
|init3=JG
|author3-link=James G. Dwyer
|etal=no
|title=Informed Consent for Neonatal Circumcision: An Ethical and Legal Conundrum
|journal=J Contemporary Health Law Policy
|location=
|date=2000-09
|volume=17
|issue=1
|pages=61-133
|url=https://scholarship.law.edu/cgi/viewcontent.cgi?article=1255&context=jchlp
|pubmedID=11216345
|pubmedCID=
|DOI=
|accessdate=2021-10-11
}}</ref>
[[J. Steven Svoboda]] (2001) discussed the limits of the law.<ref name="svoboda2001">{{REFbook
|last=Svoboda
|first=J. Steven
|init=JS
|author-link=J. Steven Svoboda
|year=2001
|title=Limits of the law: Comparative analysis of legal and extralegal methods.
|url=https://www.arclaw.org/wp-content/uploads/Limits-of-the-Law-Comparative-Analysis-of-Legal-and-Extralegal-Methods.pdf
|work=Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem
|editor=[[George C. Denniston]], [[Frederick M. Hodges]], and [[Marilyn Fayre Milos]]
|edition=
|volume=
|chapter=
|pages=297-365
|location=
|publisher=Springer
|isbn=978-1-4419-3375-1.
|quote=
|accessdate=2021-10-11
|note=
}}</ref>
Geoffrey P. Miller (2002) discussed the impact of American culture on the law of circumcision.<ref name="miller2002">{{REFjournal
|last=Miller
|first=Geoffrey P.
|init=GP
|author-link=
|title=Circumcision: Cultural-Legal Analysis
|journal=Virginia Journal of Social Policy & the Law.
|date=2002-3
|volume=9
|issue=
|pages=497-585
|url=http://www.cirp.org/library/legal/miller1/
|accessdate=2020-07-29
}}</ref>
[[George Hill]] (2003) questioned the authority of anyone to grant consent for the non-therapeutic alteration of a child's body.<ref name="hill2010">{{REFjournal
|last=Hill
|first=George
|init=
|author-link=George Hill
|etal=no
|title=Can Anyone Authorize the Nontherapeutic Permanent Alteration of a Child's Body?
|trans-title=
|language=
|journal=Am J Bioeth
|location=
|date=2003-03
|volume=3
|issue=2
|article=
|page=W6
|url=https://www.tandfonline.com/doi/abs/10.1162/152651603766436342
|pubmedID=14635628
|pubmedCID=
|DOI=10.1162/152651603766436342
|accessdate=2021-10-14
}}</ref>
[[Petrina Fadel]] founded [[Catholics Against Circumcision]].
Thomas et al. (2004) studied the incidence of [[HIV]] in circumcision and intact men in a United States Navy population. A slightly higher incidence of [[HIV]] infection was found in circumcised men (84.9%) as compared with intact men (81.8%). The authors concluded:
<blockquote>
Although there may be other medical or cultural reasons for male circumcision, it is not associated with [[HIV]] or STI prevention in this U.S. military population.<ref name="thomas2004">Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. [http://www.cirp.org/library/disease/HIV/thomas1/ Prevalence of male circumcision and its association with [[HIV]] and sexually transmitted infections in a U.S. Navy population]. Abstract no. TuPeC4861. Presented at the XV International [[AIDS]] Conference, Bangkok, Thailand, July 11-16, 2004.</ref>
</blockquote>
[[Saving Our Sons (SoS)]], an [[intactivist]] organization, commenced operations online in 2007.
[[Dr. Momma - peaceful parenting]], an [[intactivist]] organization, started in 2007.
[[Doctors Opposing Circumcision (D.O.C.)]] included this commentary on the law of circumcision of boys in their June 2008 Genital Integrity Statement. It has since been later amended by another party to include a reference to Adler (2013) that was not available at the time of writing.<ref>{{REFbook
|last=Hill
|first=George
|init=G
|author-link=George Hill
|year=2008
|title=Ch. 10: American Law and the Circumcision of Children
|url=https://www.i2researchhub.org/articles/ch-10-american-law-and-the-circumcision-of-children-doc-genital-integrity-statement/
|work=Genital Integrity Policy
|editor=
|edition=
|volume=
|chapter=
|pages=
|location=Seattle
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|isbn=
|quote=
|accessdate=2021-10-11
|note=
}}</ref>
[[Doctors Opposing Circumcision (D.O.C.)]] issued a Genital Integrity Policy in June 2008.<ref name-"doc2008">{{REFdocument
|title=Genital Integrity Policy
|url=https://www.i2researchhub.org/wp-content/uploads/2015/05/GenitalIntegrityStatement.pdf
|contribution=
|last=Hill
|first=George
|author-link=George Hill
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|format=PDF
|date=2008-06
|accessdate=2021-10-11
}}</ref>
[[Georganne Chapin]] founded [[Intact America]] in 2008.
