Leading US association for plastic surgeons lobbies for child sex changes at state level

The professional association that endorses medically unnecessary bilateral mastectomies for teenage girls who believe themselves to be boys has actively opposed attempts to ban sex change procedures for minors in states such as Montana, Alabama, Missouri, and Pennsylvania, prompting some experts to question the group’s motives.

As the number of people identifying as transgender has skyrocketed, so too have the number of people seeking experimental sex change surgeries. The ASPS has been actively campaigning for increased insurance coverage for such procedures, arguing that they are safe and improve the lives of transgender people.

While genital surgeries are rare for minors, plastic surgeons amputating the healthy breasts of teenage girls is becoming increasingly common in the US and elsewhere in the world. One paper published in the Journal of the American Medical Association showed that 1130 "gender-affirming" chest surgeries were performed on minors between 2016 and 2019, and that 1,114 of those were bilateral mastectomies on teenage girls who identify as boys.

A recent report by Reuters indicated that, according to an analysis of insurance data, 56 genital surgeries and 776 mastectomies were performed on minors who identify as members of the opposite sex from 2017-2019. However, the actual number is thought to be much higher as this report only included those with an official diagnosis of gender dysphoria who had insurance coverage. The number of children and adolescents has also surged dramatically since 2019.

“There is no question that financial rewards play a role in the adoption of gender affirming care. Hospitals and physicians generate substantial payments from insurers or self pay patients when children enter into the transition protocols,” Dr. Stanley Goldfarb, board chair of Do No Harm, a group striving for ethical medical care free from ideology, told the Daily Caller.

“Moreover, the pharmaceutical companies that produce the puberty blockers and gender-altering hormones also benefit from ‘gender affirming care.’ No matter what other motives come into play, there is no way that the surgical and medical activities would be embraced by various gender clinics and hospitals if they were financially harmed by these clinical activities,” Goldfarb added.

“I think it’s clear that both money and ideology play a role in US medical organizations’ zeal for gender transition procedures for minors,” Dr. Jay Richards, a senior research fellow at the Devos Center, told the Daily Caller. “The good news is that financial incentives can work in the other direction too. Mounting lawsuits from detransitioners seeking justice could change this dynamic overnight.”

The Daily Caller report quotes Grand View Research figures that project the value of the gender reassignment surgery market will increase from $1.9 billion in 2019 to an estimated $5 billion by 2023.

Medically unnecessary bilateral mastectomies and breast implants for males who identify as women can cost up to $10,000, while genital surgeries cost approximately $25,000. Also on offer to those who wish to surgically mimic members of the opposite sex are facial masculinization and feminization surgeries that can cost anywhere from $20,000 to $50,000.

The ASPS, with the Robert H. Ivy Pennsylvania Society of Plastic Surgeons, were part of a successful campaign to block a 2017 Pennsylvania bill that sought to prevent state-funded insurance programs from covering sex change procedures for minors, according to emails obtained by parent rights advocate Megan Brock.

The groups claimed that passing such a bill would make experimental sex change surgeries “unattainable for many transgender people who need them, depriving them of lasting concordance with their gendered self and enhanced psychological wellbeing and overall health.”

The group intervened to prevent legislation that would prevent doctors from performing sex change surgeries on children in Montana, Missouri, and Alabama, and says its 2023 legislative priorities are “opposing attempts to criminalize gender affirmation,” as well as continuing to campaign for expanded insurance coverage for sex-change related surgeries.