After the world’s largest organization of plastic surgeons recommended delaying “transgender” surgery until a patient reaches the age of 19, the American Medical Association stated it would follow that guidance—but added a key word that set off alarm bells for one medical watchdog group.
The AMA, America’s most influential doctor association, has long advocated against laws to restrict experimental transgender interventions euphemistically described as “gender-affirming care.” This activism may complicate any attempt to shift from previous support for these interventions.
“It is no surprise the AMA chooses to leave itself wiggle room, given its record of opposing government protections for minors from harmful transgender procedures,” Dr. Kurt Miceli, a board-certified physician in psychiatry and internal medicine who serves as chief medical officer at Do No Harm, told The Daily Signal on Thursday.
The American Society of Plastic Surgeons, citing a peer-reviewed study from the Department of Health and Human Services, concluded that “there is insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.”
“ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old,” the society added.
AMA’s Position
The American Medical Association told National Review that it agrees with ASPS, but critics say it misstated the society’s position.
“Our colleagues at ASPS concluded that the evidence supporting gender-related surgery in minors is insufficient and of low certainty,” the AMA said in the statement, also provided to The Daily Signal. “The American Medical Association respects the expertise and dedication of surgeons who care for patients every day.”
“The AMA supports evidence-based treatment, including gender-affirming care,” the statement added. “Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”
Misleading?
Do No Harm’s Miceli criticized the American Medical Association’s statement. He noted that its recommendation that surgical interventions “generally” be deferred to adulthood differed from the ASPS’s recommendation, which left no room for exceptions.
“The American Medical Association statement is purposefully vague and misstates ASPS’s clear rejection of all sex-change surgeries for minors,” the doctor told The Daily Signal.
“The AMA also fails to address the insufficient evidence supporting endocrine interventions, unlike ASPS,” he added. “Waffling on a question this central to the safety and wellbeing of American children is unacceptable. The AMA must clarify its position and should definitively reject all sex-change procedures for minors.”
The American Medical Association’s History
After the Supreme Court overturned Roe v. Wade in Dobbs v. Jackson Women’s Health Organization (2022), the association launched the “Task Force to Preserve the Patient-Physician Relationship When Evidence-Based, Appropriate Care Is Banned or Restricted.”
The task force focuses on abortion but also anticipated a strategy to prevent or mitigate “bans on other appropriate health care, such as gender affirming care.” The task force also includes an ad hoc committee focusing on addressing “barriers” to transgender medical interventions.
The Daily Signal reached out to the organizations in the task force, including the Endocrine Society, the American College of Obstetricians and Gynecologists, and the other members, asking if they would comment on the ASPS position and whether it would alter their advocacy with the task force. Most did not respond, though a few did.
The Texas Medical Association told The Daily Signal that it “supports Texas physicians following Texas law in this matter.”
Dr. Eric Wargotz, a pathologist and president of the Maryland State Medical Society, told The Daily Signal that his organization will follow the ASPS recommendation.
“The Maryland State Medical Society’s position, generally, is we refer to the society and support their positions,” he said. “We feel they know the science better than we, as a general medical society, so we tend to follow their lead.”
The American Society for Reproductive Medicine referred The Daily Signal to its 2021 ethics statement that patients who identify as transgender should receive access to fertility services.
The American Academy of Pediatrics, by contrast, told U.S. News & World Report that its position had not changed.
“The guidance from the American Academy of Pediatrics (AAP) for health care for young people with gender dysphoria does not include a blanket recommendation for surgery for minors,” Dr. Andrew Racine, the AAP’s president, said. “The AAP continues to hold to the principle that patients, their families and their physicians — not politicians — should be the ones to make decisions together about what care is best for them.”
HHS Weighs In
The Department of Health and Human Services declined to comment directly on the AMA’s position, but a spokesperson told The Daily Signal that “HHS continues to fight to protect America’s children from irreversible harm outlined in the Department’s peer-reviewed report.”
HHS Secretary Robert F. Kennedy Jr. praised the ASPS for its new position.
“We commend the American Society of Plastic Surgeons for standing up to the overmedicalization lobby and defending sound science,” Kennedy said in a statement Tuesday. “By taking this stand, they are helping protect future generations of American children from irreversible harm.”
