The American Society of Plastic Surgeons (ASPS) has issued a new recommendation advising doctors to postpone gender-affirming surgeries for minors, calling for such procedures to be delayed until patients reach at least 19 years of age. This update reflects ongoing debate and scrutiny over medical care for transgender youth in the United States.
Dr. Bob Basu, president of the ASPS, stated that after a careful review of current evidence, the organization decided it could no longer support performing gender-related surgeries on adolescents. Basu emphasized the “irreversible nature” of these procedures and highlighted uncertainties over long-term outcomes and safety for minors. The ASPS position aims to provide professional guidance for surgeons, helping them navigate ethical decisions and informed consent related to treating minors seeking gender-affirming care.
The policy change comes during a period of rising legal and political opposition to gender-affirming care for minors across the country. In recent months, a series of state bans have been enacted, and the federal government has signaled strong opposition to medical and surgical interventions for transgender youth. One significant development was an executive order from the White House that bars federal support for gender transition procedures involving children. Further, health agencies have warned hospitals about potential penalties or loss of federal funding if they provide these services to minors.
The ASPS acknowledged that its new stance is not a sharp reversal of existing policy but rather a reflection of evolving evidence and the complex, variable legal environment. The organization noted that these recommendations align with age guidelines for other types of plastic surgery, where waiting until adulthood is generally advised for cosmetic procedures as well.
Some medical associations, including the American Medical Association and the American Academy of Pediatrics, expressed that they continue to support evidence-based gender-affirming care. However, they often note that surgical interventions should “generally” be reserved for adulthood. Families affected by these changes have expressed a range of emotions, from frustration and disappointment to relief that patient safety is at the forefront of the discussion. Meanwhile, access to gender-affirming surgery for transgender minors is becoming increasingly restricted, with fewer hospitals and clinics offering these procedures.
