By Christy Santhosh
Feb 3 (Reuters) – The American Society of Plastic Surgeons issued a statement on Tuesday recommending surgeons delay gender-related breast or chest, genital and facial surgery until a patient is at least 19 years of age, citing a lack of evidence supporting the procedure’s benefits.
The ASPS, which represents more than 11,000 physicians in cosmetic and reconstructive plastic surgery, said there is currently insufficient evidence showing a favorable risk-benefit ratio for gender-related surgeries in children and adolescents.
According to ASPS, there is low certainty of evidence regarding mental health outcomes, along with emerging concerns about potential long-term harms and the irreversible nature of surgeries in a developmentally vulnerable population.
The association noted this position reflects recent policy shifts in countries such as the UK, Sweden, and Finland, which have also moved toward more restrictive or research-only models for minors.
Health Secretary Robert F. Kennedy, Jr. commended ASPS and said the organization was “standing up to the overmedicalization lobby and defending sound science”.
The American Medical Association in a statement said evidence on gender-affirming surgical intervention in minors remains insufficient, and agreed with the ASPS that such procedures should generally be deferred to adulthood.
In December, the U.S. Department of Health and Human Services moved to cut children’s access to gender-affirming care when it proposed rules barring hospitals that deliver such care from Medicare and Medicaid programs, and prohibiting Medicaid and the Children’s Health Insurance Program from paying for it.
Major medical organizations, including the World Health Organization, American Academy of Pediatrics and American Medical Association, have formally opposed the rules, stating they interfere with the patient-physician relationship and ignore established clinical evidence.
Many children’s hospitals and gender clinics already require patients to be adults before undergoing surgeries, which are considered the final step in gender-affirming care and are rare in those under 18, due to their irreversible nature and higher risk of complications.
(Reporting by Christy Santhosh and Siddhi Mahatole in Bengaluru and Julie Steenhuysen in Chicago; Editing by Vijay Kishore)
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