Plastic surgeons group calls for delaying gender-affirming surgery until age 19

The nation's largest professional organization for plastic surgeons recommended that gender-transitioning surgeries be delayed until patients turn 19, changing the group's stance on the politically charged issue and diverging from several other major medical organizations' guidance.

The American Society of Plastic Surgeons said Tuesday that it found “insufficient evidence” that the benefits of chest, genital, and facial surgeries on minors experiencing gender dysphoria outweigh the risks. It leaned on two recent and heavily debated publications on the topic, the Cass Review by a senior doctor in England and a 2025 report issued by the U.S. Department of Health and Human Services.

“This position statement doesn't seek to deny or minimize the reality of any patient's distress, and it does not question the authenticity of any patient's experience,” the position statement reads. “Instead, ASPS affirms that truly humane, ethical, and just care, particularly for children and adolescents, must balance compassion with scientific rigor, developmental considerations, and concern for long-term welfare.”

The statement is not a clinical guideline, the document notes. The society also did not do an independent evidence assessment or take other steps that would be involved in setting new treatment guidelines.

“Today marks another victory for biological truth in the Trump administration,” Deputy Health and Human Services Secretary Jim O’Neill said in a statement. “The American Society of Plastic Surgeons has set the scientific and medical standard for all provider groups to follow.”

Gender-transitioning treatment for youth who identify as transgender under standards widely used in the U.S. entails developing a plan with medical experts and family members that includes supportive talk therapy and can involve puberty blockers or hormone treatment. Many U.S. adolescents with gender dysphoria may decide not to proceed with medications or surgeries.

The Trump administration moved in December to cut off gender-transitioning treatment for minors, prompting a third of states to sue. Hospitals across the country have suspended gender-transitioning treatment for minors.

The plastic surgeons group also acknowledged that “variability in regulatory and legal environments” played a role in the decision to issue a statement, saying the lack of evidence on the benefits of gender-transitioning treatment means “surgical decision-making carries heightened ethical, clinical and legal risk.”

Dr. Scot Glasberg, who helped develop the statement, said deliberations over the language started in 2024 and were not politically influenced, despite the issue being highly charged.

“This was an iterative process that took time, with no outside pressure," said Glasberg, a past president of the surgeons group. "We understand there will be different opinions about it, and we respect those opinions.”