The American Society of Plastic Surgeons (ASPS) is breaking with the consensus of the U.S. medical community on best practices for so-called “gender-affirming care” for minors.
The move by the group, which represents 92 percent of all board-certified plastic surgeons in the United States, comes amid shifting sentiment internationally that psychological therapy, rather than hormone therapy or surgery, may be a better approach to treating minors who identify as transgender.
ASPS told Fox News Digital that it “does not endorse any organization’s practice recommendations regarding the treatment of gender dysphoric adolescents.” Manhattan Institute “There is considerable uncertainty about the long-term effectiveness of thoracic and genital surgical interventions,” the (MI) group said, “and the existing evidence base is regarded as being of low quality and low certainty.”
“ASPS is reviewing and prioritizing several initiatives that best support evidence-based gender surgery care to provide guidance to plastic surgeons,” the group said in a statement to Fox News Digital. “As members of the multidisciplinary care team, plastic surgeons have a responsibility to provide comprehensive patient education and maintain a strong, evidence-based informed consent process that allows patients and their families to set realistic expectations in the context of shared decision-making.”
“It’s a little surprising to see plastic surgeons championing evidence-based medicine and saying we need to be more cautious and not just give patients what they want, because they have a reputation for the exact opposite,” MI Fellow Leor Sapir told Fox News Digital.
“But when you think about it, this isn’t all that surprising, because the doctors who actually pick up the scalpel and cut people are the ones who carry the heaviest responsibility,” he added. “Especially when it comes to children, it’s natural that they’re the ones who want to know that what they’re doing is actually good and that they’re not harming the patient.”
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The widening gap between US and European standards of care comes amid new evidence such as the UK’s Cath review, commissioned by England’s National Health Service., This “may explain why there is a seeming consensus in key practice areas despite the paucity of evidence.” The Cass Review, an independent evaluation of young people’s gender treatment led by top British paediatrician Dr. Hilary Cass, “found no conclusive evidence that gender dysphoria in children and teens is resolved or alleviated by what advocates call gender-affirming care,” reports The New York Times. Reported by Pamela Paul.
Transgender Rights Advocate (Steven Zenner/SOPA Images/LightRocket via Getty Images)
“In Europe, they basically allowed health authorities to do their own assessment of the evidence, so they reversed course and found that there was no evidence,” Sapir told Fox News Digital. “Here in the U.S., instead of evidence-based medicine, we’ve relied on what I call prestige-based medicine, which is, ‘These treatments are good because these people say so.’
“We knew this consensus was fabricated and not based on solid evidence,” he added. “We know this because we’ve looked at the studies they cited and we’ve analyzed those studies, and they’re not saying anything that’s fabricated.”
a Recent Reports A study by a Canadian think tank found thatA study of gender reassignment health policies for minors in Canada, the United States, and Europe found that the United States is one of the few Western countries where minors can receive gender reassignment surgery. In Belgium, Finland, Germany, Luxembourg, Sweden, the United Kingdom, and three Canadian provinces, minors cannot receive double mastectomies before the age of 18, and nearly all European countries surveyed do not provide gender reassignment surgery to anyone under the age of 18.
However, in the United States, puberty suppressants, sex-reversing hormones, and surgical procedures are still prescribed to minors who are insecure about their gender or their developing bodies. Guidelines issued by the World Professional Association for Transgender Health (WPATH) in June 2022 recommended that some surgeries should be permitted from age 15, while some “sex-affirming” mastectomies are being performed on children as young as 12.
In addition to WPATH, organizations such as the American Academy of Pediatrics and the American Endocrine Society also maintain a commitment to “gender-affirming care,” which influences nearly all of their other guidelines, according to the Cass Review. release in June suggested WPATH, under pressure from Rachel Levin of the Department of Health and Human Services (HHS), suppressed systematic reviews of evidence and eliminated minimum ages for surgery.
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A new analysis by the Manhattan Institute based on information from the National Health Database of all insured individuals found that between 2017 and 2023, 5,288 and 6,294 “sex-affirming” double mastectomies were performed on minors, including between 50 and 179 girls who were 12.5 years old or younger at the time of surgery.
Dr. Richard Bosshart, a board-certified plastic surgeon and senior fellow at Do No Harm, said he has been an ASPS member for more than 30 years and is proud the organization has voiced serious concerns about “gender-affirming” medical practices.
Transgender flag (Alison Diner/AFP via Getty Images)
“I have been a member of the American Society of Plastic Surgeons for over 30 years, a father of three, and a grandfather of six, and have watched with dismay and alarm the uncritical embrace of experimental gender-affirming treatments for minors,” he said in a statement provided to Fox News Digital. “Those who promote puberty suppression drugs, cross-sex hormones, and surgery on minors grossly oversimplify very complex and poorly understood subjects as if they are ‘settled science.'”
Do no harm, recently Published research The study, called “Reassigned,” looked at the differences between North American and European approaches, and warned of the “alarming reality” that North American patients qualify for “potentially irreversible or medically harmful interventions at a much younger age than their European counterparts.”
“Plastic surgeons understand the unique and difficult challenges of sex-reassignment surgery better than any other professional,” Bosshardt said. “Even when performed by the best physicians under ideal circumstances, it is one of the most complex and difficult surgeries. … Given the overwhelming evidence cautioning against ‘gender-affirming’ medical care, we hope that ASPS will be the first of many organizations to take this position.”
Sapir said the ASPS statement was evidence that the manufactured consensus in the American medical community was crumbling.
Transgender activists argue that the idea of ”rapid-onset gender dysphoria” (ROGD) that prompted the European turnaround — that young people who never experienced gender distress before puberty experience gender confusion — doesn’t exist. The idea that gender dysphoria is innate, or even biological, has been used to justify the medical transition of children, but many researchers, including Sapir, believe the sharp increase in girls identifying as transgender indicates that ROGD exists.
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“In the U.S., there has been a consensus about the quality of the evidence and the medical necessity of these procedures, and now for the first time a major medical organization is publicly saying, ‘No, the evidence is actually very uncertain, and we don’t know if these procedures are beneficial or harmful to children. Given the vulnerability of the population, we need compelling evidence,'” Sapir said. “ASPS also told me they have never endorsed the recommendations of WPATH or any other medical organization, which is true. So they’re now challenging the U.S. consensus that these treatments are sound, evidence-based, and therefore ethical.”
People take part in a rally marking International Day of Transgender Visibility. (Andrea Ronchini/NurPhoto via Getty Images)
Sapir said the ASPS’s change in stance on “gender-affirming care” raises questions about the legal liability of plastic surgeons, who are part of a “multidisciplinary team,” but often accept patients after their gender has been confirmed by therapists or other doctors and they have undergone medical procedures.
He said the question of “to what extent do surgeons have the responsibility to determine the medical appropriateness and necessity of these types of surgeries” will become increasingly important as the debate over “gender-affirming” in the United States intensifies.
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Fox News Digital reached out to WPATH and the Endocrine Society for comment but did not immediately receive a response.
