Plastic Surgeons Recommend Delaying Gender-Affirming Surgery for Minors

The American Society of Plastic Surgeons (ASPS), the largest professional group for plastic surgeons, has recommended waiting until individuals reach 19 years of age before undergoing gender-affirming surgeries. This change in stance on the contentious issue cites “insufficient evidence” that chest, genital, and facial surgeries for minors with gender dysphoria outweigh associated risks.

The ASPS based its decision on two major studies: the Cass Review by a senior doctor in England and a 2025 report from the Department of Health and Human Services. The organization emphasized the importance of balancing compassion with scientific rigor, developmental considerations, and concern for long-term welfare. The statement clarified that this is not a clinical guideline, highlighting that ASPS did not independently assess evidence or establish new care protocols.

While some political figures, such as Deputy Health and Human Services Secretary Jim O’Neill, lauded the move as a “victory for biological truth,” other medical organizations expressed a more cautious approach. The American Medical Association (AMA) concurred partially with the ASPS, acknowledging insufficient evidence for supporting gender-affirming surgery in minors but not definitively advising deferral of such surgeries to adulthood.

The American Academy of Pediatrics (AAP) maintains that decisions regarding gender-affirming care should be made by patients, families, and doctors. Dr. Andrew Racine, AAP’s president, emphasized this principle. Similarly, the World Professional Association for Transgender Health supported access for minors under strict criteria, avoiding blanket age or uniform recommendations.

Despite the ASPS’s stance, it acknowledged the variability of legal and regulatory contexts influencing their statement. Such uncertainty positions surgical decision-making at greater legal, ethical, and clinical risk.

The recent decision comes amid healthcare and political controversy, with the Trump administration pressuring healthcare providers to limit gender-affirming care for minors, leading some hospitals to pause services for children due to federal threats. Hospitals like Children’s Minnesota expressed disappointment, underscoring the importance of gender-affirming care as evidence-based, safe, and lifesaving.

Dr. Scot Glasberg, instrumental in forming ASPS’s statement, clarified that this recommendation was a result of an unbiased, deliberate process initiated before 2024. Despite differing opinions on this significant statement, the ASPS respects the diversity of views on the matter.