Plastic surgeons group calls for delaying gender-affirming surgery until
age 19
[February 05, 2026]
By DEVI SHASTRI
The nation's largest professional organization for plastic surgeons
recommended that gender-affirming surgeries be delayed until patients
turn 19, changing the group's stance on the politically charged issue
and diverging from several other major medical organizations' guidance.
The American Society of Plastic Surgeons said Tuesday that it found
“insufficient evidence” that the benefits of chest, genital and facial
surgeries on minors experiencing gender dysphoria outweigh the risks. It
leaned on two recent and heavily debated publications on the topic, the
Cass Review by a senior doctor in England and a 2025 report issued by
the U.S. Department of Health and Human Services.
“This position statement doesn't seek to deny or minimize the reality of
any patient's distress, and it does not question the authenticity of any
patient's experience,” the position statement reads. “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 statement is not a clinical guideline, the document notes. The
society also did not do an independent evidence assessment or take other
steps that would be involved in setting new care guidelines.
Other medical groups stand by their guidance
The shift comes as President Donald Trump's administration pressures
health care providers to limit or stop gender-affirming care for
transgender people, particularly children.
“Today marks another victory for biological truth in the Trump
administration,” Deputy Health and Human Services Secretary Jim O’Neill
said in a statement. “The American Society of Plastic Surgeons has set
the scientific and medical standard for all provider groups to follow.”
Other major medical associations stood their ground, noting current
guidelines already call for caution around surgery for minors.
Gender-affirming surgery is rare among U.S. children, research shows.
And fewer than 1 in 1,000 U.S. adolescents receive gender-affirming
medications.
The American Academy of Pediatrics “does not include a blanket
recommendation for surgery for minors” with gender dysphoria, said its
president, Dr. Andrew Racine. “The AAP continues to hold to the
principle that patients, their families, and their physicians — not
politicians — should be the ones to make decisions together about what
care is best for them.”
The World Professional Association for Transgender Health, which
develops standards of care for transgender patients globally, reiterated
its support for access to surgical care for minors under “cautious
guidelines and criteria.”
The group's guidelines oppose a “definitive age or ‘one-size-fits-all’
approach for every patient." Decisions should be case-by-case, based on
the evaluations of multiple types of health experts and experts in
adolescent development.
“WPATH stands firm in its commitment to advancing evidence-informed
clinical guidelines to help improve the lives and well-being of
transgender people around the world,” the group said in a statement.
[to top of second column]
|
Late Wednesday, the American Medical Association said it supports
evidence-based treatment, including gender-affirming care. The
association agreed with the surgeons' society in part, but stopped short
of saying surgeries should be deferred to adulthood in all cases.
“Currently, the evidence for gender-affirming surgical intervention in
minors is insufficient for us to make a definitive statement,” the group
said in a statement. "In the absence of clear evidence, the AMA agrees
with ASPS that surgical interventions in minors should be generally
deferred to adulthood.”
Hospitals halt gender-affirming care for kids
Gender-affirming care for transgender youth under standards widely used
in the U.S. entails developing a plan with medical experts and family
members that includes supportive talk therapy and can — but does not
always — involve puberty blockers or hormone treatment. Many U.S.
adolescents with gender dysphoria may decide not to proceed with
medications or surgeries.
Still, the Trump administration moved in December to cut off
gender-affirming care for minors, prompting a third of states to sue. It
was the latest in a series of clashes between an administration that
says transgender health care can be harmful to children and advocates
who say it's medically necessary.
Under pressure from the administration, hospitals across the country
have suspended gender-affirming care for minors, most recently
Children's Minnesota, which plans to pause prescribing
puberty-suppressing medications and hormones for patients under age 18
citing federal “threats.”
“This is not the decision we wanted to make," the health system said in
a statement. "This is the decision we had to make to protect our
hospital and our providers. We stand firmly behind the fact that
gender-affirming care is evidence-based, safe and lifesaving.”
The plastic surgeons group also acknowledged that “variability in
regulatory and legal environments” played a role in the decision to
issue a statement, saying the lack of evidence on the benefits of
gender-affirming care means “surgical decision-making carries heightened
ethical, clinical and legal risk.”
Dr. Scot Glasberg, who helped develop the statement, said deliberations
over the language started in 2024 and were not politically influenced,
despite the issue being highly charged.
“This was an iterative process that took time, with no outside
pressure," said Glasberg, a past president of the surgeons group. "We
understand there will be different opinions about it and we respect
those opinions.”
___
The Associated Press Health and Science Department receives support from
the Howard Hughes Medical Institute’s Department of Science Education
and the Robert Wood Johnson Foundation. The AP is solely responsible for
all content.
All contents © copyright 2026 Associated Press. All rights reserved |
