The American Society of Plastic Surgeons, a major medical organization founded in 1931 with over 11,000 physician members, has reversed its position on gender-affirming surgeries for minors after a detransitioner won a $2 million malpractice lawsuit.
In a policy statement released Wednesday, the American Society of Plastic Surgeons (ASPS) stated that it no longer supports gender-related breast/chest, genital, and facial surgery for individuals under 19. The group noted that recent evidence reviews have revealed significant limitations in the quality of studies supporting such procedures, with emerging data indicating potential complications and harms.
The ASPS cited two major reports: a UK government-commissioned review (the Cass Review) that found the sex-rejection regime is built on weak evidence, and the U.S. Department of Health and Human Services’ 2025 report titled “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” which detailed the pseudoscientific nature of so-called gender-affirming care.
According to the statement, a substantial number of children with prepubertal onset gender dysphoria experience resolution or significant reduction of distress by adulthood without medical intervention. The ASPS concluded that there is insufficient evidence to support a favorable risk-benefit ratio for gender-related surgeries in children and adolescents.
The policy change follows a federal crackdown on sex-rejecting practices, shifting public opinion, and the first successful malpractice lawsuit brought by a detransitioner. Fox Varian, 22, won $2 million after regretting her 2019 gender-affirming surgery that involved breast removal.
Dr. Miriam Grossman, author of “Lost in Trans Nation: A Child Psychiatrist’s Guide Out of the Madness,” stated that such lawsuits are critical for preventing unnecessary surgeries on minors. She noted that malpractice insurance providers may reconsider covering these procedures after facing large payouts.
HHS Secretary Robert F. Kennedy Jr. praised the ASPS for standing against the “overmedicalization lobby” and protecting children from irreversible harm. Dr. Stanley Goldfarb of the medical advocacy group Do No Harm called the ASPS statement a model for other medical organizations to follow by rejecting experimental interventions on minors.
The ASPS now recommends that plastic surgeons adopt heightened caution, thorough documentation, and explicit disclosure of uncertainties when considering gender-related surgeries.
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