In the United States, the rate of circumcision among newborn boys has quietly slipped below the halfway mark, despite strong endorsements from leading medical organizations. This trend, revealed by a sweeping new study from Johns Hopkins University and published in JAMA Pediatrics on September 15, 2025, highlights a surprising divergence between medical guidance and parental choices—a gap that’s only widened over the past decade.
Researchers analyzed more than 1.5 million hospital records of male newborns, aged 0 to 28 days, from 2012 to 2022, using the Kids’ Inpatient Database, a nationally representative trove of pediatric hospitalizations. Their findings are clear: the share of newborn boys circumcised during their first month of life dropped from 54.1% in 2012 to just 49.3% in 2022. That’s a nearly 5% decline in a single decade, even as the World Health Organization, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention have all recommended the procedure for its health benefits.
“Despite overwhelming evidence that neonatal male circumcisions provide health benefits, increasing public skepticism in the United States toward medical recommendations may be driving more parents to choose not to have their sons get circumcised,” Dr. Aaron Tobian, co-senior author and professor of pathology at Johns Hopkins University School of Medicine, told JAMA Pediatrics.
For decades, circumcision has been promoted based on scientific research showing it reduces the risk of urinary tract infections, penile inflammation, and the acquisition of sexually transmitted infections, including HIV. These findings have prompted major health authorities to support the practice. Yet, as Dr. Tobian and his team discovered, the medical consensus hasn’t translated into steady or rising circumcision rates.
The study’s granular look at demographic trends reveals that not all groups are moving in the same direction. White families, who have historically had some of the nation’s highest circumcision rates, saw the sharpest decline. In 2012, 61% of White newborns were circumcised. That figure peaked at 65.3% in 2019, but by 2022, it had slipped to 60%. For Black families, the story is different: circumcision rates remained remarkably stable, hovering around 66% throughout the decade. Hispanic families, meanwhile, consistently reported the lowest rates—about 21%—with little change over time. Asian and Pacific Islander families saw a modest decrease, from 39.7% to 37.5%, and Native American rates fell from 44.2% to 40.9% over the same period.
Regional differences were just as stark. Hospitals in the Midwest reported the highest circumcision prevalence at 68.5% in 2022, while Western hospitals lagged far behind at 19.7%. Among White families in the West, the rate dropped from 34.3% in 2012 to 26.2% in 2022—a dramatic shift that underscores how geography and culture intersect in shaping parental decisions.
Socioeconomic factors also played a powerful role. Families living in the wealthiest zip codes started the decade with higher circumcision rates—59.4% in 2012—but saw some of the steepest declines, falling to 51.1% by 2022. Insurance status told a similar story: privately insured families had the highest baseline prevalence, at 64.2% in 2012, but their rate fell sharply to 56.3% by 2022. Medicaid-covered families saw smaller changes, with circumcision declining slightly from 44.5% to 42.3% over the same period.
One possible explanation? Policy changes. By 2011, seventeen states had ended Medicaid coverage for routine newborn circumcision, potentially creating financial hurdles for low-income families. But as the researchers noted, “cost alone cannot explain the overall decline, since reductions were also seen among privately insured families.”
So what’s really driving this shift? The study’s authors point to a complex brew of cultural and societal factors. The American Academy of Pediatrics maintains that “the health benefits outweigh the risks but stresses that the decision should remain with parents.” Yet, as Dr. Tobian explained, “increasing public skepticism in the United States toward medical recommendations may be driving more parents to choose not to have their sons get circumcised.”
Another factor is the changing face of America’s population. “Hispanics—the ethnic group that historically reports the lowest circumcision prevalence—also is the largest growing population in the United States; therefore, the overall circumcision rate is skewed downward,” Dr. Tobian told JAMA Pediatrics. This demographic trend, coupled with persistent cultural preferences, is reshaping national averages even as health officials continue to advocate for the procedure.
Of course, the study isn’t without its limitations. The researchers relied on hospital billing codes to identify circumcision procedures, which means their analysis likely missed some circumcisions performed in outpatient clinics or after the first month of life. The Kids’ Inpatient Database tracks hospital discharges rather than unique patients, so multiple hospitalizations for the same baby could be counted more than once. State-level data wasn’t available, making it tough to pinpoint the effects of specific policy changes. Still, as the authors emphasized, the study offers the most comprehensive national snapshot to date.
Funding for the research came in part from the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health (grant R01DK131926). Dr. Tobian reported receiving other grants from the National Institutes of Health and the Department of Defense during the study, but the researchers state that funders had no role in the study design, data analysis, or publication decisions. No other conflicts of interest were disclosed.
Ultimately, the findings paint a nuanced picture of health behavior in the U.S. Between 2012 and 2022, medical organizations offered some of their clearest endorsements yet of circumcision’s health benefits. Yet, parents moved in the opposite direction, choosing the procedure less often. The gap between institutional recommendations and family decisions underscores how deeply health behaviors are shaped by trust, culture, and changing demographics—not just clinical evidence.
The research letter, "Trends in Circumcision Among Newborn Males in the US," was led by Ping Yang and Dr. Aaron A.R. Tobian, along with colleagues from the Johns Hopkins University School of Medicine and Bloomberg School of Public Health. The paper was accepted for publication on June 10, 2025, and went online September 15, 2025, in JAMA Pediatrics.
As the debate over circumcision continues, one thing is clear: in the U.S., the decision remains in the hands of parents, influenced by a mosaic of beliefs, backgrounds, and—perhaps most of all—their evolving relationship with the medical establishment.
