'We cannot endorse:' Why the nation’s plastic surgeons are pulling back on youth gender surgery
While many major medical groups have maintained support for pediatric gender surgeries, Dr. Bob Basu, president of the American Society of Plastic Surgeons (ASPS), says it was time for his organization to speak up and raise caution about the "irreversible nature" of these procedures.
"Based on what we see today, we cannot endorse gender-related surgical intervention in minors and adolescent patients, given the uncertainties that we've discovered," Basu told Fox News Digital. "And therefore, we recommend deferral of surgical treatment once a patient is an adult."
The ASPS, the nation's leading plastic surgery organization, issued a new position statement this week recommending that surgeons delay all chest, genital, and facial gender surgeries until a patient reaches at least 19 years old.
Basu explained that the age 19 cutoff was a compromise between legal definitions of adulthood and developmental medicine. Late adolescence remains a period of "ongoing neurocognitive, psychosocial, and then identity development," he said.
MAJOR MEDICAL ORGANIZATION URGES DELAYING YOUTH GENDER SURGERIES
The decision to release the statement now followed an "ongoing review of the evidence" regarding these treatments and their effects on the pediatric population. The ASPS statement specifically cites the 2024 Cass Review and the 2025 HHS review, both of which identified significant limitations in the study quality of youth gender medicine and a lack of documentation regarding long-term physical and psychological effects.
Basu said available research "really hasn't resolved these uncertainties regarding treatment benefit, and in some areas they've actually highlighted some concerns about potential harms."
While youth gender medicine remains a polarizing topic, Basu emphasized that the ASPS is focused on patient safety and the current state of science.
"Our focus has been on providing our members very clear, responsible guidance that reflects the end of the current science," Basu said. "It recognizes where uncertainty remains. And we're really trying to put our patients, including those vulnerable patients, being adolescents and minors, we're trying to put their well-being and safety first."
The statement is intended to serve as professional guidance for surgeons navigating "informed consent, patient selection, and help with ethical decision-making in an area with significant uncertainty," he added.
For patients and their parents, Basu advised a cautious, patient-centered approach.
"Parents and patients should know that they have autonomy. They have the right to ask questions. They should take time to either accept or decline any treatment," Basu said. "Because the evidence is limited in this arena, some interventions are irreversible. It's important to carefully weigh the risks, the uncertainties, and potential long-term outcomes."
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Basu stressed that families should have "honest, open conversations" with medical teams regarding what remains unknown in the field.
"Shared informed decision-making is really essential to patient-centered care," he said.
The U.S. Department of Health and Human Services (HHS) celebrated the ASPS position shift this week. Secretary Robert F. Kennedy Jr. commended the organization for "standing up to the overmedicalization lobby and defending sound science."
"By taking this stand, they are helping protect future generations of American children from irreversible harm," Kennedy said in a press release.
The announcement comes on the heels of a landmark medical malpractice suit earlier this week, in which a jury ruled in favor of a former transgender teen who sued medical professionals after undergoing a double mastectomy at 16 while experiencing gender dysphoria.