RFA Statement on American Society of Plastic Surgeons’ Hypocrisy and Political Boot Licking

Signs painted in February 2026 by Rainbow Families Action youth.

February 6, 2026 - According to the American Society of Plastic Surgeons’ Briefing Paper: Plastic Surgery for Teenagers, “Teens frequently gain self-esteem and confidence when their physical problems are corrected. In fact, successful plastic surgery may reverse the social withdrawal that so often accompanies teens who feel different.” Unless those teens are transgender, in which case the ASPS suddenly thinks they should wait until they are 19, a year or more past the age they can join the military or vote. Their use of that number is a clear tell that their new position statement is politically motivated, since that is the age this administration has targeted in its efforts to roll back care for not only minors, but adults.  

The facts have not changed about gender-affirming surgeries for trans minors and young adults. They remain life-saving and life-changing for those who need them, and they are subject to rigorous clinical standards (far more rigorous than what the ASPS uses for cisgender teens) and backed by peer-reviewed research and medical organizations around the globe.

Gender-affirming surgeries for transgender minors are also extremely rare. That same ASPS briefing paper states that 23,527 cosmetic surgery procedures were performed on all American minors in 2022, along with 244,252 “minimally invasive” cosmetic procedures. How many of those were for trangender teens? The ASPS says it doesn’t track that number, but other estimates, such as this analysis of two national datasets, put it at fewer than 4,000 over a recent five-year period. The vast majority of chest-reduction surgeries performed on male teens are for cisgender boys. The ASPS does not mention this in its new statement.  

The ASPS considers cisgender teens to be good candidates for nose jobs, breast implants, and other cosmetic surgery when they initiate the request, have realistic goals, and have sufficient maturity — all of which ASPS states can be determined by the parents and surgeon. With this new statement, the ASPS is denying the same consideration even to transgender 18-year-old adults, with egregious hypocrisy and in contradiction to medical evidence. The ASPS is happy to profit from the insecurities of cisgender teens, but unwilling to provide medically necessary analogous care to transgender teens. This is blatant discrimination on the basis of gender identity.

This is about politics, not patients. It is unsurprising that the ASPS is pandering to the current administration and adopting its rhetoric. The recently elected president of the society is a generous longtime Republican donor. The ASPS statement parrots the administration’s stance on transgender care, referencing two deeply flawed and widely criticized sources, the Cass Review and HHS’s own 2025 report. 

The ASPS statement cites gaps in documentation of long-term outcomes and data uncertainty, but once again, this standard is being applied selectively only to a single population of patients. Mirroring climate science deniers, it’s a common tactic of ideological, not medical, parties to claim that the data supporting gender-affirming care is “uncertain.” As in the ASPS statement, they will use this as a justification to cease action, ignoring the fact that a large portion of clinical care involves interventions based on data with known limitations and uncertainties. As this paper from the Journal of Social Science and Medicine makes clear:

"Charges of uncertainty are also useful because GAC practices – like many best practices in healthcare (Ghosh, 2004) – involve some degree of clinically acceptable uncertainty (Shuster, 2021). Many gender-affirming clinicians acknowledge that effectively and ethically treating GD [gender dysphoria] requires practices not yet subject to randomized-controlled trials (RCTs), which are considered evidence-based medicine's “gold standard.” Importantly, RCTs are inadequate for determining clinical care alone (Deaton and Cartwright, 2018), and are considered by some to be unethical and methodologically inappropriate for GAC (Ashley et al., 2023)"

The American Medical Association (AMA) was quoted by the National Review as saying “the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.” The AMA has not put out a written statement, but the quote was picked up and touted as a reversal by conservative and anti-trans outlets. 

In fact, it is not. The AMA statement is consistent with current guidelines and practice. Surgical interventions are already “generally deferred to adulthood,” with over 92% of gender affirming surgeries being performed on adults, according to a 2023 study in JAMA. WPATH, USPATH, and other leading medical organizations continue to hold that care decisions should be made on an individual basis in collaboration with the patient, parents, and doctors — not proscribed by a “one size fits all” rule, and not made by politicians. Even the ASPS’s recent statement explicitly does not rise to the level of clinical practice guidelines and calls for “a regulatory environment that allows physicians to exercise independent professional judgment, guided by best available evidence, established ethical frameworks, and patient welfare.”

Gender-affirming surgeries can bring our kids joy, relief, and safety, and open the door to a future lived in a body that feels like their own. For decades, the decision to allow a transgender minor to receive surgery has been made in consultation with mental health providers, physicians, surgeons, and families, in accordance with the standards laid out by WPATH. Rainbow Families Action and our many partner-allies — care providers, labor unions, community organizations, and local and state elected officials — will continue to fight for access to the care that supports our kids living authentically as their full selves.