American Society of Plastic Surgeons Recommends No Gender Surgery for Minors

ARLINGTON HEIGHTS, IL – This week, the American Society of Plastic Surgeons (ASPS) became the first major U.S. medical organization to formally recommend not performing mutilating gender procedures on children. Rather, the 11,000-member ASPS recommended delaying breast, chest, genital, and facial surgeries related to gender confusion until age 19 or older admitting the evidence for any benefit is “low-certainty” and “insufficient” to outweigh the risks.

In its February 3 statement, the ASPS repeatedly cited the United Kingdom’s 2024 Cass Review and the 2025 pediatric gender study from the U.S. Department of Health and Human Services (HHS).

“In some areas,” the statement reads, these reviews “have contributed to a clearer understanding of potential harms, while also highlighting limitations of the available evidence, including gaps in documenting long-term physical, psychological, and psychosocial outcomes.”

The ASPS went on to admit that “a substantial proportion of children” with gender confusion will grow out of it “by the time they reach adulthood, absent medical or surgical intervention.” The statement noted that even clinicians with “extensive experience” lack reliable methods to know when gender distress will persist or remit, and that when it comes to “irreversible interventions” it is best to take a “precautionary approach.”

The ASPS also questioned the framework of treating children based on their “values and preferences” which focus on “aesthetic effects” rather than “avoiding potential harm” from suppressing puberty.

The autonomy of patients to accept or refuse gender interventions “does not create an obligation for a physician to provide [those] interventions in the absence of a favorable risk–benefit profile, particularly in adolescent populations where decision-making capabilities are still developing,” wrote ASPS.

Yet, despite the lack of evidence, ASPS still clung to its prior position in some areas stating these surgical interventions for minors are “typically justified” regarding mental health outcomes, but can be hard to measure when multiple interventions are taking place. While the ASPS committed to an “ongoing review of emerging evidence,” the association indicated it would support child medical mutilation if future evidence warranted such a position.

“Should the evidence base evolve to demonstrate clear benefit with acceptable risk, ASPS will reassess its recommendations accordingly,” reads the statement.

The American Medical Association (AMA), which has long favored gender interventions on children, recently stated, “the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

The ASPS statement followed several days after a New York jury found a plastic surgeon and a psychologist liable for malpractice regarding the breast removal surgery on a 16-year-old girl named Varian. On January 30, 2026, the jury in Westchester County awarded Varian $2 million in damages for past and future suffering and future medical expenses from her double mastectomy. Varian is now 22 and no longer suffers from gender confusion. The jury found that the plastic surgeon and psychologist departed from the standard of care by skipping important steps in pre-surgery evaluations.

In recent weeks, several hospitals around the United States have announced they are halting gender-related child medical mutilation as a result of the HHS proposing a withholding of federal Medicare and Medicaid funding for hospitals that conduct such procedures. Since January 2026, hospitals that formally discontinued gender interventions include:

• Rady Children’s Hospital, San Diego, CA
• MultiCare’s Mary Bridge Children’s Hospital, Tacoma, WA
• Children’s Wisconsin, Milwaukee, WI
• University of Wisconsin Health, Madison, WI
• Children’s Hospital Colorado and Denver Health, Denver, CO
• Children’s Minnesota (effective February 27, 2026), Minneapolis, MN
• University of Utah Health, Salt Lake City, UT

According to Do No Harm, a group of medical professionals who oppose divisive ideologies, at least dozens of other hospitals have also stopped administering gender interventions since President Trump issued his January 2025 executive order “Protecting Children From Chemical And Surgical Mutilation.”

Liberty Counsel Founder and Chairman Mat Staver said, “There is no justification for irreversibly mutilating children. While it is good to see the medical community beginning to halt these barbaric practices, they aren’t stopping solely because the science doesn’t support them, rather they are facing loss of federal funding and the potential for costly malpractice lawsuits. It is impossible for people to change their birth sex. The medical community needs to acknowledge this reality and return to their Hippocratic Oath of ‘do no harm,’ and to treat mental health issues with counseling rather than mutilation.”

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