Plastic surgeons recommend delaying gender surgery until 19

The American Society of Plastic Surgeons on Tuesday recommended delaying gender-related surgery for those 19 and younger, given low-quality data and emerging concerns about surgical intervention in minors.

The ASPS, which has about 11,000 physician members, recommended that members delay gender-related breast/chest, genital and facial surgery until a patient is at least 19 years old. The group laid out its recommendation in a nine-page position statement on Tuesday.

“In light of recent publications reporting very low/low certainty of evidence regarding mental health outcomes, along with emerging concerns about potential long-term harms and the irreversible nature of surgical interventions in a developmentally vulnerable population, ASPS concludes 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 group’s board wrote in the position statement.

The ASPS statement marks a break from some other U.S. medical groups that have supported such care.

Trump administration health officials supported the ASAP statement on gender dysphoria treatment.

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Health and Human Services Secretary Robert F. Kennedy Jr. said it would help “protect future generations of American children from irreversible harm.”

Centers for Medicare & Medicaid Administrator Dr. Mehmet Oz said medicine must change with science.

“When the medical ethics textbooks of the future are written, they’ll look back on sex-rejecting procedures for minors the way we look back on lobotomies,” he said in a statement.

The ASPS stopped short of issuing full clinical practice guidelines, citing “the current state of the evidence and variability in legal and regulatory environments.”

ASPS also said it was opposed to government criminalization of gender surgery, noting “regulation of medical care is best achieved through professional self-regulation, rather than criminal law or punitive legislative approaches.”

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