Why Are Medical Groups Now Opposing Gender Surgeries for Minors?

The Story: Within days of each other, the American Medical Association and the American Society of Plastic Surgeons have issued recommendations that gender-related surgeries for minors be deferred until adulthood.

The Background: The American Medical Association (AMA) has historically supported a broad range of so-called gender-affirming care for transgender adolescents, including social transition, counseling, puberty blockers, and hormones. As recently as 2023, it reiterated and even strengthened that support. But in its new policy statement, the AMA says that “surgical interventions in minors should be generally deferred to adulthood.” Their recommendation is based directly on the limited research on risks and benefits.

The American Society of Plastic Surgeons (ASPS) went even further, issuing a position statement recommending that breast and chest, genital, and facial gender-related surgeries be delayed until at least age 19. The ASPS—the largest professional body of plastic surgeons in the country—cited “insufficient evidence” and “low certainty” about the risk-benefit profile of these procedures for patients under 18. ASPS leaders said their shift was influenced in part by England’s landmark Cass Review and the 2025 U.S. Health and Human Services report on pediatric gender dysphoria, which found the overall quality of evidence supporting these interventions to be “very low.”

These shifts are converging from multiple directions. Earlier this month, a woman who underwent a double mastectomy at age 16 as part of a gender transition won $2 million in damages against her medical providers. According to the Washington Times, this was the “first time a jury has ruled in the case of a detransitioner suing over gender-change procedures performed before age 18.”

Over the past two years, at least 27 U.S. states have enacted bans on some or all forms of gender-transition treatments for minors. The Supreme Court also upheld Tennessee’s law restricting such treatment. And last year, President Trump signed an executive order banning federal funding for institutions that provide such treatment to people under 19.

If followed, the recommendations from the AMA and ASPS could profoundly affect adolescents’ health. A major national analysis of gender-transition surgeries from 2016 to 2020 found 3,678 procedures performed on patients ages 12 to 18, including 405 who underwent genital surgery and 3,215 who had breast and chest surgeries.

Why It Matters: Christians watching these developments may be tempted toward one of two responses: triumphalism or cynicism. Triumphalism says, “We told you so! The medical establishment is finally catching up to what the Bible always said.” Cynicism says, “They’re only doing this because of political pressure and fear of lawsuits. Nothing has really changed.”

Although both impulses contain a grain of truth, a more interesting—and more biblical—response is to consider what it means when a society slowly rediscovers a truth it had suppressed.

Paul’s argument in Romans 1 is often cited in discussions about sexuality, but one dimension is particularly relevant here. Paul doesn’t describe humanity’s turn from God as a single catastrophic decision. Instead, he describes a process: “Although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened” (v. 21).

The progression is from knowledge to suppression to confusion. God’s response, repeated three times, is to give them up (vv. 24, 26, 28). God “gave them up” in the sense of allowing the internal logic of their error to play out until its consequences became undeniable.

What we’re witnessing in the medical community may be the tail end of that process. This is less a revival of morality and more a reality check imposed by biology. The consequences of intervening on children’s bodies with inadequate evidence and incomplete consent have become nearly impossible to suppress. The complications, the regret, and the lawsuits are the natural results of a framework that prioritizes ideological affirmation over the welfare of children. The medical establishment is running into the guardrails that God built into the created order.

Proverbs tell us that “whoever isolates himself seeks his own desire; he breaks out against all sound judgment” (18:1). For years, gender medicine operated in exactly this kind of isolation—a closed ecosystem of activist doctors, compliant review boards, and intimidated dissenters. What the AMA and ASPS announcements represent is a small crack in that isolation.

Sound judgment is finally reasserting itself, not because the medical establishment has suddenly embraced the Creator’s design but because biological reality is stubborn and hard to ignore.

Because Christians care about the welfare of children, this is a moment for gratitude and continued vigilance. The Williams Institute estimates there are 300,000 transgender-identifying youth in the United States, many of whom live in states where these procedures are accessible and even encouraged. Every young person given room to grow rather than rushed to the operating table is a child who hasn’t been locked into a decision her or she can’t undo.

But vigilance remains necessary because the underlying ideology hasn’t changed. The AMA still affirms the broader framework of gender-transition treatments. Puberty blockers and cross-sex hormones—which carry their own serious risks to fertility, bone density, and cognitive development—remain endorsed for minors by most medical groups in the United States. This means the struggle over what is allowed to be done to children’s bodies isn’t over; it has simply moved to a new line.

The underlying ideology has, unfortunately, not changed. But reality is patient. Every year that passes without long-term data vindicating these interventions is another year the truth has room to seep into the American conscience. Of course, we Christians shouldn’t be surprised by this, for we serve a God who built the world to testify about itself. And the testimony of the body, however long suppressed, will not stay silent forever.