The Trump administration has celebrated a new American Society of Plastic Surgeons position statement recommending that surgeons delay gender-related breast/chest, genital and facial procedures until a patient is at least 19. The statement arrives as state and federal actions intensify scrutiny of gender-affirming care for minors, even as other major medical groups maintain their existing, more individualized approaches.
The American Society of Plastic Surgeons (ASPS) has issued a position statement recommending that surgeons delay gender-related breast/chest, genital and facial surgery until a patient is at least 19 years old.
The U.S. Department of Health and Human Services (HHS) praised the move in a Feb. 3, 2026, press release. In that statement, Deputy HHS Secretary Jim O’Neill said, “Today marks another victory for biological truth in the Trump administration,” and added that the ASPS had “set the scientific and medical standard for all provider groups to follow.”
The ASPS statement comes as restrictions on gender-affirming care for minors have spread across the country. As of early February 2026, 27 states had enacted laws restricting such care for minors, according to multiple news reports.
At the federal level, the Trump administration has pursued several actions aimed at limiting or discouraging gender-affirming medical interventions for young people. In December 2025, HHS said the Centers for Medicare & Medicaid Services would issue proposed rules to bar hospitals from performing what the department calls “sex-rejecting procedures” on children under 18 as a condition of participation in Medicare and Medicaid, and to prohibit certain federal Medicaid and CHIP funding for such procedures for minors.
Separately, some major health systems have changed services under legal and regulatory pressure. Kaiser Permanente said it would pause gender-affirming surgeries for patients under 19 in its hospitals and surgical centers, a move first reported in mid-2025; Kaiser cited the federal government’s campaign against pediatric gender-affirming care and, among other issues, Justice Department subpoenas as part of the pressure landscape.
How common surgery is among minors remains difficult to quantify. ASPS told NPR it does not gather data on how many gender-related surgeries are performed on minors. NPR cited one study of a surgical-procedures database that found an average of about 800 chest (“top”) surgeries per year among patients 18 and younger between 2016 and 2020.
NPR also cited ASPS statistics showing that many non-transgender minors undergo other breast-related plastic surgeries. In 2024, ASPS data shows more than 9,000 girls aged 19 or younger had cosmetic breast surgery, and nearly 3,000 boys under 19 had breast reduction surgery.
The ASPS statement argues there is an ethical distinction between gender-related procedures and other pediatric plastic surgeries, emphasizing the potential irreversibility of interventions and the uncertainty it says exists in the evidence base for minors. The society has said the document is a position statement rather than a clinical practice guideline.
Other major medical groups have not adopted the same bright-line age cutoff. The American Academy of Pediatrics has said its policy does not include a blanket recommendation for surgery for minors and has emphasized that treatment decisions should be made by patients, families and clinicians rather than politicians. The World Professional Association for Transgender Health has reiterated support for access to surgical care for minors under cautious criteria.
Families and patients affected by shifting policies describe the stakes differently. NPR reported on teenagers and parents who view chest surgery as important to reducing distress and avoiding the physical pain associated with chest binding, while opponents of adolescent surgery point to the permanence of the procedures and the possibility of regret.
