Dollars & Sense: the Business of Circumcision

You might be surprised to learn how lucrative infant circumcision in America is for the doctors, hospitals, clinics, and vendors who take part. Believe it or not, there is big money to be made in the business of circumcision. When money is involved, it becomes more important to question the motives of the one who stands to profit. “It is difficult to get a man to understand something when his salary depends on his not understanding it.” [Upton Sinclair]


I know better than to think a used car salesman is looking out for MY best interests instead of his own commission. Like a used car salesman, doctors will gloss over or completely ignore the facts that would turn you away from what they're selling. That's business.

Circumcision is a cash cow for doctors and hospitals. An OB might make a couple thousand dollars for every pregnant woman under their care, and that’s over the course of nine months. Circumcision takes about five minutes and you can charge over a grand each! I’ve searched high and low and found quite a range of prices for the surgery itself. The cost to have your son circumcised comes out to $704.83 on average. If a doctor circumcised just five boys each week at that rate, they can pull in $176,208.20 annually, and that is if they take two weeks vacation!

 To put that in perspective, that is about 25 minutes of work per week (as opposed to the 2400 minutes per week the rest of us work), for which the doctor and/or hospital are paid over 4 times the national average wage index for 2009. 

If you take that five minutes of work at $705 and extrapolate that into an hourly charge (5 goes into 60 twelve times), that’s $8,458 per hour. Per HOUR. Granted, this assumes 5 minutes per circumcision. We could expand it to 30 minutes per circumcision, which gives time for set up and clean up. That would turn this into a $1409.67 per hour charge.

Of course, we should take into account the fact that doctors and hospitals and clinics have expenses associated with performing circumcisions. The circumstraint immobilizer  (essentially the board they strap your baby to) costs anywhere from $200 - $400 each. I’ve found one for quite a bargain. This one is $298.70, marked down from $343.50.

The seller brags, “In less than 30 seconds, a nurse can immobilize the struggling infant securely in the correct position with Circumstraint. The immobilizer works on a proven principle of positive 4-point restraint. Soft wide Velcro straps encircle the infant's elbows and knees, depriving him/her of leverage. The child is held safely and securely without danger of escape. Circumstraint's comfortable contoured shape positions the infant, hips elevated, perfectly presenting the genitalia. The platform between the infant's legs provides support for a circumcision clamp. Without pins, towels, plastic shells or the threat of strangulation, Circumstraint snugly and securely immobilizes the infant with their entire torso visible.”

Sounds great, right? And when the straps wear out from having restrained hundreds of thrashing newborns, eBay has replacements on sale for $23.95 plus shipping.

There are plenty of other tools these clinics and hospitals have to pay for. The Gomco clamp, a popular tool for circumcision, runs about $150 plus shipping (marked down from $210). Of course, you have to buy two different sized clamps if you intend to circumcise both newborns and older children.

The Mogen clamp is a little more high-end, coming in around $400 apiece. I can’t tell the difference between the Moore Medical Mogen Clamp and the Skylar Mogen Clamp except that the Skylar Mogen Circumcision Clamp is more expensive: $543.44. Thank goodness both of these clamps can be used multiples times - otherwise it might really cut into profits!

The PlastiBell circumcision device is single use, so doctors and hospitals buy these in packs of 25 for around $150 or in bulk (125 devices) for about $650 If you’re planning on performing at least 125 circumcisions with this device, you’ll save $100 by buying in bulk. It’s a deal you just can’t pass up!

But really, doctors recoup their costs pretty easily. One father complained that the triple antibiotic ointment the hospital used on his child, the same ointment you can get at any drugstore for $4.95, was listed on the itemized bill at $166. That’s a 3354% mark-up.

And if the mark-ups on supplies and services don’t satisfy, there’s always money to be made from the discarded foreskins. Wait, what’s that? They can SELL foreskin? You betcha.

There are actually two different markets (that I know of) for human foreskin. One is the cosmetics industry. You may have heard that Oprah Winfrey uses a face cream made with human foreskin. It’s a pretty lucrative business when you consider that a bottle of this face cream will sell for a hundred bucks.

The other market for foreskins is in the medical field. Did you know that you can buy a milliliter of frozen foreskin for $399.00 to $559.00? These fibroblasts have many applications. The website of ATCC (the  biological resource center selling these fibroblasts) says they can be used in response to pathogens, skin aging, wound healing, gene delivery and skin diseases. One single foreskin can actually pull in $100,000 in total. Bet the owner of that foreskin won’t see a dime, poor kid. He could go to college a few times on that amount of money!

So the doctors, hospitals, clinics, and vendors are pulling in a pretty penny. And American parents? They’re paying someone anywhere from $300 to $3,000 to cut away a healthy body part from their newborn sons. They might pay hundreds or thousands more on follow-up “circumcision revision” surgeries. One way or another, the math isn’t adding up on their side.

How about instead, you take the $705 and put it in the stock market for your son. That way, if in 18 years he decides that his natural body is "icky," he can use that money to get circumcised. Or to buy a car. I bet he'll choose the car.

It’s a Boy!

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The Absence of No does NOT mean Yes.

