One of the nation’s most influential surgical organizations has formally broken with years of medical orthodoxy by declaring that gender transition surgeries for minors should not be performed, citing weak evidence, irreversible harm, and unanswered questions about long-term outcomes.
The American Society of Plastic Surgeons, which represents more than 11,000 plastic surgeons nationwide, announced last week that gender-related surgeries for children and adolescents should be deferred until adulthood. The group concluded that existing research does not establish that the benefits of such procedures outweigh the risks for patients under 18.
In its statement, the society warned that surgeries involving the removal of healthy breasts or the alteration of genital anatomy are irreversible interventions performed on a population that is still physically and psychologically developing. The organization emphasized that evidence supporting improved mental health outcomes for minors remains low quality and limited in duration.
The new position follows a growing body of evidence reviews questioning the safety and efficacy of so-called “gender-affirming” surgeries for minors, including a 2025 report from the U.S. Department of Health and Human Services that found little reliable evidence supporting such procedures. Federal officials at the time said psychotherapy, not surgery, should be the preferred approach for children experiencing gender distress.
That report noted that a significant number of children who experience gender dysphoria see symptoms resolve over time without medical or surgical intervention, reinforcing the need for what it described as a precautionary approach. The American Society of Plastic Surgeons cited those findings in announcing its updated position Tuesday.
The American Medical Association (AMA) followed with its own statement acknowledging the lack of reliable long-term data supporting gender surgeries for minors and signaling agreement that such procedures should generally be delayed until adulthood. While the AMA continues to support care for transgender adults, it conceded that evidence surrounding surgical intervention in children does not meet traditional standards for safety and efficacy.
“The evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement,” the AMA told news outlets.
For years, the AMA had defended pediatric gender transition practices and criticized federal and state efforts to restrict them. The organization previously framed opposition to these procedures as ideologically motivated or discriminatory. Its latest statement, however, reflects growing recognition that the medical evidence does not support irreversible surgical intervention in minors.
The American Academy of Pediatrics and other advocacy-oriented medical groups have continued to support individualized treatment decisions. Still, critics argue that those positions rely on evidence beyond rigorous clinical trials.
The plastic surgeons’ statement does not address hormone therapy or puberty blockers, focusing instead on surgical interventions that permanently alter healthy tissue. Still, the implications are substantial. Plastic surgeons are the physicians who perform these operations, and their assessment directly challenges the narrative that pediatric gender surgeries are settled science.
Advocates of restricting such procedures argue the issue is not one of civil rights, but of medical ethics. Children, they note, are categorically barred from consenting to many elective or irreversible procedures precisely because of their limited capacity to understand long-term consequences.
The new position also undermines claims that opposing pediatric gender surgery is discriminatory. Age-based medical standards are routine across medicine and exist to protect minors from harm, not to deny care based on identity.
The statements from the nation’s leading physician organizations suggest that the medical establishment is beginning to reckon with the consequences of a decade-long experiment carried out on children.
