transgender care

Physician Group Opposes Youth Gender Transition Surgery— Plastic surgeons support waiting until patients are at least 19 years old

nancyvalko AMA, culture, health care reform, law, media, medical ethics, transgender, transgender care

In a stunning February 3, 2026 Medpage article “Physician Group Opposes Youth Gender Transition Surgery” by Kristina Fiore, Director of Enterprise & Investigative Reporting, MedPage Today reports:

“For the first time, a major U.S. physician group has recommended against gender transition surgeries for youths.

On Tuesday, the American Society of Plastic Surgeons (ASPS) sent a position statement to its 11,000 members recommending against gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.”

and

ASPS said its understanding has evolved in light of “additional comprehensive evidence reviews” on gender dysphoria, including an HHS report that was issued last May. Both the HHS report and the U.K.’s Cass Review concluded that the “natural course of pediatric gender dysphoria remains poorly understood,” according to the position statement.

“The HHS report underscores that this uncertainty has significant ethical implications: when the likelihood of spontaneous resolution is unknown and when irreversible interventions carry known and plausible risks, adhering to the principles of beneficence and non-maleficence … requires a precautionary approach,” the statement said.

ASPS emphasized that its advice comes in the form of a policy statement, not a clinical practice guideline, given the “current state of the evidence and variability in legal and regulatory environments.”

It also advised its members to “remain aware of state laws concerning transgender and gender-diverse individuals that may impact their practices,” as many states have banned gender-affirming care in youths.

The ASPS statement comes just a few days after a jury in New York awarded $2 million to a patient who had accused her psychologist and plastic surgeon of failing to obtain adequate consent before performing a double mastectomy on her when she was a teenager. It’s the first malpractice verdict against providers of youth gender care.” (Emphasis added)

She also writes that:

“The position statement breaks with other major medical associations in the U.S., most notably the American Academy of Pediatrics (AAP) and the Endocrine Society, which support gender-affirming care. It’s also a departure from ASPS’s past stance in 2019, which was that gender surgery can help patients improve their mental health, according to the Washington Post.

The American Medical Association said in a statement that it supports evidence-based treatment, including gender-affirming care. The association agreed with ASPS in part, but stopped short of saying surgeries should be deferred to adulthood in all cases.

“Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement,” the group said in a statement. “In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

However,

“The World Professional Association for Transgender Health (WPATH), which develops standards of care for transgender patients globally, reiterated its support for access to surgical care for minors under “cautious guidelines and criteria.”

The group’s guidelines oppose a “definitive age or ‘one-size-fits-all’ approach for every patient.” Decisions should be case-by-case, based on the evaluations of multiple types of health experts and experts in adolescent development.

“WPATH stands firm in its commitment to advancing evidence-informed clinical guidelines to help improve the lives and well-being of transgender people around the world,” the group said in a statement.

and:

“AAP president Andrew Racine, MD, PhD, said his organization “does not include a blanket recommendation for surgery for minors” with gender dysphoria. “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.”

Fewer than 1,000 children under age 19 receive gender surgery in the U.S. each year, and the vast majority of those cases are mastectomies, according to a 2023 cohort study.

CONCLUSION

As the Medpage article states:

Nonetheless, the Trump administration has been cracking down on gender-affirming care in the U.S., through the HHS report, as well as through proposed CMS rules that would prohibit hospitals from performing gender surgeries for people under 18 as a condition of participation in Medicare and Medicaid programs.

HHS issued a press release supporting the ASPS position statement, with Secretary Robert F. Kennedy Jr. congratulating the group for “standing up to the overmedicalization lobby and defending sound science.”

CMS Administrator Mehmet Oz, MD, also applauded the move: “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. I applaud the American Society of Plastic Surgeons for placing itself on the right side of history by opposing these dangerous, unscientific experiments.”

This will continue to be a hot topic.

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Planned Parenthood’s Expansion into “Transgender Care”

nancyvalko abortion, culture, law, medical, medical ethics, mental health, nursing, Planned Parenthood, transgender care

In August 2023, my home state of Missouri ‘s  law banning gender-affirming medical care for minors  took effect after a legal challenge from civil right advocates. Missouri joined 22 other states with restrictions on “gender-affirming care”. Most, if not all, of these states have exemptions for a “medically verifiable disorder of sex development”.

