US circumcision rate falls to record low as DIY foreskin restoration gains traction

Fewer than half of boys born in the United States are circumcised, according to a Johns Hopkins based analysis released this month. The rate, 49.3 percent, is the lowest since the practice became routine in the mid 20th century. The decline coincides with a broader shift in parental choice over neonatal care, as more families opt to leave newborns intact. The findings add a statistical milestone to a long running public health debate about the medical necessity, cultural significance and ethics of circumcision.

Circumcision rose to prominence in the United States in the early 20th century and became a near universal hospital routine by the 1950s and 1960s, with estimates showing 80 to 90 percent of male infants circumcised during that era. The practice was embraced in part as a preventive measure against infections, diseases and masturbation, though many of those benefits later faced scrutiny. Informed consent began to appear in the 1980s and 1990s, but the majority of families still opted for the procedure as a standard option rather than a medical necessity. In recent years a public health and civil rights conversation around consent and bodily autonomy helped push some parents to forgo circumcision, contributing to the record low rate now seen among newborns.

As newborn circumcision rates slide, a growing number of adult men seek restoration of foreskins lost in infancy. Across online communities and clinical circles, men report seeking a range of cosmetic and functional outcomes, from improving sensitivity to restoring a perceived sense of wholeness. The most common approach is a set of techniques known as tugging, in which skin on the shaft is stretched to create a hood that resembles a foreskin. Supporters say these methods can be done by hand or with devices, and they can be worn during sleep or discreetly beneath clothing. The methods vary widely in routine, duration and claimed results, and they are not supported by large scale medical studies.

Devices marketed online range from about 20 to 2000 dollars, and many rely on weights, gravity or bidirectional tension to extend skin over months or years. The process is slow, with six to eight hours of daily tension, five to seven days a week over three to six years being common. Advocates compare the goal to a dental retainer or Invisalign for the penis, though medical experts caution that no technique reproduces the nerve endings and tissue lost in infancy. Two urologists affiliated with the Johns Hopkins Brady Urological Institute declined to comment, saying there are too many variables to draw general conclusions. They warned that constant tugging could potentially damage tissues or nerves.

Beyond tugging, a small number of hospitals and clinics are exploring full foreskin reconstruction, though such surgeries remain rare, expensive and typically not covered by insurance. Outcomes vary and there is no consensus on durability or sensation. One Chicago area doctor of audiology, Juan Vasquez, has spent years tugging manually and with devices and says the process also involves therapy to cope with the experience of being circumcised without consent. Vasquez notes that cutting left a lasting impact beyond the physical scar.

Not all observers view the trend as medical crisis or simple preference shift. Critics argue that nonconsensual infant circumcision is a form of genital mutilation, while supporters emphasize parental choice and potential health considerations. The anti circumcision movement, called intactivism, has grown in online and offline spaces, arguing medical systems should avoid reducing bodily integrity without patient consent. The conversation has drawn attention to adult experiences of men who say they were harmed by decisions made at birth and to the potential risks and rewards of non surgical restoration today.

Amid the controversy, some individuals have turned experiences into advocacy or art. Ron Low, a longtime intactivist who helped popularize foreskin restoration, designed a dual tension tugger and has sold devices for decades. He says his own experimentation with tugging helped him understand anatomy and body autonomy. Now 63, he has turned his efforts into performance art, staging a solo show about foreskin restoration and its social dimensions. The movement has raised questions about consent, sexuality and medical history on both sides of the debate.

Regardless of viewpoint, the rise of non surgical restoration points to broader questions about how health care addresses adult sexual function, patient consent and the long term effects of early medical interventions. The Johns Hopkins analysis adds a numerical milestone to a wider story about changing practices and beliefs, reminding readers that what is considered standard care can evolve over time. As researchers, clinicians and patients navigate these questions, the conversation is likely to continue, with new data guiding future policy and practice.