American Medical Association now says trans surgeries ‘should be generally deferred to adulthood’

In a statement to the National Review, the AMA said that because "the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement … the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood." The organization added that it supports "evidence-based treatments," including other types of so-called gender-affirming care for minors. This is a change from past positions.

As recently as 2021, the AMA told governors, faced with passing legislation to ban sex change surgeries for minors, that "Empirical evidence has demonstrated that trans and non-binary gender identities are normal variations of human identity and expression. For gender diverse individuals, standards of care and accepted medically necessary services that affirm gender or treat gender dysphoria may include mental health counseling, non-medical social transition, gender-affirming hormone therapy, and/or gender-affirming surgeries."

"The AMA opposes the dangerous intrusion of government into the practice of medicine and the criminalization of health care decision-making," said AMA Board Member Michael Suk, MD, JD, MPH, MBA. "Gender-affirming care is medically-necessary, evidence-based care that improves the physical and mental health of transgender and gender-diverse people."

The ASPS has now concluded that "there is insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents. ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old."

The organization said that "Overall evidence base for gender-related endocrine and surgical interventions is low certainty, and in light of recent publications reporting very low/low certainty of evidence regarding mental health outcomes, along with emerging concerns about potential long-term harms and the irreversible nature of surgical interventions in a developmentally vulnerable population."

This comes after the Department of Health and Human Services announced in 2025 a new rule that would ban hospitals receiving Medicare and Medicaid funding from performing such procedures on children.

In response to the ASPS’s move, Health and Human Services Secretary Robert F. Kennedy, Jr. said, "We commend the American Society of Plastic Surgeons 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."