Now a shocking October 4, 2023 article in the Washington Free Beacon titled “Planned Parenthood is Helping Teenagers Transition After a 30 Minute Consult. Parents and Doctors are Sounding the Alarm” says that “The abortion provider is wading into transgender care, doling out prescriptions for estrogen and testosterone, including to special needs kids.”

The article writes about a teenager diagnosed with autism whose parents were shocked “when, in December 2022, at 17 years old, he announced he was a transgender woman” after his best friend with autism announced he was a transgender woman.

“The parents were “Concerned that this was another phase, but open to the possibility that it wasn’t, Fred’s parents tried to enroll their son, whom they were now calling by a female name at home, in the Gender and Autism Program at Children’s National Hospital, the only gender clinic in the country specializing in autistic youth. Fred was determined to take hormones, they told the clinic, which is known for its lengthy assessments. Before he did, they wanted to be sure his dysphoria wasn’t transient or peer-driven.” There was a waiting list of a year.”

But according to the article “while his parents were out of town and after he had come of age, Fred went to Planned Parenthood, which prescribes hormones to any legal adult without a letter from a therapist or a formal diagnosis of gender dysphoria. The only requirement is a brief consultation, usually with a nurse practitioner, about the drugs’ effects, which range from mood swings and male pattern baldness to permanent infertility.” (Emphasis added)

After a nurse practitioner saw him for a “little over 30 minutes” , the nurse practitioner “prescribed their special-needs son a powerful drug without their knowledge or consent.”

The mother, a New Jersey pediatrician,  told the Beacon that “It’s criminal what Planned Parenthoods all over the country are doing,” “And most people have no idea this is happening.”

The article also quotes the liberal psychologist who helped bring pediatric gender medicine to the US:

“I have always been a very strong supporter of Planned Parenthood and am pro-choice,” said Laura Edwards-Leeper, who co-founded the nation’s first pediatric gender clinic, at Boston Children’s Hospital, in 2007. “But they have taken on something that they are not equipped to handle.” The lack of gatekeeping is so bad, she added, that some of her patients received hormones from Planned Parenthood before coming to her for an assessment.

Others, like Erica Anderson, a former president of the US Professional Association for Transgender Health, say patients they’ve sought to delay from transitioning have simply turned to Planned Parenthood. “I’ve had patients desperate to get hormones where I’ve been the voice of caution,” said Anderson, who is transgender herself. “In some cases, they say, ‘I’ll just go to Planned Parenthood when I’m 18.’ Usually I can dissuade them but sometimes I can’t.”

CONCLUSION

As the article points out:

“Planned Parenthood is one of the largest providers of cross-sex hormones in the United States, and one of the fastest growing. Affiliates in the greater Portland area saw a nearly 400 percent increase in “gender-affirming care visits” between 2021 and 2022, according to their annual reports, while those in Ohio saw a 544 percent increase over the same period. Hormones now appear to be in higher demand than abortion at some branches: A Planned Parenthood in Knoxville, Tenn., told NPR that nearly a fifth of its patients sought hormone therapy in 2021, whereas abortion makes up just 3 percent of Planned Parenthood’s services nationally. (Emphasis added)

This growth has come as pediatric gender clinics, which used to wait months before prescribing hormones, are becoming more laissez faire themselves. Some now prescribe hormones on the first visit, a Reuters investigation found last year, while others say ballooning caseloads have made it harder to conduct the kind of in-depth assessments once standard in the field.”

Now, even the World Professional Association of Transgender Health (WPATH), whose standards of care are among the most aggressive and controversial in the field, says “it is critical to differentiate gender incongruence” from autistic “obsessions” and “rigid thinking.” Though the group does recommend an informed consent standard for people over 18, it also states that its guidelines for minors—which call for “comprehensive” evaluations by experts on autism and other disorders—are “often relevant” to young adults. (Emphasis added

Fred’s parents have now filed a  complaint  with New Jersey’s nursing and medical boards.