Fox Varian underwent “gender-affirming care” and had a double mastectomy at just 16. Soon after, Varian regretted both the quick decision and the surgery itself, leading to a lawsuit against the doctors involved. This makes her the first person in the U.S. known to have detransitioned, winning a medical malpractice case citing irreversible harm incurred as a minor.
Coinciding with Varian’s win, the American Society of Plastic Surgeons became the first major medical organization to issue a recommendation that diverges from the prevailing medical consensus. The American Medical Association also aligned itself with this new stance. In contrast, the American Academy of Pediatrics has stated it will maintain its existing position despite these developments.
The AAP’s commitment to “recognizing and providing gender-affirming care” was highlighted during their Annual Leadership Conference in August 2025, notably shortly after an executive order by President Trump that aimed to block federal support for medical procedures intended to change children’s gender, including surgeries and hormonal treatments for those under 19. However, the AAP nevertheless received over $19 million in federal grants for fiscal year 2025.
While the ASPS and AMA are stepping back from their earlier support for “gender-affirming care,” the AAP continues to push back against what it labels as misinformation. For example, in one campaign video, a young girl expressed concern over her identity as “genderqueer” and was reassured by her doctor to seek support outside her family, suggesting she didn’t need to discuss her feelings with them.
It seems the AAP should indeed take a firmer stand against irreversible interventions, particularly in light of accumulating evidence and changing perspectives among its peer organizations.
Many medical institutions struggle to communicate the risks associated with “gender-affirming care” accurately. These interventions—social transition, cross-sex hormones, and surgeries—are often portrayed as safe for minors, despite societal norms that see them as too young to vote, drive, or consume alcohol.
At the same time, legitimate inquiries into the risks of such treatments are frequently dismissed, while studies showing negative outcomes receive pushback.
Interestingly, promoting gender ideology has proven profitable, with over $119 million acquired for gender reassignment treatments for minors since 2019, including thousands of surgeries and hormone prescriptions.
Mounting pressure from adverse testimonies and legal cases related to regret over childhood transitions has prompted the ASPS and AMA to reconsider their positions. So, what will it take for the AAP to do the same?
How many more cases of medical malpractice do we need? What about the stories of those who experienced regret? How much evidence regarding the risks must accumulate before a cautious approach prevails over certainty?
The AAP holds significant influence over medical practices affecting doctors, schools, and families. With that influence comes a responsibility to provide guidance grounded in humility and thorough discussion. If the AAP chooses not to reflect on its stance, should taxpayer funding continue for an organization resistant to evaluating the outcomes of its strong recommendations? Probably not.
Ultimately, children deserve healthcare rooted in evidence and an emphasis on their long-term well-being, not ideology or institutional loyalty.
