The American Medical Association (AMA) recently issued a statement indicating that surgical interventions for transgender minors should generally be deferred until adulthood. This announcement has stirred significant discussion among healthcare professionals and commentators, with varying interpretations of its implications for gender-affirming care.
In the context of gender-affirming care, the prevailing view among clinicians is that surgeries involving breasts, facial features, or genitals are primarily intended for adults. Nonetheless, some medical professionals argue that such procedures may be appropriate for minors on a case-by-case basis. The AMA’s comment, which was not formally published on its website nor attributed to any specific leader within the organization, has been interpreted by some conservative commentators as a retreat from its previous support for gender-affirming surgeries.
Leor Sapir, a political scientist, voiced concerns on social media regarding the AMA’s position, questioning whether the organization might similarly reconsider its stance on hormone treatments for minors. The AMA’s statement follows a recent position from the American Society of Plastic Surgeons (ASPS), which suggested that gender-affirming surgeries be postponed until patients reach the age of 19.
Political Context and Institutional Pressures
The AMA reiterated its support for evidence-based treatment, emphasizing that the existing data regarding surgical outcomes for minors is “insufficient.” The organization acknowledges the ASPS’s recommendation and aligns with it, stating that surgical interventions in minors should generally be deferred to adulthood.
The response from the conservative media and activists has been swift, celebrating what they perceive as a change in the AMA’s approach. However, some experts caution against viewing this statement as a significant shift. According to Kellan Baker, a senior adviser for health policy at the Movement Advancement Project, the AMA and ASPS comments can be seen as responses to pressures from a politically charged environment, particularly as many medical professionals grapple with uncertainty regarding federal policies that impact transgender healthcare.
Legal expert Hannah Oliason highlighted that the real concerns for hospitals and providers extend beyond the AMA’s comments. Proposed federal regulations that threaten funding for institutions providing gender-affirming care pose more immediate challenges. Since the beginning of 2025, approximately a dozen hospitals across the United States have ceased performing surgical procedures on minors due to federal scrutiny and investigations.
Understanding the Guidelines and Their Implications
Surgery for transgender minors remains rare. Research indicates that between 2016 and 2020, only about 3,200 individuals aged 18 and under underwent top surgery, a procedure that alters breast size or removes breast tissue. In the same period, fewer than 760 minors received any other gender-affirming surgeries.
Lindsey Dawson, director of LGBTQ health policy at KFF, commented on the implications of the AMA and ASPS statements, noting that while they may not drastically change current practices, they represent the substantial pressure healthcare providers face. The statements may impact how individual providers assess risk in relation to medical malpractice claims.
Despite the recent comments, the AMA has not altered its existing policies regarding gender-affirming care. Its position, reaffirmed in 2024, states that gender-affirming medications and surgeries, as determined through shared decision-making between the patient and physician, are medically necessary. The AMA continues to oppose legislation that criminalizes such care.
Other medical organizations, including the American Academy of Pediatrics (AAP), support case-by-case evaluations for transgender minors seeking surgery. In a statement, AAP President Andrew Racine emphasized the importance of collaborative decision-making among patients, families, and healthcare providers, free from political influence.
Guidelines from the World Professional Association for Transgender Health (WPATH) outline specific criteria that must be met before a clinician can recommend surgical treatment for minors. These criteria include documented gender incongruence, mental health assessments, and discussions regarding reproductive effects of treatment.
The Society for Evidence-Based Gender Medicine, a group that questions the current evidence supporting gender-affirming care, has also indicated that it will continue to scrutinize these practices. In a recent post, the organization suggested that the ASPS’s assessment of evidence may lead to increased caution among providers treating patients in their twenties.
As the discussion around transgender healthcare continues to evolve, the AMA’s latest comments reflect the complex interplay of medical ethics, political pressures, and the need for clear guidance in providing care for transgender minors.
