On February 3, the American Society of Plastic Surgeons released a statement officially recommending that surgery for gender-affirming care be postponed until patients reach the age of 19.
The organization says they found “insufficient evidence” in the cast of chest, genital, or facial surgery on minors having significant benefits. They argue that the risks outweigh the mental benefits.
The official claim is that the recommendation “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,” rather they affirm “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 society did not do any independent research of evidence analysis, and they did not provide new guidelines for care.
The problem with this recommendation is timing. It comes after the Trump administration put pressure on providers in the healthcare industry to reduce or stop all types of gender-affirming care for transgender people, with a heavy emphasis on transgender minors.
Jim O’Neill, the Deputy Health and Human Services Secretary, says that the ASPS’s statement is a “victory for biological truth in the Trump administration.” O’Neill has no training in medicine, or health care, holding degrees in humanities.
When it comes to gender-affirming care, a singular approach does not work at an individual level. Each case is different, and should be handled as such. Hospitals across the U.S. are pausing gender-affirming care, citing federal “threats” to cut millions dollars of funding. The federal government has taken distinct action to pressure and influence the suspension of gender-affirming care. A number of state governments stand with the federal branch in this stripping of rights.
Many groups agree with the ASPS’s statement that gender-affirming surgery does not always outweigh the risks. But the majority—including the American Academy of Pediatrics—say that the decision ultimately lies with the patients and their families and physicians, no one else.

