On remedicalisation: male circumcision in the United States and Great Britain

Abstract

This paper compares the histories of male circumcision in the United States and Great Britain to explicate the theoretically important, yet inadequately specified, processes of demedicalisation and remedicalisation. Circumcision became medicalised to a similar extent, through similar processes, in both countries before World War II. However, by the 1960s, circumcision was almost completely demedicalised in Britain and almost universal in the US, where it became partially demedicalised after the 1970s. Medical professionals and insurance/healthcare systems drove demedicalisation in both countries; in the US, grassroots activists also played a critical role, while medical community 'holdovers' and parents resisted demedicalisation. Recent research linking circumcision to HIV prevention and deaths following religious circumcision are differentially likely to produce remedicalisation in the two nations, given differences in circumcision prevalence, HIV epidemiology, insurance/health systems, activism opportunities, and status of religious groups. Research on (de/re)medicalisation should theorise the life cycle of medicalisation, explore comparative cases, and attend more closely to medical holdovers from previous eras, prevalence and duration of medicalised practices, and barriers to promoting non-medical interpretations.