[[Robert S. Van Howe|Van Howe]] & Svoboda (2008) said of the American practice of medically-unnecessary, non-therapeutic infant circumcision:
<blockquote>
Once all factors are revealed, it
is impossible to consider circumcision a minor issue,
but rather circumcision comes to symbolize one of the
greatest ongoing systemic ethical violations for which
modern medicine has been responsible.<ref name="vanhowe2008">{{REFjournal
|last=Van Howe
|first=Robert S.
|init=RS
|author-link=Robert S. Van Howe
|last2=Svoboda
|first2=J. Steven
|init2=JS
|author2-link=J. Steven Svoboda
|etal=no
|title=Neonatal pain relief and the Helsinki Declaration
|journal=Journal of Law, Medicine, and Ethics
|location=
|date=2008-12
|volume=36
|issue=4
|article=
|pages=803-23
|url=https://www.academia.edu/download/33981944/27_Van_Howe.pdf
|pubmedID=19094008
|pubmedCID=
|DOI=10.1111/j.1748-720X.2008.00339.x
|accessdate=2021-10-31
}}</ref>
</blockquote>
The British journal, ''The Lancet'', published reports of two randomized controlled trials (RCTs) that were carried out in sub-Saharan Africa which purported to prove that male circumcision was protective against infection with [[HIV]]. The American Academy of Pediatrics consulted with the American College of Obstetricians and Gynecologists ([[ACOG]]) and the American College of Family Physicians ([[AAFP]]) (those being the medical trade associations that represent the specialties that perform most non-therapeutic infant circumcisions and make most of the money from the performance of the non-therapeutic [[amputation]]). The three associations determined to make common cause to produce a position statement that would promote male circumcision based on its alleged protection against [[HIV]] infection. The AAP was to take the lead, but ACOG and AAFP provided representatives to the new [[AAP Circumcision Task Force 2012| AAP task force]], of which New York Jewess [[Susan Blank]], {{MD}}, {{MPH}}, was the chairwoman. This new task force did not publish a statement until 2012. The AAP declined to re-affirm the statement so it expired in August 2017.
[[Dan Bollinger|Bollinger]] (2010) estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States.<ref name="bollinger2010">{{BollingerD 2010}}</ref>
[[Anthony Losquadro]] formed [[Intaction]], an [[intactivist]] organization in 2010.
The Centers for Disease Control and Prevention ([[CDC]]) reported an incidence of newborn circumcision of 58.3 percent in 2010.<ref name="cdc2015">{{REFweb
|url=https://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.htm
|title=Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010
|publisher=Centers for Disease Control and Prevention
|website=cdc.gov
|date=2015-11-06
|accessdate=2021-10-16
}}</ref>
Professor [[Peter W. Adler]], J. D., (2011) argued that it is unlawful for United States Medicaid to pay for non-therapeutic circumcision.<ref name="adler2011" />
[[Brother K]] formed the [[Bloodstained Men]] in 2012.
The AAP, lead by the [[AAP Circumcision Task Force 2012]], finally published the [[American_Academy_of_Pediatrics#Fifth_policy_.282012.29| fifth circumcision policy statement]] in the September 2012 issue of ''Pediatrics''. The [[American_Academy_of_Pediatrics#Criticism| adverse criticism]] was overwhelming.
[[Dan Bollinger|Bollinger]] (2012) estimated that the total cost of non-therapeutic male circumcision, including hospital costs, repair of botched circumcisions, treatment of complications, and so on is more than $3 billion per year,<ref name="bollinger2012">{{REFweb
|url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually
|title=High Cost of Circumcision: $3.6 Billion Annually
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|date=2012
|accessdate=2020-11-25
}}</ref> of which the beneficiary is the American circumcision industry.
