The American Society of Plastic Surgeons has reversed its position on gender-affirming care for minors, now urging delays in surgical procedures until patients reach age 19 and warning of irreversible risks associated with early interventions.
Founded in 1931 and representing over 11,000 physicians, the ASPS previously endorsed plastic surgery as a means to help children align their bodies with their gender identity. However, in its latest policy statement, the group stated that “there is insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.”
The statement referenced international reviews, including the UK’s 388-page Cass Review and the U.S. Department of Health and Human Services’ 410-page 2025 report on pediatric gender dysphoria treatment. These documents highlighted significant gaps in evidence, potential harms, and the fact that many children experience resolution or reduced distress without medical procedures.
The ASPS noted that “a substantial proportion of children with prepubertal onset gender dysphoria experience resolution or significant reduction of distress by adulthood,” and recommended delaying breast/chest, genital, and facial surgery until age 19. It also called for heightened ethical scrutiny in practice, requiring plastic surgeons to provide explicit uncertainty disclosures.
This policy shift follows the first medical malpractice lawsuit victory for a detransitioner who was awarded $2 million after regretting gender-affirming surgeries she underwent as a minor. Dr. Miriam Grossman, author of “Lost in Trans Nation,” stated that such cases could deter surgeons from performing irreversible procedures on young patients.
HHS Secretary Robert F. Kennedy Jr. praised the ASPS decision, calling it “a stand against overmedicalization.” Dr. Stanley Goldfarb of Do No Harm noted the group has become “the first major medical organization to support evidence-based medicine and reject harmful procedures.”
The American Society of Plastic Surgeons previously claimed in 2019 that it firmly believed plastic surgery services could help gender dysphoria patients align their bodies with whom they know themselves to be and improve their overall mental health.
