Two major medical organizations have withdrawn support for surgical interventions for transgender youth following successful medical malpractice lawsuits by transgender people.
The American Society of Plastic Surgeons (ASPS), which represents more than 11,000 plastic surgeons in the United States, reported that it has instructed its members to postpone transition-related chest, genital, and facial surgeries until patients are at least 19 years old. washington post.
According to a study published today, fewer than 1,000 minors in the United States undergo surgery for gender dysphoria each year. Japan Automobile Manufacturers AssociationAnd the vast majority of those surgeries are mastectomies, or “top surgeries,” rather than genital surgeries, or “bottom surgeries.”
Much of the debate surrounding transgender youth centers on when they should receive medical intervention, amid controversy over the strength of supporting evidence.
ASPS’ recommendations are significant because they represent a continuing shift in the organization’s thinking regarding gender-affirming care and become the first major medical organization to explicitly oppose transition-related surgeries on minors.
In 2019, ASPS opposed state efforts to restrict gender-affirming care for minors, arguing that plastic surgery can improve patients’ mental health and well-being. But five years later, in August 2024, the organization announced it was developing new guidance, saying there was “substantial uncertainty” about the long-term benefits of breast and genital surgery for minors.
New guidance approved by the ASPS board last month says there is “insufficient evidence to demonstrate a favorable risk-benefit ratio” for gender-related endocrine and surgical interventions in children and adolescents.
Under the new guidance, surgeons will need to determine whether the minor is able to understand the irreversibility and long-term effects of the surgery and meaningfully engage with uncertainty, alternative approaches, and the potential for distress and “the potential for perceived identity to change over time.”
The document goes on to say there is “substantial uncertainty” about the long-term benefits of hormones and puberty blockers, but stops short of recommending their availability.
said Scottish Bradley Glassberg, a former ASPS president who participated in the discussion but did not vote on the guidance. post This recommendation was based on a review that examined the medical evidence for gender-affirming care.
Glassberg cited three systematic reviews by researchers at Canada’s McMaster University and cited their findings. limited evidence The effects of puberty blockers and hormone therapy, Cass reviewa 2024 UK report stated that the evidence supporting hormonal interventions in minors was “remarkably weak”.
The U.S. Department of Health and Human Services has released a similar report, ruling out hormone therapy and surgical intervention and recommending “exploratory psychotherapy,” a conclusion critics say is politically driven and designed with a predetermined end result in mind.
Glassberg said that while none of the reviews examined surgical outcomes in detail, the lack of widespread evidence prompted ASPS to revise its position, even if it meant “going in a different direction than other organizations.”
He also said he is starting to perform more surgeries for people seeking reversal of gender-affirming surgical interventions.
The ASPS changes coincide with a New York jury’s decision to award $2 million to a transitioning woman who underwent a double mastectomy at age 16 and then claimed that she and her mother were pressured by a psychologist and surgeon to agree to the surgery.
Since ASPS announced its position, the American Medical Association has also taken a more cautious stance on surgical intervention, although it had previously recommended it primarily for adults but acknowledged cases in adolescents on a case-by-case basis.
The ASPS and AMA’s change in policy comes amid a broader policy landscape that bans doctors from performing sex reassignment surgeries on minors in 27 states and Puerto Rico, and the Trump administration is proposing regulations that would strip federal funding from health care providers who provide such procedures to patients under 19.
Other medical institutions have not withdrawn their opposition to the total ban. The American Academy of Pediatrics says treatment decisions should be made by patients, families, and doctors, while the World Professional Association for Transgender Health continues to support the procedure in limited circumstances, with incoming president Lauren Schechter saying, “The answer lies somewhere in the middle.”
Source: Metro Weekly – www.metroweekly.com