[[Doctors Opposing Circumcision (D.O.C.)]] (2013) provided evidence that the purpose of the 2012 AAP Circumcision Policy Statement was to get more money for doctors,<ref name="doc2013">{{REFdocument
|title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statemeni
|url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf
|contribution=
|last=
|first=
|publisher=[[Doctors Opposing Circumcision (D.O.C.)]]
|format=PDF
|date=2013-04-01
|accessdate=2021-10-21
}}</ref>
Professor [[Peter W. Adler]], {{JD}}, (2013) argued that non-therapeutic circumcision of boys is unlawful.<ref name="adler2013">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|title=Is circumcision legal?
|journal=Richmond Journal of Law and the Public Interest
|date=2013
|volume=16
|issue=3
|pages=439-86
|url=https://scholarship.richmond.edu/cgi/viewcontent.cgi?article=1265&context=jolpi
|accessdate=2020-05-08
}}</ref>
[[Robert S. Van Howe|Van Howe]] & [[J. Steven Svoboda|Svoboda]] (2013) criticized the 2012 AAP statement because it failed to include important points, inaccurately analyzed and interpreted current medical literature, and made unsupported conclusions.<ref name="vanhowe2013">{{REFjournal
|last=Van Howe
|first=Robert S.
|init=RS
|author-link=Robert S. Van Howe
|last2=Svoboda
|first2=J. Steven
|init2=JS
|author2-link=J. Steven Svoboda
|date=2013-07-01
|title=Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision
|url=https://jme.bmj.com/content/39/7/434
|journal=Journal of Medical Ethics
|language=en
|volume=39
|issue=7
|pages=434-41
|DOI=10.1136/medethics-2013-101346
|issn=0306-6800
|pubmedID=23508208
}}</ref>
[[Jen Williams]] organized [[Your Whole Baby]] in 2014.
[[Doctors Opposing Circumcision (D.O.C.)]] commissioned a [https://www,doctorsopposingcircumcision.org new website] in 2016.
[[J. Steven Svoboda]] argued against non-therapeutic circumcision.<ref name="svoboda2017">{{REFjournal
|date=2017-08-01
|title=Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury
|journal=AMA Journal of Ethics
|language=en
|volume=19
|issue=8
|pages=815-24
|DOI=10.1001/journalofethics.2017.19.8.msoc2-1708
|pubmedID=28846521
|issn=2376-6980
|last1=Svoboda
|first1=J.S.
}}</ref> He stated that this decision should be considered in the context of benefit vs risk of harm, rather than simply risk-benefit due to the non-therapeutic nature of the procedure.<ref name="svoboda2017"/> He states that benefits do not outweigh the risks, and also claims that foreskin removal should be considered a sexual harm.<ref name="svoboda2017"/> He also went on to conclude that non-therapeutic circumcision largely violates the physician's duty to respect a patient's autonomy since many procedures take place before a patient is able to freely give consent himself.<ref name="svoboda2017"/>
Reis-Dennis & Reis (2017) asked if physicians should be blamed for harm resulting from unnecessary genital surgeries, including infant circumcision.<ref name="reis-dennis2017">{{REFjournal
|last=Reis-Dennis
|first=
|init=
|author-link=
|last2=Reis
|first2=
|init2=
|author2-link=
|etal=no
|title=Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries?
|trans-title=
|language=
|journal=AMA Journal of Ethics
|location=
|date=2017
|volume=19
|issue=8
|article=
|pages=825-33
|url=
|pubmedID=28846522
|pubmedCID=
|DOI=10.1001/journalofethics.2017.19.8.msoc3-1708
|accessdate=2021-10-14
}}</ref>
The ill-fated 2012 AAP Circumcision Policy Statement expired on August 31, 2017 in accordance with AAP policy, because it was not reaffirmed. The AAP has had ''no'' official circumcision policy since that time.
[[Dan Bollinger|Bollinger]] (2019) discussed circumcision as an adverse childhood experience,<ref name-"bollinger2019">{{REFdocument
|title=Child genital cutting as an adverse childhood experience
|url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|last2=Chapin
|first2=Georganne
|author2-link=Georganne Chapin
|publisher=Intact America
|location=Tarrytown
|format=PDF
|date=2019-08
|accessdate=2021-04-02
}}</ref>
[[Peter W. Adler|Adler]], [[Robert S. Van Howe|Van Howe]], Wisdom & Daase (2020) examined male non-therapeutic circumcision as fraud.<ref name="adler2020">{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|last2=Van Howe
|first2=Robert S.
|init2=RS
|author2-link=Robert S. Van Howe
|last3=Wisdom
|first3=Travis
|init3=T
|author3-link=
|last4=Daase
|first4=Felix
|init4=F
|author4-link=Felix Daase
|etal=no
|title=Is circumcision a fraud?
