The link between adult circumcision, loss of sensitivity and impotence has been noted in the medical literature. Since infant circumcision also decreases sexual sensitivity, it is likely than circumcision is an unrecognized factor in the high rates of impotence in American men and by association, is also detrimental to male psychological health. According to a randomized study of 1290 men aged 40-70 years, 52% reported some degree of impotence, ranging from minimal to complete. This rate varied from ~40% at age 40 to 67% at age 70. (A literature search yielded no comparable European study.) Higher rates of impotence were associated with increased levels of anger and depression. Self-esteem was also lower in impotent men. The psychological  response to impotence would compound any pre-existing psychological symptoms that have already been discussed.

• A circumcised boy who matches others may nevertheless have negative feelings about being circumcised. These feelings can last for a lifetime.
• It is not possible to predict before circumcision how a boy will feel about it later.
• Even though intact men are in the minority in the USA, there is no evidence that many of them are dissatisfied with being intact.
• An intact male who is unhappy about it can choose to be circumcised, but this is rarely done. The estimated rate of adult circumcision in the USA is 3 in 1000.
• An intact male who is unhappy about his status may feel different after learning more about circumcision and the important functions of the foreskin.

The social factor is much less of an issue for boys born in the USA today because of the lower circumcision rate (60% nationally, under 40% in some states).