surge in Minors Seeking Gender-Affirming Chest Surgeries Raises Ethical and Medical Concerns
WASHINGTON, D.C. – The number of minors undergoing mastectomy, the surgical removal of breasts, as part of gender-affirming care has seen a critically important increase in recent years, according to data presented at the American Society of Plastic surgeons (ASPS) annual meeting this week. Presentations detailed a rise from 497 procedures performed on individuals under 18 in 2019 to 1,762 in 2022 – a 254% jump. This trend is prompting debate among medical professionals, ethicists, and policymakers regarding the long-term effects, appropriate age of consent, and potential for detransition.
The increasing demand for these surgeries, often referred to as “top surgery,” reflects a broader rise in the number of young people identifying as transgender or gender diverse. While gender-affirming care is supported by major medical organizations like the American Academy of Pediatrics and the Endocrine Society, the rapid increase in surgical interventions for minors is fueling concerns about irreversible decisions made during a period of significant developmental change. Experts are now grappling with questions surrounding the psychological evaluation process, the role of parental consent, and the need for more complete long-term follow-up studies to assess outcomes and potential regret.
The ASPS data, compiled from a survey of its members, indicates that the majority of these procedures are performed on individuals aged 16-17, though a smaller percentage involve younger patients. Dr. Nicholas Lalone, a plastic surgeon presenting at the conference, noted that the increase is likely due to a combination of factors, including greater awareness of gender-affirming options, reduced stigma, and increased access to care. “We’re seeing more patients who have been through a thorough evaluation process with mental health professionals and endocrinologists,” Dr. Lalone stated. “However, it’s crucial to continue refining our protocols to ensure we’re providing the best possible care and support for these young people.”
The debate extends beyond the medical community. Conservative advocacy groups have voiced strong opposition to gender-affirming surgeries for minors, arguing they are experimental and perhaps harmful. Conversely, LGBTQ+ rights organizations emphasize the importance of allowing transgender youth to access the care they need to align their physical bodies with their gender identity, citing potential benefits to mental health and well-being.Several states have introduced or enacted legislation restricting access to gender-affirming care for minors, leading to legal challenges and further complicating the landscape.
Looking ahead, researchers are calling for more robust data collection and analysis to better understand the long-term outcomes of gender-affirming chest surgeries in minors.The ASPS is planning to establish a national registry to track these procedures and monitor patient outcomes, aiming to provide evidence-based guidance for clinicians and inform policy decisions. The ethical and medical considerations surrounding this evolving area of care are expected to remain at the forefront of discussion for years to come.
