American Medical Association Adjusts Stance on Transgender Surgery

The American Medical Association (AMA) recently indicated a shift in its stance regarding surgical interventions for transgender minors. In a statement issued to some media outlets, the AMA suggested that “surgical interventions in minors should be generally deferred to adulthood.” This comment has sparked a significant reaction from various quarters, particularly among conservative commentators who view it as a victory in their campaign against pediatric gender-affirming medical care.

Clinicians specializing in gender-affirming care have historically agreed that surgeries on breasts, facial features, or genitals are primarily reserved for adults. Nevertheless, they acknowledge that such procedures may be appropriate for minors on a case-by-case basis. The AMA’s recent statement appears to contradict this nuanced approach, raising concerns among advocates for transgender rights.

The AMA’s comments followed a position statement from the American Society of Plastic Surgeons (ASPS), which recommended delaying gender-affirming surgeries until patients reach age 19. While the AMA reiterated its commitment to evidence-based treatment, it characterized the evidence supporting surgical procedures for minors as “insufficient.” The organization expressed agreement with the ASPS’s recommendation, emphasizing that surgery should be postponed until adulthood.

Reactions from various commentators have underscored the politically charged environment surrounding care for transgender youth. Leor Sapir, a conservative political scientist, questioned whether the AMA’s revised stance on surgeries might also cast doubt on its previous support for hormone therapies. The political implications of these medical statements are significant, especially as healthcare providers navigate the potential risks posed by federal scrutiny and funding pressures.

Kellan Baker, a senior adviser for health policy at the Movement Advancement Project, noted that the AMA and ASPS statements reflect a desire among healthcare professionals to avoid conflict with political authorities. “We don’t understand exactly what the Trump administration is doing,” Baker remarked, highlighting the uncertainty faced by medical practitioners.

Despite the AMA’s recent comments, experts in healthcare law suggest that concerns about potential legal repercussions are more pressing for hospitals than the statements from the AMA and ASPS. Hannah Oliason, an attorney at Nilan Johnson Lewis, pointed out that many institutions are already facing pressure, including threats of federal investigations.

Surgical procedures for transgender minors remain rare. Research indicates that between 2016 and 2020, approximately **3,200 individuals** under the age of 18 underwent top surgery, which involves breast augmentation, reduction, or removal. In the same timeframe, fewer than **760** minors received other gender-affirming procedures. As political pressures mount, several hospitals have ceased to perform surgeries on young people, citing concerns about federal oversight.

Lindsey Dawson, director of LGBTQ health policy at the Kaiser Family Foundation, acknowledged the substantial pressures medical institutions are confronting. “It’s really hard to speculate on that, but the pressure [medical institutions] are already facing is substantial,” she stated, emphasizing the challenges in maintaining gender-affirming care.

The AMA did not provide further clarification on its statement, which has not been formally published on its website or attributed to specific leaders within the organization. Over the past year, the AMA has focused on finding common ground with federal health leaders, a strategy aimed at enhancing its advocacy efforts.

Carmel Shachar, director of the Health Law and Policy Clinic at Harvard Law School, expressed concerns regarding the potential impact of the AMA’s shift. She noted that the organization had previously opposed restrictions on age-related gender care, advocating for decisions to be made collaboratively between patients and healthcare providers. The recent comments, she argued, could influence perceptions in a malpractice lawsuit context.

Despite the publicized statements, the AMA has not altered its official policies on gender-affirming care. In **2024**, the organization reaffirmed its position that gender-affirming medications and surgeries, determined through shared decision-making with patients, are medically necessary. The AMA also opposes legislation that seeks to criminalize such care.

Other prominent medical organizations continue to support case-by-case assessments for surgical interventions in minors. The American Academy of Pediatrics (AAP) reiterated its stance in **2023**, emphasizing that decisions regarding care should be made by patients, families, and physicians rather than politicians. AAP President Andrew Racine stated, “The guidance from the American Academy of Pediatrics for health care for young people with gender dysphoria does not include a blanket recommendation for surgery for minors.”

The World Professional Association for Transgender Health (WPATH) outlines a comprehensive set of criteria that must be met for clinicians to recommend surgical treatment before the age of majority. These criteria include specific diagnostic evaluations, sustained gender incongruence, and mental health considerations.

Questions surrounding the validity of evidence supporting gender-affirming care are being raised by organizations such as the Society for Evidence-Based Gender Medicine. This group has expressed that it will continue its critical examination of the evidence, suggesting that the ASPS’s assessment may lead to increased caution among healthcare providers treating patients in their twenties.

As the dialogue around gender-affirming care evolves, the implications of the AMA’s recent statements will likely remain a point of contention within healthcare policy and practice.