American Society of Plastic Surgeons Acknowledges ‘Low Quality’ Evidence Backing Gender Surgeries for Minors

Advocates for gender ideology have long argued that gender medical interventions for minors are grounded in well-established scientific evidence, citing support from American medical associations.

The American Society of Plastic Surgeons, however, appears to be charting a different course.

The ASPS recently told Manhattan Institute fellow Leor Sapir that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” for minors and that “the existing evidence base is viewed as low quality/low certainty.”

Additionally, the association “has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

The ASPS’ statements stand in stark contrast to the World Professional Association for Transgender Health’s (WPATH) standards of care for gender medicine. WPATH’s guidelines recommend healthcare providers offer certain surgical procedures to adolescents experiencing gender dysphoria, provided they meet a few preliminary conditions. 

Now, the ASPS says that it “is reviewing and prioritizing several initiatives that best support evidence-based gender surgical care to provide guidance to plastic surgeons.”

ASPS members are taking note, and they like what they see.

“As a proud member of the American Society of Plastic Surgeons for over thirty years, a father of three, and grandfather of six, I have viewed the uncritical rush to embrace experimental gender-affirming care for minors with dismay and alarm,” said Dr. Richard Bosshardt, senior fellow at Do No Harm.

“I have wondered and even asked on the ASPS discussion forums why my society, which should be in the forefront of discussions regarding transgender surgery, has not weighed in on this issue. Those pushing for puberty blockers, cross-sex hormones, and surgery on minors have grossly oversimplified something which is incredibly complex and poorly understood as though this is ‘settled science,’ when it is not even close.”

“I am proud that my society has finally stepped up and raised serious concerns about this practice,” Bosshardt added. “Plastic surgeons appreciate better than any other specialist the unique and daunting challenges of transexual surgery. Even in the best of hands and ideal circumstances, these are among the most complex and challenging surgeries, with a high rate of complications, some of which can be permanently crippling and with no good data on long term results in minors.”

It’s time for other major medical associations to follow the ASPS’ lead. Even the most dogmatic proponents of gender medical interventions for children, such as the Endocrine Society, can return to evidence-based medicine and jettison gender ideology.

“Medical associations have long been bullied by gender activists into endorsing standards of care for minors that are based more on ideological zeal than well-established science,” said Michelle Havrilla, a certified nurse practitioner and director of programs for gender ideology at Do No Harm. 

“The ASPS is taking an important step by committing to evidence-based surgical care. With any luck, the ASPS’ actions will inspire other organizations to recognize what numerous European countries already seem to know: that gender medical interventions for minors lack firm scientific backing.”

Cracks are beginning to show in the medical field’s blind support for gender ideology; ASPS’ statement comes as more and more physicians are recognizing that gender medical interventions for minors carry unknown long-term dangers and lack quality evidence.

While numerous American medical associations have adopted positions backing minors’ access to “gender-affirming care,” several European countries in recent years have significantly limited children’s access to puberty blockers and cross-sex hormones, citing the treatments’ lack of evidence.

In the United Kingdom, the Cass Report, an exhaustive review of gender medicine for children published earlier this year, found that there is “remarkably weak evidence” to support the use of puberty blockers and cross-sex hormones to treat children with gender dysphoria.

In fact, WPATH buried the results of a systematic review conducted by Johns Hopkins University that found little evidence supporting “gender-affirming care” for minors. 

“Something must be terribly wrong when more than 80 percent of children with gender dysphoria will outgrow their condition, but 100 percent of medical associations publicly support aggressive, permanent, and unproven transition treatments for minors,” said Scott Centorino, vice president of policy and programs at Do No Harm. 

“But eventually, the truth wins. It’s gratifying to see more physicians – and now a major medical association – acknowledging reality.”

If you are a member of the ASPS, consider speaking out (publicly or privately to the leadership) to thank them for their point of view.