The American Society of Plastic Surgeons (ASPS) has issued a position statement urging surgeons to refrain from performing “breast/chest, genital, and facial gender surgery” on individuals under the age of 19. The statement cites evidence indicating that sex-rejecting procedures lack sufficient scientific support for minors, emphasizing the absence of a favorable risk-benefit ratio for such interventions in children and adolescents.

The Department of Health and Human Services (HHS) endorsed the recommendation, noting ASPS’s alignment with its 2025 review of pediatric gender dysphoria treatment protocols. HHS stated that the evidence base for sex-rejecting procedures is “low quality/low certainty” and that medical interventions for minors may not be necessary given natural resolution patterns in most cases.

ASPS clarified that while its statement addresses hormonal therapies, it specifically targets surgical interventions, advising delays until age 19. The organization highlighted that a substantial proportion of children with prepubertal gender dysphoria experience distress reduction without medical or surgical intervention, and adolescent cases—increasing since the mid-2010s—show similar outcomes without procedures.

The position statement directly references HHS’s conclusion that pediatric gender-affirming care protocols have undergone “rapid expansion and implementation” lacking adequate scientific or ethical justification. ASPS became the first major U.S. medical association to oppose gender transition surgeries for minors, citing the need to prioritize patient safety over unproven interventions.

HHS Secretary Robert F. Kennedy Jr. praised ASPS for “standing up to the overmedicalization lobby,” while Deputy HHS Secretary Jim O’Neill described the move as “another victory for biological truth.” Centers for Medicare & Medicaid Administrator Mehmet Oz, MD, added that future medical ethics texts would “look back on sex-rejecting procedures for minors the way we look back on lobotomies.”

ASPS, founded in 1931 and representing over 11,000 physicians, emphasized that untreated gender dysphoria typically resolves in children and adolescents, reinforcing ethical obligations to protect patients’ health over premature interventions. The statement underscores that adolescent autonomy does not compel medical professionals to provide procedures unsupported by evidence.