American Society of Plastic Surgeons

ASPS advises surgeons to delay breast/chest, genital, and facial gender surgery until patients are at least 19. It cites insufficient evidence of a favorable risk–benefit ratio, low-certainty mental-health evidence, concerns about long-term harms, and irreversibility in a developmentally vulnerable population. This is professional guidance for members — not a legal ban or a clinical practice standard.

• Issued February 3, 2026. The ASPS/PSF Board of Directors approved the position on January 23, 2026.
• ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.
• The Society concludes there is insufficient evidence of a favorable risk–benefit ratio for that endocrine-and-surgical pathway in children and adolescents, citing low-certainty mental-health evidence, emerging long-term harm concerns, and the irreversible nature of surgery.
• The document states it is not a clinical practice guideline, not a standard of medical care, and not legal advice. ASPS has not undertaken a formal guideline-development process.