Nevertheless, relief agents are available and should be used. Initially, there was some apprehension about using local anesthesia in neonatal circumcision, but the safety and effectiveness of such use has been convincingly documented. Anticircumcision activists claim that the foreskin increases sexual pleasure. But data from recent studies suggest the contrary. While nearly every type of sexual dysfunction was likelier for uncircumcised men, the likelihood of difficulty in getting or maintaining an erection was significantly higher than the likelihood of other types of dysfunction.
Sex appeal is another valid concern, but beauty is in the eye of the beholder.
According to a study published in 1988, young, heterosexual, middle-class women in Iowa City preferred the circumcised penis over the uncircumcised penis by a margin of 3 to 1. Cultural, religious, and ethnic factors strongly affect the decision whether or not to request circumcision. Circumcision of members of observant Muslim and Jewish families is a religious rite. In California, where 45 percent of newborns are Hispanic, the rate of circumcision is less than 50 percent. Circumcision has been on the decline there as the birth rate of Hispanics and Asians has increased.