The American Society of Plastic Surgeons, which represents 92% of all board-certified American plastic surgeons, has broken with the general consensus among medical associations, indicating it disagrees with “gender-affirming care” for minors.

In July, ASPS informed Leor Sapir of the Manhattan Institute that it “has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria,” adding that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”

ASPS follows Doctors Protecting Children, a group part of a nonprofit that issued a declaration on July 6 that stated in no uncertain terms how it felt about “gender-affirming care,” saying:

Given the recent research and the revelations of the harmful approach advocated by WPATH and its followers in the United States, we, the undersigned, call upon the medical professional organizations of the United States, including the American Academy of Pediatrics, the  Endocrine Society, the Pediatric Endocrine Society, American Medical Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry to follow the science and their European professional colleagues and immediately stop the promotion of social affirmation, puberty blockers, cross-sex hormones and surgeries for children and adolescents who experience distress over their biological sex.  Instead, these organizations should recommend comprehensive evaluations and therapies aimed at identifying and addressing underlying psychological co-morbidities and neurodiversity that often predispose to and accompany gender dysphoria. We also encourage the physicians who are members of these professional organizations to contact their leadership and urge them to adhere to the evidence-based research now available.

“As the U.K.’s Cass Review pointed out, the World Professional Association for Transgender Health (WPATH) and the U.S. Endocrine Society were especially important in forging this consensus, and they did so by citing each other’s statements, rather than conducting a scientific appraisal of the evidence,” Sapir noted, adding, “The U.S. is one of the few Western countries where minors can receive gender surgeries, according to a new report.”

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Beverly Hills plastic surgeon Sheila Nazarian told Sapir, “We are physicians with responsibility for the health and well-being of our patients. We can get input from other clinicians, but ultimately the responsibility for determining medical readiness lies with us. That means that we have to examine all the data and studies available to us. Furthermore, you can’t help people by ignoring the reasons they want to go under the knife.”