Former ASPS president Scot Bradley Glasberg acknowledged the adolescent population as “vulnerable” due to the irreversible nature of these surgeries and noted the “insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.”
The ASPS represents more than 11,000 board-certified plastic surgeons, the vast majority of the specialty nationwide, released its official Position Statement on Gender Surgery for Children and Adolescents in February 2026.
Evidence-Based Framework
The society’s position draws on an extensive review of current scientific literature, which the organization characterizes as showing “low certainty” regarding long-term outcomes. Key findings cited in the statement include:
- Overall evidence for gender-related surgical interventions in minors remains of low to very low certainty
- Systematic reviews indicate limited data on long-term mental health benefits
- Emerging research highlights potential complications, long-term risks, and the irreversible nature of surgical procedures performed during developmentally sensitive periods
- A substantial proportion of children experiencing early-onset gender dysphoria see resolution or significant reduction of symptoms by adulthood without medical or surgical intervention
Balancing Compassion with Caution
The ASPS statement explicitly acknowledges the genuine distress experienced by young people with gender dysphoria and affirms the dignity of all patients, including those who may later detransition or discontinue treatment.
The organization emphasizes that its guidelines reflect a commitment to both compassionate care and scientific rigor:
“The threshold of age 19 reflects current evidence regarding developmental maturity, independence, and capacity for fully informed consent,” the statement notes, framing the recommendation as an application of the foundational medical principle of “first, do no harm.”
The society also took a firm stance against criminalization of medical decisions, advocating instead for professional self-regulation grounded in evidence and ethics.
A Pivotal Moment for Pediatric Care
Medical experts and child safeguarding advocates are hailing the policy as a watershed moment that prioritizes long-term patient welfare during critical developmental years. The guidance also establishes a new benchmark for evidence-based practice in pediatric gender medicine and may influence policy discussions both within the medical community and in the broader healthcare landscape.
By setting clear professional standards based on accumulating evidence, the ASPS position statement represents a victory for science-driven medicine, the protection of our youth, and the principle that major medical decisions should be made with robust data and developmental considerations firmly in view.
