AMA and ASPS Recommend Restricting Gender-Affirming Surgeries For Minors
The American Society of Plastic Surgeons cited “insufficient evidence” that the benefits of gender-affirming surgeries on minors outweigh potential harms.
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Note: This article was updated on Feb. 7, 2026
In an adjustment to their prior positions, the American Medical Association (AMA) and the American Society of Plastic Surgeons (ASPS) now recommend that gender-related surgeries be delayed until age 19. The referenced procedures include breast/chest, genital, and facial surgery.
In explaining their rationale for the reversal of previous recommendations, the ASPS stated: “Systematic reviews and evidence reassessments have subsequently identified limitations in study quality, consistency, and follow-up alongside emerging evidence of treatment complications and potential harms.”
ASPS stated that their understanding has evolved – that they’ve become enlightened about potential long-term harm – and pointed to a 2024 article, Plastic and Reconstructive Surgery for individuals with gender dysphoria younger than 26 years, as well as a 2025 HHS report, produced under the auspices of Robert F. Kennedy, Jr., Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices.
The AMA, the nation’s largest organization representing doctors, appears to be taking its cue, in part, from ASPS. In a statement issued on Wednesday, the group said: “Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”
The AMA did not recommend delaying other gender-affirming treatments, such as mental health support, puberty blockers, and hormone therapy.
While AMA and ASPS statements are not clinical guidelines or mandates, they can be expected to carry weight, if previous deference to major medical group opinion is any indication – particularly when used by media and politicians to support a specific stance. The timing of the organizations’ updated positions also aligns with the Trump administration’s efforts to limit gender-affirming care by healthcare providers – efforts aided by threats to withhold federal funding to facilities, and state-level moves to criminalize such care.
Related: House Passes Bill Criminalizing Gender-Affirming Care For Trans Youth
The new statements favoring restriction were celebrated by HHS. “Today marks another victory for biological truth in the Trump administration,” Deputy Health and Human Services Secretary Jim O’Neill said in a statement. “The American Society of Plastic Surgeons has set the scientific and medical standard for all provider groups to follow.”
The American Academy of Pediatrics’ position on gender-related surgery for minors remains unchanged, along with other major medical associations that oppose a ‘one-size-fits-all’ approach and cite caution already undertaken with regard to pediatric surgical care.
“The AAP continues to hold to the principle that patients, their families, and their physicians — not politicians — should be the ones to make decisions together about what care is best for them,” the organization said in an issued statement.
The World Professional Association for Transgender Health, which develops care standards for transgender patients globally, reaffirmed its position that minors should have access to surgical care under “cautious guidelines and criteria.”
These announcements come on the heels of last week’s legal first, when a New York jury awarded a woman $2 million in damages after finding her medical providers liable for malpractice related to a double mastectomy she received as a teenager. She later regretted the decision, said that she had not been adequately counseled, and claimed that the surgery left her disfigured.
It should be noted, as previously reported by GO: Research points to little incidence of gender-affirming surgeries (GAS) among children. Some data published by notable medical journals also fails to distinguish between 12-year-olds and 18-year-olds, the latter of whom are legal adults.
JAMA published research in 2023 that looked at 48,019 patients who underwent GAS between 2016 to 2020; of those, 3,678 (7.7%) were aged 12 to18 years of age. This included facial and cosmetic procedures such as hair removal or transplantation, liposuction, and collagen injections – routines not unknown to many straight and CIS teenagers. The researchers do not appear to distinguish between 12-year-olds and 18-year-olds, children still developing versus physically mature adults.
The title of one study by Harvard T.H. Chan School of Public Health (2024) speaks to the findings: “Gender-Affirming Surgeries Rarely Performed on Transgender Youth.” Harvard researchers “found little to no utilization of gender-affirming surgeries by transgender and gender-diverse (TGD) minors in the U.S. The study also found that cisgender minors and adults had substantially higher utilization of analogous gender-affirming surgeries than their TGD counterparts.”