|journal=Cornell Journal of Law and Public Policy
|location=
|date=2020-11
|volume=30
|issue=1
|pages=45-107
|url=https://www.lawschool.cornell.edu/research/JLPP/upload/Adler-et-al-final.pdf
}}
</ref>
Adler & Daase (2020) reviewed the American debate on non-therapeutic child circumcision for a French-speaking audience.<ref name="adlerB2020>{{REFjournal
|last=Adler
|first=Peter W.
|init=PW
|author-link=Peter W. Adler
|last2=Daase
|first2=Felix
|init2=F
|author2-link=Felix Daase
|etal=no
|title=Actualié du débat sur la circoncision aux États-Unis: Is the Circumcision Debate Over?
|journal=Droit et Cultures
|location=
|date=2020
|volume=79
|issue=1
|pages=207-22
|url=https://journals.openedition.org/droitcultures/6276?lang=en
|accessdate=2021-06-19
}}</ref>
[[Ronald Goldman]] led a group of Massachusetts taxpayers who filed a suit against [https://www.mass.gov/topics/masshealth MassHealth] (Massachusetts Medicaid), which is unlawfully paying for non-therapeutic circumcisions with public funds.<ref>{{REFweb
|url=https://circumcision.org/taxpayers-sue-massachusetts-medicaid-about-circumcisions/
|title=Taxpayers Sue Massachusetts Medicaid About Circumcisions
|first=Ronald
|last=Goldman
|author-link=Ronald Goldman
|publisher=[[Circumcision Resource Center]]
|date=2020-07-22
|accessdate=2021-10-13
}}</ref>
Navia et al. (2020) surveyed the incidence of non-therapeutic neonatal circumcision in four states. The incidence of circumcision in 2016 was found to have declined to 54.5 percent, which translates to an increase in [[genital integrity]] and wholeness rate to 45.5 percent.<ref>{{REFjournal
|last=Navia
|first=Mateo Zambrano
|init=
|author-link=
|last2=Jacobson
|first2=Deborah L.
|init2=
|author2-link=
|last3=Balmert
|first3=Lauren C.
|init3=
|author3-link=
|last4=Rosoklija
|first4=Ilina
|init4=
|author4-link=
|last5=Holl
|first5=Jane L.
|init5=
|author5-link=
|last6=Davis
|first6=Matthew M.
|init6=
|author6-link=
|last7=Johnson
|first7=Emilie K
|init7=
|author7-link=
|etal=no
|title=State-Level Public Insurance Coverage and Neonatal Circumcision Rates
|trans-title=
|language=
|journal=Pediatrics
|location=
|date=2020-11
|volume=146
|issue=5
|article=
|page=e20201475
|url=https://pediatrics.aappublications.org/content/146/5/e20201475
|pubmedID=33055226
|pubmedCID=
|DOI=10.1542/peds.2020-1475
|accessdate=2021-10-13
}}</ref>
The Lavine family of New Jersey has brought a lawsuit against a New Jersey practitioner and the [[American Academy of Pediatrics]] that alleges fraud.<ref>{{REFweb
|url=https://www.circumcisionisafraud.com/docket-mer-l-000272-21
|title=Circumcision is a Fraud
|last=
|first=
|accessdate=2021-10-13
}}</ref>
A study by [[Intact America]] (2020) reveals how hospitals pressure mothers into granting consent for unneeded and unwanted injurious non-therapeutic [[circumcision]] of a newborn boy.<ref>{{REFweb
|url=https://www.prweb.com/printer/17552844.htm
|title=Having a Baby Boy? Intact America Warns, ‘Get Ready for the Circumcision Sellers!
|last=Chapin
|first=Georganne
|author-link=Georganne Chapin
|publisher=Intact America
|website=prweb
|date=2020-11-18
|accessdate=2021-10-13
|format=
|quote=
}}</ref> Infant circumcision is a profit center for many American hospitals so parents are pushed to circumcise.
== Staatliche finanzielle Unterstützung für nicht-therapeutische Beschneidung ==
The United States government provides [[financial incentive]] for medically-unnecessary, non-therapeutic [[circumcision]] by [[third-party payment]] through numerous government health insurance programs:
* [https://www.medicaid.gov/ Medicaid] — About 45 percent of births are under Medicaid.
* [https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/ Child Health Insurance Program (CHIP)] — Covers children whose family income is higher.
* [https://www.ihs.gov/ Indian Health Service] — Covers the indigenous population.
