A group representing plastic surgeons primarily in America and Canada on Feb. 3 said it opposes carrying out breast removal and other gender transition surgeries on minors.
The American Society of Plastic Surgeons (ASPS) told members in a 9-page statement outlining its position that there is insufficient evidence supporting a favorable risk-benefit calculus for performing the surgeries on children.
“ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old,” the group, which represents more than 11,000 doctors around the world, many of whom are based in the United States or Canada, stated.
ASPS in 2019 had said states should not restrict the surgeries for children experiencing gender dysphoria, or the belief that they are a different gender from their birth sex. In 2024, the organization said there was “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions for the treatment of adolescents with gender dysphoria” and that it was reviewing the available evidence.
The new position stems in part from recent reports and papers summarizing the available evidence, including a 2025 report from the U.S. Department of Health and Human Services that found little evidence supporting the “gender-affirming” surgeries. Officials at the time said therapy was the preferred approach for the children in question.
That report highlights how some children who report that they are suffering from gender dysphoria eventually improve without surgery, emphasizing the need for “a precautionary approach,” ASPS said on Tuesday.
An estimated 3,678 minors in the United States underwent surgical procedures such as breast removal from 2016 to 2020, according to a 2023 study by physicians at Columbia University and the University of Southern California.
U.S. health officials hailed the new development.
“We commend the American Society of Plastic Surgeons for standing up to the overmedicalization lobby and defending sound science,” Health Secretary Robert F. Kennedy Jr. said in a statement. “By taking this stand, they are helping protect future generations of American children from irreversible harm.”
“When the medical ethics textbooks of the future are written, they’ll look back on sex-rejecting procedures for minors the way we look back on lobotomies,” Centers for Medicare & Medicaid Administrator Dr. Mehmet Oz said. “I applaud the American Society of Plastic Surgeons for placing itself on the right side of history by opposing these dangerous, unscientific experiments.”
Dr. Stanley Goldfarb, chairman of Do No Harm, a group that opposes gender-reassignment surgeries for minors, said in a separate statement that ASPS was “the first major medical organization to support evidence-based and ethical medicine and reject, in their words, these harmful and irreversible procedures.”
The American Academy of Pediatrics is among other medical groups that support performing the surgeries on children if certain criteria are met.
“The American Academy of Pediatrics remains committed to ensuring that all children—including gender-diverse youth and children covered by Medicaid—receive care that is backed by science, delivered with compassion, and offered without political interference,” Dr. Susan Kressly, at the time the organization’s president, said in a statement in late 2025.
Correction: A previous version of this article misstated the number of physicians represented by the American Society of Plastic Surgeons.