Circumcision… once a fairly routine procedure in the United States… is becoming a cutting-edge issue for many parents-to-be. Cuts in Medicaid coverage and increased concerns about potential risks have reduced the number of infant boys who go under the knife for the traditional foreskin-removing procedure.

A contingent of circumcision opponents known as intact-ivists say the procedure amounts to involuntary cosmetic surgery that can lead to physical and sexual problems later in life. Plenty of adult men agree, blaming circumcision for diminished sexual desire and loss of sensitivity.

But their complaints are countered by public health officials who insist that intact foreskin raises the risk for kidney infection, penile cancer and a slew of S-T-Ds. They say the brief moments of pain inflicted by circumcision are well-worth the reduced risk of infection.

Despite the admonitions from public health professionals, an increasing number of parents are opting to forgo circumcision. The National Hospital Discharge Survey finds that nowadays almost half the boys born in the United States are left intact. Many are born to Latin American or Asian parents who traditionally forgo the procedure. Others are born into low-income families living in states where Medicare doesn’t foot the bill. But the most surprising converts to the intact-ivist movement are young, educated, middle-class whites who remain skeptical of the benefits of circumcision and are hesitant to inflict unnecessary pain on their infants.

Either way, criticism from both sides has fueled concern over a procedure that, until recently, was fairly routine and largely unquestioned.