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Plastic Surgeons’ Society Urges Waiting Until 19 for Youth Gender Surgeries

The group cites low-certainty evidence, highlighting potential harms to support a precautionary approach.

Overview

  • The American Society of Plastic Surgeons recommended delaying chest, genital, and facial gender surgeries until at least age 19, citing insufficient evidence for a favorable risk–benefit profile in minors.
  • The position draws on recent reviews, including the U.K. Cass Review and a 2025 U.S. Department of Health and Human Services reassessment, which found low-quality studies and gaps in long-term outcomes.
  • ASPS flagged substantial uncertainty around puberty blockers and cross-sex hormones without issuing specific guidance on endocrine treatments.
  • HHS leaders, including Secretary Robert F. Kennedy Jr., praised the move, while the society reaffirmed opposition to criminalizing medical care and emphasized professional self-regulation.
  • The statement follows a $2 million New York malpractice verdict involving a detransitioner and notes surgeries for those under 18 are uncommon in the U.S., with no uniform consensus across major medical organizations.