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ASPS and AMA Urge Deferring Gender-Related Surgeries for Minors to Adulthood

The shift follows evidence reviews that found low-certainty data on long-term outcomes for adolescents.

Overview

  • On Feb. 3, the American Society of Plastic Surgeons recommended delaying gender-related breast, genital and facial surgeries until at least age 19, citing insufficient evidence of benefit and potential harms based on the Cass Review and a 2025 HHS report, and framed the move as a position statement to be revisited as data improve.
  • On Feb. 4, the American Medical Association said evidence for surgical interventions in minors is insufficient and agreed such procedures should generally be deferred to adulthood, while continuing to support other evidence-based care.
  • The American Academy of Pediatrics said its guidance does not include a blanket recommendation for surgery for minors and emphasized decisions made by patients, families and physicians.
  • WPATH and USPATH reaffirmed case-by-case standards of care for adolescents and maintained there is no definitive age threshold for surgical access under their criteria-based approach.
  • Senior HHS officials publicly praised the ASPS stance, and the reassessments followed reporting of a $2 million malpractice verdict last week in New York involving a detransitioner.