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The Economics of Circumcision: A Full Breakdown of This Penis Business

the business of circumcision

The economics of circumcision are entirely unfamiliar to the average person. However, considering that this surgery is permanent and cannot be undone, wouldn’t you want to know who benefits from it? (Hint: it isn’t you or your child.)

Federal law prohibits the use of federal health care dollars for medically unnecessary services. Medicaid funding of routine infant circumcision clearly flies in the face of that prohibition, but the AAP has managed to obfuscate the practice’s purely cultural origins (I include religion in the broad category of culture) by its serial quest to find medical benefits. — Georganne Chapin, author of “This Penis Business” (Lucid House Publishing, 2024)

In this article, we’ll be diving deep into the financial side of circumcision, pulling back the curtain on its direct and indirect costs, its value within medical and cultural spheres, and the subtle economic currents that flow within this often controversial realm. Join us as we demystify the complex business of circumcision and who profits from it.

Medical Costs of Circumcision

The costs of circumcision go beyond the surgical procedure and include the use of anesthetics for pain management, post-surgical care, wound dressings, and follow-up appointments, all of which contribute significantly to the overall expenditure.

A prestigious obstetrician or urologist practicing in a fancy hospital in an affluent city can demand upwards of $2,500 to pry away, clamp, and cut off your baby’s foreskin. If you’re a middle-class parent in a middle-class town, you’ll probably find someone willing to do the same thing for $500 or less. In addition, hospitals add fees for the procedure room, nursing staff, supplies, and equipment (including single-use circumcision kits, gauze, and petroleum jelly for bandaging the baby’s fresh circumcision wound). These fees vary widely and are either hidden in a global bill or listed separately, the latter leaving a parent to wonder how on earth a travel-size tube of petroleum jelly and a small packet of gauze can cost more than a dinner out. I recently saw an online complaint from a mom who had been billed $600 by the doctor, $20 for “pharmacy,” $91 for supplies, and an additional fee of $2,200 by the hospital for her son’s circumcision.” — Georganne Chapin, author of This Penis Business (Lucid House Publishing, 2024)

This Penis Business, by Georganne Chapin

However, it is crucial to consider the indirect costs as well. Complications from circumcision, which are vastly underreported, can necessitate further medical intervention, leading to additional expenses. Issues such as infections, excessive bleeding, or improper healing can inflate the overall financial burden. Therefore, although the upfront cost of circumcision may initially appear straightforward, it is important for individuals and families to be fully informed before making decisions.

Economic Incentives for Circumcision in Medical Institutions and Others

Circumcision has the potential to generate significant revenue for medical institutions, ranging from small clinics to large hospitals, even beyond the initial surgery and any post-surgery complications. Foreskin derivatives, often overlooked, play a profitable role in various industries, including cosmetics and medical research.

In 2013, television personality Oprah Winfrey began advertising the virtues of SkinMedica, an anti-wrinkle face cream made from human foreskin fibroblasts that promised to “rapidly restore the skin’s barrier and moisture balance.” SkinMedica claimed that it hasn’t bought a foreskin in twenty years—that just one “donated” foreskin is the gift that keeps on giving. — Georganne Chapin, author of “This Penis Business” (Lucid House Publishing, 2024)

Beyond the immediate financial benefits of circumcision, foreskin tissue has found its way into the world of high-end creams and treatments, thanks to its rich cellular content. However, there is a darker side to this story. Reports of illicit foreskin trafficking have surfaced, with the tissue being sold on black markets. Additionally, foreskin cells hold great value in medical research, particularly in regenerative studies, due to their unique properties.

Do parents know that they are agreeing to have their infant’s foreskin donated or sold for research or commercial benefit when they sign the informed consent in the hospital? Do we know what happens to the foreskins of infants who are circumcised as part of a religious ceremony?

Future Economic Predictions Around Circumcision

As societal norms, medical recommendations, and cultural values continue to evolve, the demand for circumcision stands at the precipice of potential shifts in the coming decades. Numerous factors, such as increased awareness about bodily autonomy, changing religious demographics, and a growing body of research on the long-term effects of the procedure, possess the power to exert influence and potentially save millions of children and men from this harmful surgery.

“In a 2015 survey from the Centers for Disease Control and Prevention (CDC), 71% of U.S. adult men reported being circumcised, but younger generations showed a slight decrease in rates compared to older generations.”

A decline in routine circumcisions would, logically, mean reduced revenues for medical institutions and related industries that have long relied on the steady income from this surgery. Medical equipment manufacturers, post-operative care providers, and other stakeholders will find their fortunes intertwined with the fluctuations in circumcision rates, which means each of these groups has a vested interest in keeping this practice ongoing.

