First Major US Medical Association Opposes Trans Youth Healthcare, Changing Previous Position

The American Society of Plastic Surgeons Cites the HHS and Cass Report to argue against trans surgeries for anyone under 19.

By Artemis T. Douglas & Jane Migliara Brigham

The American Society for Plastic Surgeons (ASPS), has issued a statement opposing transsexual surgeries for minors and 18 year-olds, making ASPS the first (and as of yet only) major medical association to throw its weight behind opposing transition medicine. 

In their statement, they explicitly cite the anti-trans misinformation of the Cass Report from the UK and the more recent HHS report from the US. They use these reports’ findings, despite the lack of quality in those reports, to falsely claim that “high quality research” is “missing in this area of medicine”. 

It is telling that in the position statement, they don’t once write “transgender people” and exclusively use euphemisms such as “people who identify as transgender” and “adolescents with gender dysphoria”.

This sets up an explicit double standard whereby the same surgeries which are routinely done to cis children, such as mastectomies for gynecomastia is cis boys, are banned for similar trans children.

The move has since been endorsed by Mehmet Oz’s Department of Health and Human Services (HHS). The HHS statement opens with,

“U.S. Department of Health and Human Services (HHS) leadership today issued statements commending the American Society of Plastic Surgeons for protecting children from harmful sex-rejecting procedures…”

HHS Deputy Secretary Jim O’Neill is cited as stating “Today marks another victory for biological truth in the Trump administration.”

Secretary Oz is cited as saying “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.” 

Of course, those statements are revealing. The fact that HHS leadership is still using the euphemism “sex-rejecting procedures” to describe transition medicine is proof and a tacit admission that transsexuals do change sex. 

If it was truly impossible to change sex, they wouldn’t need to ban the medicine that makes it possible.

Returning to the ASPS statement, ASPS claims that,

“Relevant to ASPS’s position and understanding of the larger patient assessment process, both the Cass Review and the HHS report emphasize that the natural course of pediatric gender dysphoria remains poorly understood.”

Of course, the Cass report is pseudoscientific misinformation  at best, and its methodological and other problems have been heavily critiqued by practitioners and trans rights orgs/advocates alike, with one such critique in the references of the ASPS document. 

If you support our coverage, consider subscribing to The Needle as a Platinum tier supporter, at $15 a month- you'll get access to all content AND credited as a supporter! For a limited time, you can get 60% off your first three months!

Become Platinum!

Another claim by ASPS regards the,

“Irreversibility and long-term medical dependency. While breast reduction is also considered irreversible and carries the potential for harm (e.g., loss of nipple sensation, inability to breastfeed), it does not typically result in lifelong medical dependency or foreclose on broad future developmental pathways. In contrast, gender-related surgical interventions permanently shape sexual function, fertility, embodiment, and future.”

This is ASPS stating that they are more worried about maintaining pure cissexual bodies that don’t need medicine than addressing and alleviating transsexual discomfort to improve transsexual health and well-being. Also, it’s certainly an interesting choice to focus on “loss of nipple sensation” and “inability to breastfeed” in the same sentence focused on “sexual function, fertility, embodiment and future” within a document supposedly focused on best practices for teenagers’ medical options. 

Once again, the anti-trans movement is shaped around a weird obsession with the sexual capacity of children. 

The ASPS position also states,

“Respect for emerging adolescent autonomy is also cited as a rationale for the provision of care in the face of low certainty evidence. However, patient autonomy is more properly defined as the right of a patient to accept or refuse appropriate treatment; it does not create an obligation for a physician to provide interventions in the absence of a favorable risk–benefit profile, particularly in adolescent populations where decision-making capabilities are still developing.”

This is ASPS setting up the standard to undermine the current best-practice in transition medicine: the informed consent model. Informed-consent is something advocates and activists alike have fought and bled for in the US, and are still fighting for in other countries, such as Ireland. It is also a case of supporting a lack of bodily autonomy and decision-making rights for younger people based on notions that they can’t make their own decisions, or at least not the right decisions.

Another part of the statement aligns with HHS and Congressional attempts to criminalize supporting transition medicine. Despite stating that they oppose criminalization for providers of medicine, they have no words on attempts to criminalize others involved in providing these procedures, such as parents and patients. 

This absence of a position is notable, as a recent federal bill has a clause which could be used to criminalize the parents of children who receive transsexual medicine.

It is important to underline that the ASPS statement aligns with current White House policy and President Trump’s Executive Order regarding transition for minors. The ASPS position doesn’t only target those under 18, but those who are 19 and under.