The American Society of Plastic Surgeons sent shockwaves through the medical community yesterday when it became the first major medical association to strongly disavow child sex-rejection surgeries.
The ASPS, the world’s largest organization of plastic surgeons, left no uncertainty about its position, recommending that “surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old,” in a <a href="https://www.plasticsurgery.org/documents/health-policy/positions/2026-gender-surgery-children-adolescents.pdf">policy statement</a> on gender surgery for minors, which could have a worldwide impact on the transgender surgical industry.
&#8220;Medical societies shape far more than professional opinion — they set the guardrails for how medicine is practiced, taught, and reimbursed,” Dr. Kurt Miceli, chief medical officer at Do No Harm, told The Daily Wire.
“That’s why the ASPS statement on pediatric medical transition lands with such weight,” Miceli added. “When a leading surgical society acknowledges that the risks of endocrine and surgical interventions outweigh their benefits, it makes clear that the so-called ‘standard of care’ pushed by gender activists is far from established. In fact, the evidence points to the harms of so-called ‘gender-affirming care.’” 
After reviewing the science supporting pediatric gender medicine, ASPS concluded there was “insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents,” according to the statement.
The ASPS statement was published just days after a <a href="https://www.dailywire.com/news/detransitioner-awarded-millions-in-first-malpractice-verdict-this-is-how-it-all-ends">landmark</a> $2 million settlement was awarded to detransitioner Fox Varian, who sued her psychologist and surgeon after receiving a double mastectomy at age 16.    
Several comprehensive evidence reviews, including the Department of Health and Human Services <a href="https://opa.hhs.gov/gender-dysphoria-report">report</a> on the treatment of gender dysphoria, were cited as providing a basis for the ASPS statement, showing a departure from the consensus model adopted by many medical organizations. 
“In the United States, pediatric medical transition has relied heavily on support from medical associations rather than, and against the findings of, systematic reviews of evidence,” Leor Sapir, PhD, a Senior Fellow at the Manhattan Institute, told The Daily Wire. “That consensus was also very thin. It reflected the viewpoints of only a small number of groups that were, in essence, beholden to activists within their ranks.”
The peer-reviewed HHS report on the treatment of gender dysphoria found that pediatric gender medicine puts children at risk of “significant harms” and is supported by deeply flawed science.
“This is the first major medical group to cite the HHS report in a favorable way. The ASPS&#8217;s citation of the HHS report (alongside the Cass Review) is very significant because it suggests that leaders of a doctor organization have read it, engaged with its findings in a serious way, and found it persuasive,” Sapir, who co-authored the HHS report, told The Daily Wire. 
The American Academy of Pediatrics has sharply criticized the HHS report on gender medicine, saying it &#8220;prioritizes opinions over dispassionate reviews of evidence,” in a May 2025 <a href="https://publications.aap.org/aapnews/news/32145/AAP-speaks-out-against-HHS-report-on-gender?autologincheck=redirected">press release</a>.  
As staunch supporters of pediatric gender surgeries, the AAP <a href="https://dailycaller.com/2024/11/20/exclusive-how-small-band-pediatricians-aap-pushed-wpath-age-minimums-sex-changes/">used its influence</a> to persuade the World Professional Association of Transgender Health to abandon the inclusion of lower age limits for sex-rejection surgeries in its transgender medical guidance, the Standards of Care Version 8 (SOC-8), according to an <a href="https://www.supremecourt.gov/DocketPDF/23/23-477/328275/20241015131826340_2024.10.15%20-%20Ala.%20Amicus%20Br.%20iso%20TN%20FINAL.pdf">October 2024 brief</a> submitted to the Supreme Court by Alabama Attorney General Steve Marshall. 
“Days before SOC-8 was to be published, pressure from the American Academy of Pediatrics (AAP) tipped the scales when it threatened to oppose SOC-8 if WPATH did not remove the age minimums,” Marshall wrote in the brief.
“Thanks to the Biden Administration and AAP, SOC-8 does not contain age minimums for any transitioning hormonal or surgical intervention except for one: phalloplasty, the surgical creation of a neopenis,” Marshall wrote.  
The Daily Wire asked the AAP if it supported or opposed the ASPS position statement on pediatric gender surgery, but did not receive a response.   
“It is now time for the Endocrine Society, American Academy of Pediatrics, and others in organized medicine to re-evaluate their clinical practice guidelines and position statements; ASPS has given the house of medicine an opening to end these harmful, unscientific, and dangerous practices on our youth,&#8221; Miceli said.

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Megan Brock

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