American Medical Association’s Stance on Transgender Minors Sparks Debate

The American Medical Association (AMA) recently made headlines by expressing that surgical interventions for transgender minors should generally be postponed until adulthood. This comment emerged in response to a position statement from the American Society of Plastic Surgeons (ASPS), which recommended delaying gender-affirming surgery until patients reach the age of 19. The AMA’s statement has prompted significant reactions, particularly from conservative commentators who view it as a shift from previous support for gender-affirming care for minors.

While many clinicians agree that surgery for transgender minors is typically reserved for adults, they support a case-by-case approach. The AMA emphasized the need for evidence-based treatment, stating, “the evidence for surgery on minors is insufficient.” The organization aligned its position with the ASPS, suggesting that surgical interventions should be deferred to adulthood when clear evidence is lacking. This statement, however, was not formally published on the AMA’s website and did not include direct attribution to its leadership.

The fallout from the AMA’s remark highlights the contentious landscape surrounding transgender healthcare, particularly as political pressures mount. Kellan Baker, a senior adviser for health policy at the Movement Advancement Project, noted that the AMA and ASPS statements might serve as clarifications of existing care standards in an environment where medical professionals feel uncertain about federal policies.

Concerns extend beyond the AMA’s comments. Proposed regulations that would limit federal funding for hospitals providing gender-affirming care, as well as potential legal investigations, are more pressing issues for healthcare providers. According to attorney Hannah Oliason, hospitals are grappling with the risk of criminal investigations and funding threats, which have already led approximately a dozen institutions to cease surgical procedures for minors since January 2025.

Data indicates that surgery for transgender minors is rare. A study covering the period from 2016 to 2020 found that around 3,200 individuals aged 18 and under received top surgery, which involves breast augmentation, reduction, or removal. Fewer than 760 young people underwent other gender-affirming procedures. The pressures faced by healthcare providers are compounded by aggressive policies from the Trump administration aimed at curtailing medical care for transgender youth.

Lindsey Dawson, director of LGBTQ health policy at KFF, remarked on the uncertainty surrounding the implications of the AMA and ASPS statements. They may not lead to immediate changes in practices, but the existing pressures in the healthcare landscape are substantial.

The AMA did not respond to inquiries regarding its statement. Over the past year, its strategy has included emphasizing areas of agreement with federal health leaders to enhance its advocacy efforts. Experts suggest that while the AMA’s comments may influence how individual providers assess their risks concerning medical malpractice lawsuits, the organization has not formally altered its policies on gender-affirming care. In 2024, the AMA reaffirmed its belief that gender-affirming medical treatment, decided through shared decision-making between patient and physician, is medically necessary.

The American Academy of Pediatrics (AAP) supports case-by-case evaluations for surgery in minors, emphasizing that decisions should involve patients, their families, and healthcare professionals—not politicians. AAP President Andrew Racine reiterated this principle, stating that there is no blanket recommendation for surgery for minors.

Standards from the World Professional Association for Transgender Health (WPATH) include specific requirements for clinicians before recommending surgical treatment for minors. These include documented and sustained gender incongruence, addressing mental health concerns, and discussing potential reproductive effects of treatment.

The Society for Evidence-Based Gender Medicine has indicated that it will continue to scrutinize the evidence surrounding gender-affirming care. The organization expressed on social media that the ASPS’s assessment of evidence may prompt increased caution among healthcare providers, particularly concerning patients in their twenties.

As the conversation surrounding transgender healthcare continues to evolve, the implications of statements from organizations like the AMA and ASPS will likely be debated. Their impact on the political landscape and the provision of care for transgender minors remains to be seen.