Personal Economics of Circumcision

Circumcision has far-reaching financial implications that extend beyond the initial procedure’s cost. Throughout a lifetime, there are various direct expenses to consider. Georganne Chapin, in “This Penis Business,” refers to Intact America board member Dan Bollinger’s estimate of the cost of circumcision in the United States. This included repairs—around 2.8 percent of cut boys require such surgery, referred to in the trade as “revisions,” some done for aesthetic reasons (“not enough skin taken off”), and some that attempt to correct serious medical errors—as well as other expenses over a lifetime. Bollinger estimated that the total money spent in 2020 as a direct result of “routine” infant circumcision was nearly six billion dollars.1 In cases where complications or dissatisfaction arise, therapeutic interventions may be necessary, both physically and psychologically, resulting in additional financial burdens.

It’s important to acknowledge that the costs go beyond the tangible. The psychological and emotional toll can be profound, leading to feelings of loss, violation, or struggles with body image. Seeking counseling or therapy becomes crucial in addressing these issues, as they can impact personal and professional aspects of one’s life, potentially affecting opportunities and productivity. It is evident that while the economic aspect of circumcision may appear straightforward initially, the long-term implications, both tangible and intangible, are complex and significant, and complicit parties continue to profit from the pain they have caused.

The economics of circumcision are purposefully obscured. As you have seen throughout this article, many people profit from the bloody business of circumcision. The commodification of this practice demands transparent discussions. These dialogues should include the major risks and irreversible harms of circumcision, along with the financial and societal consequences of allowing parents to consent and medical professionals to perform circumcision on children who cannot give consent. As societies evolve, it is crucial to approach the topic of circumcision with an open mind, informed by both medical and economic insights. This ensures that the choices we make are holistic, compassionate, and well-informed.

I await the day, long overdue, when insurance companies and the government in this country stop paying for the “benefit” of circumcision—which has already happened in other Westernized countries that corrected their course based on scientific evidence that circumcision was extremely invasive, conferred no benefit to boys’ health, and imposed considerable risk and unjustifiable costs upon children and their families. — Georganne Chapin, author of “This Penis Business” (Lucid House Publishing, 2024)





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Marilyn Fayre Milos, multiple award winner for her humanitarian work to end routine infant circumcision in the United States and advocating for the rights of infants and children to genital autonomy, has written a warm and compelling memoir of her path to becoming “the founding mother of the intactivist movement.” Needing to support her family as a single mother in the early sixties, Milos taught banjo—having learned to play from Jerry Garcia (later of The Grateful Dead)—and worked as an assistant to comedian and social critic Lenny Bruce, typing out the content of his shows and transcribing court proceedings of his trials for obscenity. After Lenny’s death, she found her voice as an activist as part of the counterculture revolution, living in Haight Ashbury in San Francisco during the 1967 Summer of Love, and honed her organizational skills by creating an alternative education open classroom (still operating) in Marin County. 

After witnessing the pain and trauma of the circumcision of a newborn baby boy when she was a nursing student at Marin College, Milos learned everything she could about why infants were subjected to such brutal surgery. The more she read and discovered, the more convinced she became that circumcision had no medical benefits. As a nurse on the obstetrical unit at Marin General Hospital, she committed to making sure parents understood what circumcision entailed before signing a consent form. Considered an agitator and forced to resign in 1985, she co-founded NOCIRC (National Organization of Circumcision Information Resource Centers) and began organizing international symposia on circumcision, genital autonomy, and human rights. Milos edited and published the proceedings from the above-mentioned symposia and has written numerous articles in her quest to end circumcision and protect children’s bodily integrity. She currently serves on the board of directors of Intact America.


Georganne Chapin is a healthcare expert, attorney, social justice advocate, and founding executive director of Intact America, the nation’s most influential organization opposing the U.S. medical industry’s penchant for surgically altering the genitals of male children (“circumcision”). Under her leadership, Intact America has definitively documented tactics used by U.S. doctors and healthcare facilities to pathologize the male foreskin, pressure parents into circumcising their sons, and forcibly retract the foreskins of intact boys, creating potentially lifelong, iatrogenic harm. 

Chapin holds a BA in Anthropology from Barnard College, and a Master’s degree in Sociomedical Sciences from Columbia University. For 25 years, she served as president and chief executive officer of Hudson Health Plan, a nonprofit Medicaid insurer in New York’s Hudson Valley. Mid-career, she enrolled in an evening law program, where she explored the legal and ethical issues underlying routine male circumcision, a subject that had interested her since witnessing the aftermath of the surgery conducted on her younger brother. She received her Juris Doctor degree from Pace University School of Law in 2003, and was subsequently admitted to the New York Bar. As an adjunct professor, she taught Bioethics and Medicaid and Disability Law at Pace, and Bioethics in Dominican College’s doctoral program for advanced practice nurses.

In 2004, Chapin founded the nonprofit Hudson Center for Health Equity and Quality, a company that designs software and provides consulting services designed to reduce administrative complexities, streamline and integrate data collection and reporting, and enhance access to care for those in need. In 2008, she co-founded Intact America.

Chapin has published many articles and op-ed essays, and has been interviewed on local, national and international television, radio and podcasts about ways the U.S. healthcare system prioritizes profits over people’s basic needs. She cites routine (nontherapeutic) infant circumcision as a prime example of a practice that wastes money and harms boys and the men they will become. This Penis Business: A Memoir is her first book.