The American Society of Plastic Surgeons Challenges Gender-Affirming Care Consensus

The American Society of Plastic Surgeons (ASPS) is the first major medical organization that has broken the consensus surrounding gender-affirming care (GAC) for minors. According to a new report, the organization stated, “ASPS has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria. ASPS currently understands that there is considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions for the treatment of adolescents with gender dysphoria, and the existing evidence base is viewed as low quality/low certainty. This patient population requires specific considerations.”

Multiple websites list the major medical organizations that support gender-affirming care, including the American Society of Plastic Surgeons. This site includes a statement from the organization in 2017 asking the Center for Medicare and Medicaid Services (CMS) to reconsider its position on breast augmentation procedures. While it’s unclear if the organization still supports this position, the recent statement appears to disagree with the use of gender-affirming care treatments on minors under the age of 18.

Whether this represents a change in position or a clarification of their stance on GAC, it reflects ongoing debates within the medical community and the idea that the consensus is not always clear. Studies on the long-term effects of gender-affirming treatments present conflicting results. A Lancet study found that 98% of adolescents who began receiving gender-affirming care treatments continued at the first follow-up. Meanwhile, other research indicates that up to 98% of children experiencing gender dysphoria grow out of it by adulthood. The Lancet study, co-authored by Sabine Elisabeth Hannema, acknowledged financial ties to Pfizer, a fact furthering the debate about the potential influence of pharmaceutical companies on medical research.

Leor Sapir, a fellow at the Manhattan Institute, said it was a little surprising to see plastic surgeons stand against the established medical consensus regarding gender-affirming care for minors because of their reputations.

“But when you think about it, it’s actually not that surprising,” Sapir added in an interview with Fox News. “Because the doctors who actually take the scalpel and cut into people tend to have the heaviest sense of responsibility on their shoulders. It’s understandable that they would be the ones who would want to know that what they’re doing, especially when it involves kids, is actually good, is not harming their patients.”

The U.K. has reversed its position on gender-affirming care in the aftermath of the independent review by Hilary Cass, which said there is no reliable evidence regarding the long-term effects of these treatments. They have now blocked the use of puberty blockers in children.

Sapir explained, “Here in the United States, instead of evidence-based medicine, we’ve relied on what I sometimes call eminence-based medicine, which is: ‘These treatments are good because these people say so.'”

That is the nature of “consensus-based medicine,” which is also the cause of the American Board of Internal Medicine’s decision to revoke the certifications of Dr. Pierre Kory and Dr. Paul Marik for sharing information that doesn’t align with the “consensus.”

Independent Journalist Christina Buttons explained in an X post that organizations create “media reference guides” for media professionals as a reference to use when discussing gender-affirming care. This includes the Gay and Lesbian Alliance Against Defamation (GLAAD), the Human Rights Campaign (HRC), and the American Civil Liberties Union (ACLU).

GLAAD’s “checklist for media” coverage of transgender issues in healthcare states “Avoid “both sides” reporting. Efforts to restrict or remove evidence-based healthcare are not a “debate” or a “culture war,” they are one-sided, baseless attacks against transgender people. Recognize trans people and youth are people, not a “side,” and like all human beings, want to be themselves and be safe.”

GLAAD has received over a million dollars from many prominent companies, including Google, Procter and Gamble, and Gilead Sciences. Google has 91.5% of the global search market. They also link to the Human Rights Campaign as a top search result for the query “gender-affirming care.”

Among the frequently asked questions on the HRC page is about legislators who are passing bills in an attempt to protect children. The HRC declares that these legislators are trying to “enshrine discrimination into law.” The page states that “the safety, efficacy, and life-saving nature of gender-affirming care for transgender and non-binary youth and adults is clear.”

The platinum partners for the HRC include Google and Pfizer. Johnson and Johnson and Merck are also listed as bronze partners for the organization. The HighWire reported on the lawsuits filed by the social media platform X and the video platform Rumble against the World Federation of Advertisers (WFA). It involves a monopolistic advertising conglomerate that dictates terms for platforms to abide by in order to receive ad dollars from the companies it represents. Many of the same brands that are members of the WFA also contribute to the HRC and/or GLAAD, including Walt Disney, Procter and Gamble, and Diageo. Rumble founder Chris Pavlovski shared communications with Diageo in which they said there is “no scenario where we approve a platform that has Steven Crowder, Alex Jones, and the like.”

The interconnectedness with the U.S. medical groups, the informational activist groups, the pharma companies, and Google illustrates the inherent conversation limitations that go against the established “consensus.” Google also owns the most popular video-streaming platform, YouTube. When searching for “gender-affirming care,” the top results discuss the treatment in a positive light. A CNN podcast titled “Pediatricians on the Frontlines of Gender-Affirming Care” states in the show notes that politicians are passing “anti-trans bills.” The notes summary also says that “life-saving care” is at risk.

These phrases do not open the door to a discussion about the range of scientific evidence, which would include studies that show no support for gender-affirming care treatments for minors.

A Daily Caller exclusive report found that Boston Children’s Hospital received $1.4 million from the Massachusetts Health and Human Services Department for gender transition services between January 2015 and May 2023.

The HighWire has extensively covered concerns related to gender-affirming care, including reports on the Biden administration’s efforts to pressure WPATH into removing age minimums for certain procedures. Additionally, The HighWire has reported on the potential negative effects of puberty blockers on adolescent brain development. In one of these reports, Del Bigtree interviewed Luka, a detransitioner who medically transitioned as a teen before returning to her female identity.