The American Society of Plastic Surgeons (ASPS) became the first major medical organization to oppose gender transition surgeries for minors, recommending that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old. ASPS represents more than 11,000 physician members worldwide. The organization cited “recent publications reporting very low/low certainty of evidence regarding mental health outcomes,” “emerging concerns about potential long-term harms and the irreversible nature of surgical interventions,” and “insufficient evidence demonstrating a favorable risk-benefit ratio.”
ASPS previously supported gender-transition surgeries for minors alongside other mainstream medical organizations, but moderated its stance in August 2024, when it communicated that the Society had not endorsed any external organization’s clinical practice guidelines for treating children or adolescents with gender dysphoria. In its statement, ASPS noted “considerable uncertainty” over such treatments. Since then, the organization’s understanding evolved in light of additional comprehensive evidence reviews, including the United Kingdom’s Cass Review and the 2025 review by the Trump administration’s Department of Health and Human Services.
Evidence and Recommendations
The statement emphasized that available evidence suggests a substantial proportion of children with prepubertal onset gender dysphoria experience resolution or significant reduction of distress by adulthood, absent medical or surgical intervention. Evidence regarding adolescent-onset presentation is more limited but similarly does not allow confident prediction of long-term trajectories. Importantly, clinicians currently lack reliable methods to distinguish those whose distress will persist from those whose distress will remit. The statement noted that when likelihood of spontaneous resolution is unknown and when irreversible interventions carry known and plausible risks, adhering to principles of beneficence and non-maleficence requires a precautionary approach. ASPS committed to ongoing review of emerging evidence, pledging to revisit its position as higher-quality data become available. Should the evidence base evolve to demonstrate clear benefit with acceptable risk, the organization stated it will reassess its recommendations accordingly.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.dailysignal.com/2026/02/05/american-society-of-plastic-surgeons-recommends-against-transgender-surgery-for-minors/