ASPS Recommends Delaying Gender-Affirming Surgeries for Minors Until Age 19

The American Society of Plastic Surgeons (ASPS) released new guidance on February 3, 2026, recommending that gender-affirming surgeries for minors be postponed until individuals reach age 19. This development marks a shift in procedural recommendations among U.S. medical associations regarding surgical interventions for gender dysphoria in adolescents.

According to the ASPS statement, the organization advises delaying chest, genital, and facial surgeries for minors, citing a lack of sufficient evidence to support a favorable risk-benefit profile for these procedures in children and adolescents. The ASPS referenced findings from the Cass Review in the United Kingdom and a 2025 report from the U.S. Department of Health and Human Services (HHS) as part of its rationale for the new guidance.

In response to the ASPS announcement, the U.S. Department of Health and Human Services issued a press release on the same day. The department commended ASPS for its position and noted that existing evidence supporting pediatric gender-affirming surgeries is of low quality or low certainty, according to its own recent review.

The American Medical Association (AMA) also addressed the issue, stating that current research does not provide enough information to make a definitive recommendation regarding gender-affirming surgeries for minors. The AMA indicated that, in the absence of clear evidence, it agrees with the ASPS recommendation to generally defer these procedures until adulthood.

What the numbers show

• ASPS released its statement on February 3, 2026
• The recommended minimum age for surgery is 19
• ASPS is the first major U.S. medical association to make this recommendation

The ASPS is the first major medical association in the United States to formally recommend delaying gender-affirming surgeries for minors. This position differs from those of the American Academy of Pediatrics and the World Professional Association for Transgender Health (WPATH), which continue to support individualized, case-by-case approaches to care for transgender youth.

The ASPS statement specifically addresses surgical procedures and does not provide guidance on non-surgical interventions. The organization’s position is based on its review of available evidence and recent reports from both U.S. and international sources.

The HHS press release highlighted the department’s own findings, which align with the ASPS position regarding the quality of evidence for pediatric gender-affirming surgeries. The department stated that it considers the current evidence base to be limited in certainty and quality.

Industry reaction

The American Medical Association stated that the available evidence does not allow for a definitive recommendation on gender-affirming surgeries for minors and supported the approach of deferring such procedures to adulthood in the absence of clear data.

The U.S. Department of Health and Human Services welcomed the ASPS statement and confirmed that its own review found the supporting evidence for these procedures in minors to be of low quality or low certainty.

The ASPS position represents a change in guidance among professional medical organizations in the United States, as other groups continue to endorse more individualized approaches. Ongoing reviews and statements from government agencies and medical associations indicate continued evaluation of the evidence base for gender-affirming care in adolescents.

* This article is based on publicly available information at the time of writing.