First Major US Medical Association Says Evidence For Child Sex-Change Surgeries Is ‘Low Quality’

The American Society of Plastic Surgeons (ASPS) does not believe there is strong evidence for providing sex-change surgeries to minors, the organization confirmed in a statement provided to the Daily Caller News Foundation.

The ASPS, a group representing 92% of plastic surgeons in the U.S. and over 11,000 worldwide, is now the first major U.S.-based medical association to question guidelines set by organizations like the World Professional Association for Transgender Health (WPATH), which recommend allowing adolescents to undergo hormone therapy and genital surgeries, the City Journal first reported Monday. The organization confirmed to the DCNF that it “has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

“ASPS currently understands that there is 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 the existing evidence base is viewed as low quality/low certainty,” the organization said in a statement. “This patient population requires specific considerations.”

In 2021, the ASPS stated that it “actively opposed legislation seeking to criminalize actions by physicians and guardians when minors receive gender affirmation surgery.” Its 2023 legislative priorities included “opposing attempts to criminalize gender affirmation.”

“It has always been ASPS’s position that members should be able to provide medical care without fear of government-sanctioned penalties and criminalization,” ASPS told the DCNF. “It is a deeply rooted pillar of ASPS to oppose any attempts at legal encroachment into the practice of medicine.”

The organization said it is “reviewing and prioritizing several initiatives that best support evidence-based gender surgical care to provide guidance to plastic surgeons.”

Transgender activists in the past have frequently claimed that “every major medical association” recognizes interventions such as cross-sex hormones, puberty blockers and genital surgeries as medically necessary. U.S. medical associations, such as the American Academy of Pediatrics and the American Medical Association, have opposed restrictions on transgender procedures for minors in a number of states on this basis.

Following the April publication of the Cass review, a four-year review of medical studies commissioned by the National Health Service (NHS) England that found “weak evidence” for offering puberty blockers to children, most U.S. medical associations remained silent and did not express any concern about its findings.

The review found the “apparent consensus” on these issues may stem from the “circularity” of groups like WPATH and the Endocrines Society citing each other’s recommendations. Though the Cass review concluded that its findings should “raise questions about the quality of currently available guidelines,” neither WPATH nor the Endocrine Society committed to doing their own review.

Over the past several months, court documents and internal leaks revealed a lack of internal consensus within WPATH and showed it allowed its purportedly evidence-based standards to be influenced by policy and litigation considerations. They also showed that WPATH suppressed or chose not to seek evidence reviews that undermined their recommendations.

Assistant Secretary for Health Rachel Levine also pressured WPATH to remove minimum age recommendations, court documents revealed.