If there is one thing I've learned about newborns, it's that they communicate their feelings quite clearly. Unfortunately (for us and for them), we don't speak the same language.

A baby's cry means that something is wrong. I'm too hot, I'm too cold, I'm hungry, I'm sleepy, I'm bored out of my incomplete skull... We get pretty good at interpreting these cries and figuring out what baby needs, but it takes time - time that baby boys can't afford.

Imagine you are warm, safe, happy, maybe a little cramped, but generally content. The next thing you know, after a great deal of pressure, some harsh lighting and cold air on wet skin, you are removed from the woman who has been your home, your safe place, for every previous moment of your existence. This already sounds like a bad day, doesn't it? Like waking up to someone yanking your blankets off in a cold room, perhaps while sitting on your head.

If you're a girl, the story ends with a meal and a nap and some time for bonding with mom and dad. If you're a boy, you're not so lucky. Even though mom and dad love you just as much as they love your sisters, there is a part of your body that is unfamiliar to them. They've been fed inaccurate information that tells them that you weren't put together right in the womb, and you now need to be "fixed" even though all your parts work exactly as they're supposed to.

Of course, you don't understand this. You're a newborn. This is all a bit beyond your grasp right now. All you know is that you were swaddled in mom's arms a minute ago, but now you're stripped and strapped down to what we call a circumstraint. It looks a little something like this:

That's right - there is a special medical restraint made just for infant circumcisions. Kind of looks like what they'd use to strap down a death-row inmate in order to execute him or her, doesn't it?

These run around $300 to $450 each, and it's about $25 to replace the straps after they've been worn out by hundreds of thrashing infants.

But what do you care if a company is turning a profit on the backs of innocent children? You're a baby. You've never heard of commerce. All you care about is that you can't move your arms or legs.

You can't curl up like you're used to, you can't sooth yourself by sucking on your hand, you can't get your mom to come to your rescue no matter how much you scream. Nobody understands that your screaming means "I AM NOT OKAY WITH THIS!" And you don't even know what's coming next, you poor little thing.

First is the betadine swab. They smear it around your penis and scrotum, which is cold and uncomfortable. If you're lucky, the next thing that happens is someone putting a needle inside the base of the most nerve-rich part of your body to inject a local anesthetic into your penis. This itself is painful enough, and it doesn't do enough to block the pain of the next part of the procedure. Next the medical professionals take two metal clamps and put them on the end of your foreskin and pull on it to stretch it out. You're still screaming, and they're not stopping. An instrument is stuck inside your foreskin and used to forcibly separate the fused foreskin from the delicate internal organ inside - the head of your penis. You would probably give anything to go back to a time when the most painful thing in your life was a needle in your penis. You're screaming so much that you're actually choking on your saliva.

This is probably where you go into shock. The pain is beyond your comprehension. It is excruciatingly painful. The pain causes a permanent change in your brain (this is scientifically proven). While your body is still reeling from the shock and pain of having your tender little penis ripped apart, the skin that was there to protect you is cut away and cast aside. You have no idea how much you just lost, but you know something is very wrong.

The pain is so distracting that after being placed back in mom's arms, you're really not all that interested in your next meal. Your sleep patterns and breastfeeding are disrupted because of the pain.  In fact, you're in too much pain to really respond to your parents' attempts to bond with you. You might even flinch when touched, and studies show that you'll probably have a higher pain response to painful stimuli in the future. There are a lot of physical and behavioral issues you and your parents are unaware of just yet. You aren't thinking about sex right now, though you will have to suffer through painful erections while you heal from this surgery, and when you're older you're more likely to have erectile dysfunction. You've lost all the fine touch nerve receptors in your penis, and after time and constant contact with your clothing causes your glans to keratinize, you'll only be able to sense temperature and pressure. Not pleasure.

But you're lucky - you survived. Not all babies do. It doesn't take much blood loss to kill an infant. You could have met a much worse fate.

The fact still stands that if anyone had been listening to you, this wouldn't have happened. Your foreskin was not a ruptured appendix. It wasn't an impacted wisdom tooth. It wasn't a vestigial tail. It was a healthy, normal part of your body, there to serve several functions. Your memory may not include this moment when you're older, but your body will always remember this. You will wear a scar on your body for the rest of your life, and you will never experience the joy of sex as nature intended it.

You said no.
You said it over and over again.
You said it with your body.

You said it with your voice.

Nobody listened.

Let it end here. A language barrier is not an excuse not to listen. Our baby boys are saying no. They are shouting it, they are screaming it, they are begging you to stop the pain. They are losing their lives. There is no excuse for this. There is no reason to keep this tradition alive when so many boys no longer are. There is not a single major medical organization on the planet that recommends non-therapeutic, routine infant circumcision. Not one. It is a cure looking for a disease.

Your son will not always be an infant. He will be a grown man one day. Respect your son and the man he will become by protecting him until he can give informed consent for elective, cosmetic procedures. The absence of the word "no" does NOT mean "yes." If we believed that it did, we'd be no better than someone who rapes an unconscious woman. We would not sit back and condone that violation of someone else's body without consent, but we do it to the most vulnerable of us - a newborn baby. He is saying "no" every way he knows how, and it's our job to listen.

Be your child's voice. Say no to circumcision.