The American Society of Plastic Surgeons is the first major medical body to oppose gender treatments for children.

A statement sent Tuesday to the group’s 11,000 members and obtained by The Washington Post recommends surgeons delay gender-related chest, genital and facial surgery until a patient is at least 19 years old. Fewer than 1,000 minors in the United States receive such surgeries every year, according to research published in JAMA, the American Medical Association’s journal, and the vast majority of the procedures are mastectomies, not genital surgeries.

This is a turn around from 2019 when the peak body recommended that “plastic surgery services can help gender dysphoria patients align their bodies with whom they know themselves to be and improve their overall mental health and well-being”. 

The new guidance, approved by the association’s board of directors in January, says “there is insufficient evidence demonstrating a favourable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.” It cites “substantial uncertainty” about the long-term benefits and harms of hormones and puberty blockers more routinely prescribed for gender transition but does not give any specific recommendations for those treatments.

A detransitioner in the US recently won $2 million after suing those who removed her breasts and sent her down the “affimation-only” pathway. 

Health Secretary Robert F. Kennedy Jr., who is leading efforts to restrict medical interventions for youth gender transition, said in a statement that he commends the group for “standing up to the overmedicalization lobby and defending sound science.”

Not only is there insufficient evidence for any form of treatment including drugs or surgery, the fact remains no human can change sex. It is immeasurably cruel to convince children, who are too young to consent to the irreversible harm caused by these treatments, that they could pass as the opposite sex.

Most children who are supported through puberty accept their natal sex as adults. Puberty is a human right that all must endure as a pathway to maturity. Pausing or robbing children of this pathway does catastrophic, irreversible harm.