* [https://www.tricare.mil/ Tricare] — Covers military dependents.
* [https://www.benefits.gov/benefit/4440 Federal Employees Health Benefits (FEHB) Program] — Covers federal employees and families.
* [https://www.medicare.gov/ Medicare] − Covers persons who have reached 65 years of age.
== Einige statistische Daten ==
=== Verbreitung der Beschneidung ===
Peter Moore (2015) reported that 62 percent of all American males reported being ]]circumcised]],<ref name="moore2015">{{REFweb
|url=https://today.yougov.com/topics/lifestyle/articles-reports/2015/02/03/younger-americans-circumcision
|title=Young Americans less supportive of circumcision at birth
|last=Moore
|first=Peter
|date=2015-02-03
|accessdate=2022-02-07
}}</ref> which increases the prevalence of [[intact]] [[foreskin]] to 38 percent of living American males of all ages. This percentage is expected to gradually but constantly decline, while the percentage of males who are intact due to the declining incidence of newborn boys receiving medically-unnecessary, non-therapeutic [[circumcision]] is expected to increase. The percentage of males with [[intact]] [[foreskin]] is highest in the youngest age groups.
=== Häufigkeit der Beschneidung ===
The incidence of non-therapeutic neonatal circumcision hit its peak at 85-90 percent in 1980. It has been slowly declining ever since.
Peter Moore (2015) reported that the incidence of circumcision was 55 percent.<ref name="moore2015"/>
Jacobson et al. (2021) collected circumcision statistics from the Kids' Inpatient Database from 2002 to 2016. They reported that the incidence of non-therapeutic neonatal circumcision has "decreased significantly over time" with 55 percent being circumcised, which translates to a [[genital integrity]] (intact) rate of 45 percent. The previous intact rate for the nation had been reported to be 41.7 percent in 2010, so this represents an improvement of 7.9 percent in the number of intact boys. The incidence of circumcision for the entire United States had declined to 52.1 percent at the end of the study period (2016), which indicates that 47.9 percent of boys born in that year are intact.<ref name="jacobson2021" />
In the Midwest, the incidence of circumcision had declined to 75 percent, which translates to a [[genital integrity]] rate increase to 25 percent or 1 in 4 boys having an [[intact]] foreskin.<ref name="jacobson2021" /> The previous report from 2010 was one boy in five being intact,<ref name="bollinger2017" /> and before that it was 1 in 10 boys being intact, so this in an increase of 250 percent (0.25/0.10 X 100 = 250%) in the rate of [[Intact| intactness]] for the Midwest. The populularity of non-circumcision of boys has increased to the point that non-circumcision has become the NORM in many sections of the United States.
== Gleichstellung ==
The percentage of American boys being [[circumcised]] has been slowly declining for a long time, while the number of boys with [[intact]] [[foreskin]] has correspondingly increased.<ref name="jacobson2021" /> A state of parity has now been reached where the percentage of [[intact]] boys is about equal to the percentage of [[circumcised]] boys.
As the present trend continues, it is expected that being [[intact]] will shortly become the more usual, normal condition for young boys in America, if it has not already done so.
== Amerikanische [[genitale Integrität]]-Organisationen ==
The United States of America now have numerous [[genital integrity]] ([[intactivist]]) organizations working to promote and encourage the protection of the [[physical integrity]] of American boys.
{{SEEALSO}}
* [[Financial incentive]]
* [[Intakt-freundlich]]
{{LINKS}}
These documents by [[Dan Bollinger]] are included here because they contain significant information about the United States:
* {{REFweb
|url=https://www.academia.edu/23494197/Infant_Male_Genital_Cutting_Incidence_Worldwide
|title=Infant Male Genital Cutting Incidence Worldwide
|last=Bollinger
|first=Dan
|author-link=Dan Bollinger
|publisher=Academia
|date=2017-05-19
|accessdate=2021-10-21
|format=PDF
}}
* {{REFjournal
|last=Bollinger
|init=D
|author-link=Dan Bollinger
|url=https://www.researchgate.net/publication/321837170_Origins_of_the_Intactivist_Movement_A_Masculine_Foundation
|title=Origins of the intactivist movement: A masculine foundation
|journal=
|date=2017-11-17
|accessdate=2021-10-14
}}
{{ABBR}}
{{REF}}
[[Kategorie:BSM]]
[[Kategorie:USA]]
[[Kategorie:Männliche Beschneidung]]
[[Kategorie:Geschichte]]
[[en:United States of America]]