When and why did circumcision rates rise in the United States during the 19th century?
Executive summary
Circumcision rates in the United States began a marked rise in the mid-to-late 19th century and became widespread by the turn of the 20th century, driven not by longstanding cultural tradition but by a medicalized reframing of the procedure as preventive surgery and a tool of moral hygiene [1] [2] [3]. Physicians, public-health advocates and popular anxieties about cleanliness, masturbation, cancer and degenerative disease together turned a previously minority religious rite into a routine medical intervention [4] [5].
1. The when: medicalization took hold in the late 19th century
For most of American history circumcision was uncommon outside Jewish and Muslim communities, but “medicalized circumcision” appears in U.S. practice in the latter part of the 19th century and was “quietly democratized in the last decade of the nineteenth century,” after which it spread rapidly into hospitals and general practice by the early 20th century [3] [2] [4].
2. The why — a catalogue of medical rationales
Late‑Victorian physicians promoted circumcision as a preventive, therapeutic and prophylactic measure against a bewildering list of ills — from phimosis and balanitis to venereal disease, cancer, epilepsy, paralysis and even “masturbation”‑related mania — claims that framed the operation as legitimate preventive medicine despite weak scientific grounding [3] [2] [5].
3. Moral hygiene and sexual anxieties as accelerants
The rise coincided with a powerful cultural campaign against masturbation and “immoral” sexuality; doctors and reformers presented circumcision as a civilizing, moralizing intervention that could curb sexual excess and protect future citizens’ bodies and minds, an argument that appealed beyond the consulting room to parents anxious about child rearing and public virtue [5] [6] [7].
4. Technology, surgery’s prestige and institutional adoption
Surgery gained prestige and technical advances in the 1890s — including clamp methods and safer operative techniques — which made neonatal and hospital circumcision more practicable and less risky; coupled with endorsements from influential clinicians and public‑health officials, these changes helped institutionalize the practice in American hospitals [8] [9] [2].
5. Politics, immigration and an implicit civilizational narrative
Wider social currents—germ theory, middle‑class obsessions with cleanliness, and a desire to “civilize” immigrant bodies—fed adoption; historians note that circumcision became culturally coded as a mark of modernity and cleanliness in Anglo‑American contexts, an implicit agenda that linked medical authority to social control [6] [4] [2].
6. Competing viewpoints and the limits of evidence
Contemporaneous critics and pamphleteers opposed medical circumcision as unnecessary or as overreach, and later historians underscore that many 19th‑century medical claims lacked rigorous evidence; the literature supplied here shows both the medical advocacy for universal neonatal circumcision and later reassessments that question those early etiological claims [8] [4] [3]. Sources such as David Gollaher and reviews in medical journals document how the practice became normalized despite contested science [4].
7. What the sources reveal about motives and agendas
Primary motives were mixed: clinicians seeking simple preventive interventions, public‑health authorities wanting to reduce perceived social ills, surgical culture elevating operative solutions, and publishers and reformers amplifying moral narratives; recognizing these overlapping agendas—medical, moral and social—explains why a procedure with weak empirical backing nonetheless became standard practice [2] [5] [6].