This November, voters in San Francisco are expected to weigh in on a controversial topic: whether parents should be allowed to circumcise their baby boys.

The proposition, backed by members of an anti-circumcision group that calls its members “intactivists,” has ignited heated debate.

It’s hardly a new issue. Historians have found evidence of circumcision dating to ancient Egypt. Since then, the practice has gone in and out of public favor for myriad reasons, including hygiene, religion, cultural norms and beliefs about masculinity. Circumcised men are now in the minority worldwide, but they are the vast majority in the U.S.

Major medical associations have not yet taken a stance. The American Academy of Pediatrics states that circumcision has both risks and benefits and that parents should be given all the information available to make an informed decision. The Centers for Disease Control and Prevention is working on recommendations regarding the practice, but they have yet to be released.

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