Rates For Male Newborns Drop Below 50% Despite Medical Support
In A Nutshell
- Newborn circumcision rates in the US decreased from 54% in 2012 to 49% in 2022.
- White families experienced the largest decline, while rates for Black and Hispanic families remained stable.
- Wealthier families with private insurance had higher rates, but also faced significant drops.
- Researchers suggest growing skepticism towards medical recommendations and Hispanic population growth as possible influencing factors.
BALTIMORE — Circumcision rates among newborn boys in the United States have seen a steady decrease over the last decade, despite endorsements from major health organizations.
Researchers at Johns Hopkins University analyzed over 1.5 million hospital records from across the country, finding that the percentage of newborn boys circumcised within their first month of life declined from 54.1% in 2012 to 49.3% in 2022.
This trend follows recommendations from the World Health Organization (2007), the American Academy of Pediatrics (2012), and the Centers for Disease Control and Prevention (2018), which have all advocated for access to circumcision, citing research that links the procedure to lower risks of urinary tract infections, penile inflammation, and transmission of sexually transmitted infections, including HIV.
White Families Account for the Largest Circumcision Decline
Differences in trends emerged across racial and ethnic groups. Among White newborns, circumcision rates were 61.0% in 2012, peaked at 65.3% in 2019, and then fell to 60.0% in 2022. Conversely, Black families maintained the highest circumcision rates at around 66%, while Hispanic families had the lowest, hovering around 21%.
Regional variations were also notable. The Midwest had the highest prevalence at 68.5% in 2022, while the West reported just 19.7%. For White families in the Western region, circumcision rates dropped from 34.3% in 2012 to 26.2% in 2022.
Wealth and Insurance Status Shape Decisions
Factors such as household income and insurance coverage influenced circumcision rates. Initially, families in wealthier areas had higher circumcision rates (at 59.4% in 2012) but saw significant declines, dropping down to 51.1% by 2022.
Similar patterns were observed regarding insurance. Families with private insurance had the highest baseline rate at 64.2% in 2012, yet this decreased sharply to 56.3% by 2022. In comparison, families covered by Medicaid experienced a smaller decline, from 44.5% to 42.3% during the same period.
Policy shifts may also have played a role. For instance, by 2011, 17 states had stopped offering Medicaid coverage for routine newborn circumcision, which likely created some financial barriers. Regardless, the decline appeared across both insured and uninsured families.
Cultural Factors and Changing Attitudes Towards Circumcision
The researchers highlighted several reasons why parents are becoming less likely to choose circumcision, despite medical backing. While the American Academy of Pediatrics affirms the health benefits, they emphasize that the decision should ultimately rest with the parents.
Increased skepticism regarding medical recommendations in the U.S. and the continuous rise of the Hispanic population—who generally have low circumcision rates—are noted as significant factors. The study, published in JAMA Pediatrics, found that while circumcision rates among Black newborns remained stable across regions, White newborns experienced the greatest decreases. The reasons behind these racial disparities weren’t explored in detail.
Medical Guidance Meets Parental Autonomy
The study utilized the Kids’ Inpatient Database, which is a nationally representative sample of pediatric hospitalizations, to analyze circumcision procedures performed within 28 days of birth. Certain limitations were acknowledged—like potential underreporting, absence of state-level identifiers, and that the database counts hospital discharges rather than unique infants. Yet, it still offers a comprehensive national outlook.
From 2012 to 2022, despite clear endorsements from medical organizations regarding circumcision’s health benefits, parents opted for the procedure less often. This disconnect points to the complexities of health behaviors, which don’t always align with clinical recommendations.
The study concludes that circumcision trends are shaped by a variety of factors, including demographic changes, cultural attitudes, and evolving trust in healthcare—elements that influence decisions even amidst emphasized medical benefits.
Disclaimer: This article provides general information and shouldn’t be considered medical advice. It’s important for parents to consult healthcare professionals when deliberating over circumcision or other medical procedures.
Paper Summary
Methodology
The researchers analyzed data from the Kids’ Inpatient Database from 2012 to 2022, focusing on over 1.5 million hospital records of male newborns aged 0-28 days each year. They excluded those with bleeding disorders, penile abnormalities, or premature births. Circumcision procedures were identified through billing codes, employing statistical weights for national estimates while calculating annual rates and employing regression analysis to assess changes across demographic groups.
Results
Overall circumcision rates dropped from 54.1% in 2012 to 49.3% in 2022. The decline was largely driven by White families, whose rates fell from 65.3% to 60%. Black families maintained stable circumcision rates around 66%, while those from Hispanic backgrounds remained at roughly 21%. The Midwest recorded the highest circumcision rates (68.5%), contrasted with the West’s low rates (19.7%). Wealthier families and those with private insurance not only had higher rates but also faced the steepest declines.
Limitations
The study only accounted for hospital-based circumcisions using billing codes, which may underestimate total rates due to coding issues or outpatient procedures. The database tracks hospital discharges instead of individual patients, meaning multiple records for the same baby could appear. State-level data availability was limited, impeding detailed policy effect analyses. Additionally, the study considered only the first 28 days of life, possibly missing procedures conducted later.
Funding and Disclosures
The study was partially funded by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. It was disclosed that there were no conflicts of interest regarding study design or publication decisions.
Publication Information
The research letter titled “Trends in Circumcision Among Newborn Males in the US” was published online on September 15, 2025, in JAMA Pediatrics. Researchers from Johns Hopkins University School of Medicine and Bloomberg School of Public Health, led by Ping Yang and Dr. Aaron A.R. Tobian, conducted the study, which was accepted for publication on June 10, 2025.
