Did the AMA change its position on surgery for transgender minors?

STAT News – Tuesday, February 10, 2026
By Theresa Gaffney

Among clinicians who provide gender-affirming care, the general consensus is that surgery — on breasts, facial features, or genitals — is mostly reserved for adults, though it should be available to minors on a case-by-case basis.

But when the American Medical Association told some media organizations last week that “surgical interventions in minors should be generally deferred to adulthood,” conservative commentators that want to end any pediatric gender-affirming medical care celebrated. Some media outlets and online commentators have also interpreted the comment as a backpedal on previous support.

“If the AMA was wrong about surgeries, could it also have been wrong about hormones?” Leor Sapir, a conservative political scientist and co-author of a recent federal report on gender dysphoria, wrote on X.

The AMA’s comment came in response to a recent position statement from the American Society of Plastic Surgeons that, while endorsing “individual decision-making” by its members, recommended that gender-affirming surgery be delayed until a patient is 19 years old.

“The AMA supports evidence-based treatment, including gender-affirming care,” reads the comment, which was not published on its site or attributed to any of the group’s leaders. But it goes on to call the evidence for surgery on minors “insufficient” and says that, “in the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”

While the AMA’s statement (posted on X by a writer at the National Review) is less of a departure from the group’s past positions than either conservatives or trans-rights activists are contending, its issuance and the reactions it sparked are indicative of the high-stakes political moment in which caring for transgender young people can draw the ire of the federal government.

“I see what ASPS and AMA have put out as clarifications of long-standing principles of the standard of care in an environment where many of their members are likely looking at them and saying, ‘We don’t understand exactly what the Trump administration is doing. How do we try to make sure that we don’t end up in its crosshairs?’” said Kellan Baker, a senior adviser for health policy at the Movement Advancement Project, an independent think tank.

Experts say that neither the ASPS statement nor the AMA’s comment are the first concern for hospitals and providers assessing whether they should continue providing gender-affirming care like surgery to young people. Proposed rules that would withhold federal funding to hospitals providing any such care, along with subpoenas and the threat of federal investigation are much bigger concerns, according to Hannah Oliason, an attorney at Nilan Johnson Lewis who works with hospitals.

Surgery on transgender minors is rare — one study found that between 2016 and 2020, about 3,200 people aged 18 and under received top surgery, in which someone’s breasts are augmented, reduced in size or removed. In the same span, fewer than 760 received any other gender-affirming procedure.

Since taking power, the Trump administration has pursued many strategies to stop medical care for young transgender people. Since January 2025, around a dozen hospitals nationwide have ceased to perform any surgical procedures on young people due to federal pressure including criminal investigations and threats to funding.

“I don’t know that this is going to be the straw that breaks the camel’s back in any one scenario,” Lindsey Dawson, director of LGBTQ health policy at KFF, said about the ASPS and AMA statements. “It’s really hard to speculate on that, but the pressure [medical institutions] are already facing is substantial.”

The AMA did not respond to questions about its statement. But over the last year, the group’s strategy has been to emphasize areas of agreement with federal health leaders in order to gain better access for its advocacy work.

If statements from medical groups have any impact in the current political atmosphere, experts say it might be on how individual providers consider risk regarding potential medical malpractice lawsuits.

“The AMA was very vocal in opposing restrictions on gender-related care based on age, saying this should be driven by the patient and their perspective on their needs. And now they are walking it back,” said Carmel Shachar, director of the Health Law and Policy Clinic at Harvard Law School. “That is something that would matter to a jury.”

Still, the organization does not appear to have changed any of its policies or position statements on gender-affirming care. In 2024, the AMA reaffirmed its policy that gender-affirming medication and surgery, “as determined by shared decision making between the patient and physician, are medically necessary as outlined by generally-accepted standards of medical and surgical practice.” The policy also opposes legislation criminalizing the care.

Since the latest comment only appeared in the media, its significance would likely be debated in any malpractice lawsuit, Oliason said.

“This [ASPS] position statement is more authoritative, or would be seen as more authoritative by a jury,” Oliason said. But clinical guidance would be the most authoritative, she added.

Other major medical organizations support the idea of surgery for minors on a case-by-case basis, including the American Academy of Pediatrics, which last reaffirmed its policy statement in 2023.

“The guidance from the American Academy of Pediatrics for health care for young people with gender dysphoria does not include a blanket recommendation for surgery for minors,” the group’s president, Andrew Racine, said in a statement. “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.”

Standards of care from the World Professional Association for Transgender Health, last updated in 2022, include a list of eight requirements that must all be met for a clinician to recommend surgical treatment before adulthood, including specific diagnostic criteria; documented and sustained gender incongruence over time; the need to address any mental health concerns that might inhibit their capacity to consent; a requirement for clinicians to discuss any reproductive effects of treatment; and more.

The Society for Evidence-Based Gender Medicine, a group that questions the evidence around gender-affirming care, has made it clear that its scrutiny will continue. In a post on X, the organization wrote that the ASPS assessment of evidence “may prompt greater caution with patients in their 20s as well.”

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