Plastic Surgeon Group Becomes First Major American Medical Association To Oppose Transgender Surgeries for Minors

The American Society for Plastic Surgeons, or ASPS, has issued new guidance opposing gender transition surgeries on patients under 19, becoming the first major medical association in America to issue such guidance.In a statement Tuesday, the ASPS said that clinical management of children with gender dysphoria or “gender incongruence” has “undergone rapid change.” The organization said that there is “insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.”“ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old,” the statement added. The statement also said that there is “substantial uncertainty” about the “long-term benefits and harms of medical interventions such as puberty blockers and cross-sex hormones.”In May 2025, the Department of Health and Human Services released a report suggesting that there is no strong evidence to show that “gender affirming care” is effective for minors. The review, referenced in the ASPS’s guidance, said that the “overall quality of evidence concerning the effects of any intervention on psychological outcomes, quality of life, regret, or long-term health, is very low.”“Proponents of [pediatric medical transition] often describe it as lifesaving. Some physicians recommending PMT have urged anxious parents to consent to irreversible interventions for their distressed children, warning that not doing so may increase the risk of suicide,” the report said. “Such claims are not supported by the evidence and have been criticized as unethical.”Additionally, HHS warned that such interventions “carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.”A report released in the United Kingdom, known as the Cass Review, found that there is “remarkably weak” evidence about the benefits of such procedures for children. The secretary of the Department of Health and Human Services, Robert F. Kennedy Jr., celebrated Tuesday’s announcement from the ASPS in a statement, saying, “We commend the American Society of Plastic Surgeons for standing up to the overmedicalization lobby and defending sound science.”“By taking this stand, they are helping protect future generations of American children from irreversible harm,” he added. The HHS general counsel, Mike Stuart, said, “Almost daily, another major hospital system in America is ending the tragic and irreversible practice of sex-rejecting procedures for minors.”“The American Society of Plastic Surgeons is bravely standing with Secretary Kennedy in courageously leading on this critical issue,” he added.Several hospitals have said they will stop performing transgender procedures for minors amid pressure from the Trump administration. In December, HHS said it planned to propose a new rule that would prevent hospitals from receiving Medicare and Medicaid funding if they perform what it calls “sex-rejecting procedures.”An LGBTQ advocacy organization, the Human Rights Campaign, has sought to downplay concerns about gender transition surgeries, saying that they are “exceedingly rare” for children. A report published in the American Medical Association’s journal, JAMA, found that fewer than 1,000 minors a year undergo such surgeries. The ASPS’s guidance on Tuesday marks a departure from its 2019 stance, when it opposed efforts to restrict gender transition surgeries. In August 2024, the group said it was crafting new guidance due to the “considerable uncertainty” about the benefits of the surgeries. It also marks a departure from other major medical associations in America, which have expressed support for transgender services —including surgeries — for minors.In 2021, the World Professional Association for Transgender Health, an international organization that makes recommendations for transgender care, proposed age minimums for transgender procedures. The group recommended minimums of 14 for hormonal treatments, 15 for mastectomies, 16 for breast augmentation or facial surgeries, and 17 for genital surgeries. However, the final guidelines released by WPATH did not include the age minimums. Court documents later showed that the Biden Administration pressured WPATH to remove its age minimums due to concerns that they would fuel political opposition to such procedures.

Plastic Surgeon Group Becomes First Major American Medical Association To Oppose Transgender Surgeries for Minors

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