Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice

JAMA. 1997 Apr 2;277(13):1052-7.


Objective: To assess the prevalence of circumcision across various social groups and examine the health and sexual outcomes of circumcision.

Design: An analysis of data from the National Health and Social Life Survey.

Participants: A national probability sample of 1410 American men aged 18 to 59 years at the time of the survey. In addition, an oversample of black and Hispanic minority groups is included in comparative analyses.

Main outcome measures: The contraction of sexually transmitted diseases, the experience of sexual dysfunction, and experience with a series of sexual practices.

Results: We find no significant differences between circumcised and uncircumcised men in their likelihood of contracting sexually transmitted diseases. However, uncircumcised men appear slightly more likely to experience sexual dysfunctions, especially later in life. Finally, we find that circumcised men engage in a more elaborated set of sexual practices. This pattern differs across ethnic groups, suggesting the influence of social factors.

Conclusions: The National Health and Social Life Survey evidence indicates a slight benefit of circumcision but a negligible association with most outcomes. These findings inform existing debates on the utility of circumcision. The considerable impact of circumcision status on sexual practice represents a new finding that should further enrich such discussion. Our results support the view that physicians and parents be informed of the potential benefits and risks before circumcising newborns.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Circumcision, Male* / adverse effects
  • Circumcision, Male* / ethnology
  • Circumcision, Male* / statistics & numerical data
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Minority Groups
  • Multivariate Analysis
  • Prevalence
  • Sexual Behavior
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexually Transmitted Diseases / epidemiology
  • Socioeconomic Factors
  • United States / epidemiology