American Society of Plastic Surgeons Recommends Against Transgender Surgery for Minors |
The American Society of Plastic Surgeons on Tuesday became the first major medical organization to oppose gender transition for minors when it recommended “that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.” The ASPS represents “more than 11,000 physician members worldwide,” which is more than the number of surgeons the American Board of Plastic Surgery has certified since 1937.
In support of this recommendation, the ASPS cited “recent publications reporting very low/low certainty of evidence regarding mental health outcomes,” “emerging concerns about potential long-term harms and the irreversible nature of surgical interventions,” and “insufficient evidence demonstrating a favorable risk-benefit ratio.”
ASPS previously joined with other mainstream medical organizations in supporting gender-transition surgeries for minors. However, it moderated its stance two years ago. “In August 2024, ASPS communicated to members that the Society had not endorsed any external organization’s clinical practice guidelines or recommendations for the treatment of children or adolescents with gender dysphoria,” ASPS described, citing the “considerable uncertainty” over such treatments.
Since then, “ASPS’s understanding has continued to evolve in light of additional comprehensive evidence reviews,” the statement explained, including the United Kingdom’s Cass Review and the 2025 review by the Trump administration’s Department of Health and Human Services. “In some areas,” the statement summarized, these reviews “have contributed to a clearer understanding of potential harms, while also highlighting limitations of the available evidence, including gaps in documenting long-term physical, psychological, and psychosocial outcomes.”
Indeed, “available evidence” was a fundamental theme of the ASPS’s new position statement. “Available evidence suggests that a substantial proportion of children with prepubertal onset gender dysphoria experience resolution or significant reduction of distress by the time they reach adulthood, absent medical or surgical........