ARLINGTON HEIGHTS, Ill. (BP) – The American Society of Plastic Surgeons has issued a statement recommending its members delay gender-reassignment surgeries for patients until the age of 19.
The statement cited adolescents’ developing emotional and mental states, juxtaposed with the permanence of such surgeries, for a “low certainty” that transitioning at that age brought “a favorable risk-benefit ratio.”
The position was approved by the board of directors for the ASPS and its research arm, the Plastic Surgery Foundation, on Jan. 23 and published on Feb. 3.
“The natural course of pediatric gender dysphoria remains poorly understood,” it read. “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 intervention.”
In August 2024, the group communicated the “considerable uncertainty” of gender assignment surgeries among adolescents with gender dysphoria.
The ASPS was the first major medical group to publicly oppose gender transitioning medical treatments for minors. It appears the American Medical Association may be poised to follow suit.
“The evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement …,” the AMA said in a statement to National Review Feb. 3. Therefore, “the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”
Last November, the Department of Health and Human Services produced a report that reviewed the evidence and best practices for treating pediatric gender dysphoria. The ASPS cited that study amid the “significant ethical implications” of gender assignment surgery for children.
“When the likelihood of spontaneous resolution is unknown and when irreversible interventions carry known and plausible risks, adhering to the principles of beneficence and non-maleficence (i.e., promoting health and well-being while avoiding harm) requires a precautionary approach,” said the ASPS statement.
“We commend the American Society of Plastic Surgeons for standing up to the overmedicalization lobby and defending sound science,” HHS Secretary Robert F. Kennedy, Jr. said. “By taking this stand, they are helping protect future generations of American children from irreversible harm.”
Katy Roberts, public policy manager for the Southern Baptist Ethics & Religious Liberty Commission, called the ASPS statement “a pleasant and welcome surprise” that reflects both peer-reviewed research and public sentiment on the ethics of subjecting children “to irreparable harm.”
“Public positions like this from the American medical community also prove the effectiveness of consistent advocacy efforts,” said Roberts. “The ASPS statement comes on the heels of persistent action by coalition groups as well as recent rulemaking by the Department of Health and Human Services that would bar hospitals that offer ‘gender transition’ drugs and procedures from federal funding. The ERLC has been resolute in amplifying Southern Baptists’ vehement objections to these types of dangerous procedures that harm children.
“HHS’s celebration of ASPS’ announcement is significant and deeply appreciated. It serves as an important signal that the Trump administration is committed to protecting vulnerable children from radical gender ideology.”
Gender-assignment procedures, which include options such as puberty blockers, tripled from 2016 to 2019, according to a joint study by Columbia University and the University of Southern California, from 4,552 to 13,011. COVID restrictions in 2020 led to a slight dip to 12,818. From those figures, 3,678 surgeries occurred from 2016 to 2020, with 87.4 percent being breast and chest surgeries and genital surgeries accounting for 11 percent.
A landmark Supreme Court ruling last year, United States v. Skrmetti, ruled that state laws banning gender transition medical treatments is constitutional, thus providing legal standing for Tennessee and some 25 other states with similar statutes.
The ASPS stated that its position does not “deny or minimize” a patient’s experience as to their gender.
“Instead, ASPS affirms that truly humane, ethical, and just care, particularly for children and adolescents, must balance compassion with scientific rigor, developmental considerations, and concern for long-term welfare,” the group said.
The ASPS was also clear in its wording that the release is a position statement for members, not a clinical practice guideline. Even so, it urged them to be mindful of their shared responsibility for determining if patients are capable of understanding the long-term implications of such surgeries.
“This includes assessing whether the adolescent patient can meaningfully engage with information about uncertainty, alternative approaches, and the possibility that distress or perceived identity may evolve over time,” it read, further encouraging members to recognize “that their role is not simply technical but ethical.”
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