About half of newborn boys in the United States are circumcised, with the national rate dropping from 54.1% in 2012 to 49.3% in 2022. That marks a significant shift from the procedure’s peak popularity, when roughly two out of three newborn boys were circumcised in the late 1990s. The U.S. remains one of the few developed countries where routine newborn circumcision is widespread, but the practice is no longer the clear-cut norm it once was.
How Rates Have Changed Over Time
Circumcision became a routine hospital procedure in the U.S. during the mid-20th century, and by 1999, 65.3% of male newborns born in hospitals were circumcised. That number has been declining steadily since. A Johns Hopkins study reviewing over 1.5 million hospitalizations of male newborns found the rate fell from 54.1% in 2012 to 49.3% in 2022, meaning the country has essentially reached a 50/50 split.
Several forces are driving the decline. Immigration from Latin America and Asia, where circumcision is far less common, has changed the demographic makeup of newborn populations. Insurance coverage plays a role too, as does a growing cultural conversation about whether the procedure is necessary. The American Academy of Pediatrics issued a policy statement in 2012 saying the health benefits of circumcision outweigh the risks but stopped short of recommending it universally. That statement has since expired and has not been replaced, leaving no active recommendation from the nation’s leading pediatric organization.
Dramatic Differences by Region
National averages obscure enormous regional variation. The Midwest has the highest circumcision rate at 75.2%, followed by the Northeast at 67.0% and the South at 55.7%. The West is a stark outlier: only 24.6% of newborn boys born in Western hospitals were circumcised in 2009, and that number has likely continued to fall. A baby boy born in a Midwest hospital is roughly three times more likely to be circumcised than one born on the West Coast.
These differences reflect regional demographics, cultural norms, and insurance policies. Western states have larger Hispanic and Asian American populations, communities where circumcision has historically been less common. The Midwest and Northeast have larger proportions of families with northern European and African American backgrounds, groups where the procedure has been more routine for decades.
How Insurance Coverage Affects Rates
Whether a family’s insurance covers circumcision turns out to be one of the strongest predictors of whether the procedure happens. Seventeen states do not provide Medicaid coverage for newborn circumcision, and the impact is measurable. States where Medicaid covers the procedure have circumcision rates roughly 24% higher than states where it does not.
The pattern becomes clearer when you look at individual states that dropped coverage. After Florida stopped covering circumcision through Medicaid, the rate fell from 47.4% to 37.5%. Colorado saw a drop from 61.9% to 52.0%. Those are 16% and 21% reductions, respectively, suggesting that out-of-pocket costs (typically $150 to $400 for an uninsured procedure) are enough to change many families’ decisions. The coverage gap also creates racial disparities: in states without Medicaid coverage, Black newborns had significantly lower odds of being circumcised compared to white newborns, likely because Black families are disproportionately covered by Medicaid.
Health Benefits and Risks
Circumcision does carry documented health benefits. The strongest evidence comes from studies of HIV transmission, where circumcision is associated with roughly a 60% reduction in the risk of female-to-male HIV transmission. The procedure also reduces the risk of urinary tract infections in the first year of life and lowers the likelihood of certain sexually transmitted infections. These benefits are real but modest in the context of a country with low HIV prevalence and widely available condoms and antibiotics.
The procedure is also very safe when performed on newborns. The overall complication rate is slightly less than 0.5%, and the vast majority of complications are minor, primarily bleeding or the need for a small follow-up procedure. Serious adverse events are exceedingly rare, measured in single digits per million procedures.
Why Families Choose Differently
For most American families today, the decision is less about medicine and more about culture, religion, and family identity. Jewish and Muslim families typically circumcise for religious reasons. Many other families choose the procedure so their son “looks like dad” or matches peers, though that social pressure weakens as circumcision rates approach 50/50. Families who decline often cite bodily autonomy, the belief that the procedure is cosmetic rather than necessary, or simply the absence of a compelling medical reason.
The U.S. is unusual among Western nations in this regard. Routine newborn circumcision is uncommon in Europe, Canada, Australia, and most of the developed world outside of religious communities. In many of those countries, circumcision rates sit below 20%. The American practice traces back to 19th-century beliefs about hygiene and morality that became embedded in hospital culture and persisted through generations of “like father, like son” reasoning.
With the national rate now below 50% for the first time in modern record-keeping, the next generation of American boys will grow up in a country where being circumcised or uncircumcised is equally common.