Medical Group Does a U-Turn on Gender-Affirming Surgery

A major medical group for plastic surgeons is urging a pause on gender-affirming surgeries for minors, putting it at odds with much of the US medical establishment and squarely in the middle of a heated political fight. The American Society of Plastic Surgeons on Tuesday advised its 11,000 members not to perform gender-transition surgeries until patients are at least 19, citing what it called weak data on long-term outcomes and "emerging evidence" of complications and possible harms, per the New York Times. It's the first major medical group in the country to issue such guidance, notes the Washington Post.

Most major medical associations in the US continue to support a spectrum of care for transgender adolescents, including puberty blockers, hormones, and, in limited cases, surgery. The ASPS move drew swift praise from the Trump administration, which has moved to cut federal funding for hospitals treating transgender youth and backed state-level restrictions. Deputy health secretary Jim O'Neill called the society's shift "another victory for biological truth." The Society for Evidence-Based Gender Medicine also applauded the move as a "watershed moment in US medicine," per STAT News.

The Supreme Court last year allowed Tennessee's ban on certain treatments for transgender minors to stand, and more than 20 states now restrict such care. Other countries including Finland, Norway, and Britain have also tightened rules. Kinnon Ross MacKinnon, a York University researcher who studies transgender medicine, said the society's stance reflects both political pressure and rising liability concerns, especially after a New York jury recently awarded damages to a woman who said a teen mastectomy left her disfigured.

The plastic surgeons' group, which as recently as 2019 publicly defended such surgeries as potentially beneficial for "overall mental health and well-being," now says doctors must assume responsibility for irreversible procedures on adolescents and "adopt a posture of heightened caution," emphasizing uncertainty, alternatives, and the possibility that a young person's identity or distress may change over time. The group noted this is "professional guidance," not a clinical practice guideline.