In a development that many feared would only come after further institutional collapse, the United States is—at last—reorienting itself toward the cautionary, evidence-based approach adopted years ago by more ethically intact European systems. It is with solemn satisfaction that we note the shift: the American Society of Plastic Surgeons (ASPS) has now formally recommended that gender-related surgical interventions not be performed on individuals under age 19. One day later, the American Medical Association (AMA) issued a matching statement acknowledging that the evidence for such irreversible interventions in minors is, in their own words, insufficient.

This is no minor rhetorical shift. This is a profound recalibration of medical ethics—long overdue.

The European Model: Evidence, Ethics, and Caution

Sweden, Finland, Norway, France, and the United Kingdom each underwent what the United States is only now confronting: a reckoning with evidence, harm, and the collapse of consent. Each nation reversed its course not through ideology but through method. National reviews of outcomes, harm registries, and patient follow-up all converged on the same realization: the evidence was astonishingly weak, the risks irrevocable, and the patients—children.

The Cass Review in the UK concluded that the treatment model was built not on data but on untested belief. Sweden’s Karolinska Institute halted all puberty blockers and hormones outside strict research protocols. Finland elevated psychotherapy over medical transition. Norway’s health directorate classified pediatric transitioning as experimental. These decisions followed from evidence, not pressure.

The American Turn Begins

Until recently, the United States had remained an outlier, with its professional societies insulated from accountability by narrative capture. But that era is ending.

See “Evidence of Harm and Lack of Evidence of Improved Health Brings Down Pre-Pubertal Transitioning in Europe”, 2/3/2026

The ASPS’s February 3, 2026 position statement explicitly advises surgeons to delay all gender-related breast/chest, genital, and facial surgeries until a patient is at least 19. The language is clinical and damning: “insufficient evidence demonstrating a favorable risk-benefit ratio” for the use of surgery in minors.

The AMA’s alignment the following day compounds the shift. While couched in the typical language of prudence, the core message was unmistakable: the evidence does not support this practice. For an organization that just three years ago defended so-called “gender-affirming care” for adolescents, this is nothing short of a reversal.

Litigation Exposes Institutional Negligence

The statements came on the heels of the Fox Varian malpractice verdict—an event that stripped bare the myth of clinical due diligence. A Westchester County jury awarded $2 million to Varian, who received a double mastectomy at age 16. Her testimony included evidence of unresolved psychiatric distress, cursory evaluation, and a consent process marred by therapeutic pressure and bureaucratic haste.

This is not an outlier. It is the overdue harbinger.

The Trump-Kennedy Policy Stack

President Trump’s January 28, 2025 Executive Order—flanked by HHS Secretary Robert F. Kennedy Jr.—prohibited federal funding for what it termed “chemical and surgical mutilation” of children. Critics scoffed. Agencies complied.

• OPM followed with a mandate that all federal employee health plans exclude coverage for puberty blockers, cross-sex hormones, and surgical procedures for individuals under 19.

• CMS released proposed rules banning Medicaid and CHIP funding for these interventions, and another rule that would strip hospital eligibility for Medicare/Medicaid reimbursement if such procedures are conducted on minors.

The deadline for public comment: February 17, 2026.

The Data: Absence, Avoidance, and Suppression

Far from clarifying the benefits, the scientific literature now reveals just how little was ever known. The popular claim that medical transition reduces suicide in youth has not held up under scrutiny. The oft-cited Swedish study (Dhejne et al.) showed a 19-fold suicide rate in post-operative adults—but explicitly rejected causal attribution.

Meanwhile, U.S.-based studies on mastectomy “satisfaction” and “low regret” fail basic methodological thresholds: they rely on short follow-up periods, lose large portions of their cohorts to attrition, and define regret so narrowly that silent suffering is excluded by design.

On Consent: A Line Finally Drawn

The core ethical issue—consent—has been consistently and willfully misrepresented. Adolescents cannot legally consent to cosmetic breast implants, alcohol consumption, or elective sterilization. Yet under the old model, they were permitted to amputate healthy tissue and receive endocrine-disruptive drugs whose long-term effects are unknown or undisclosed.

This was never ethical medicine. It was institutional fantasy fueled by captured gatekeepers.

Cassidy’s Press Release on Pediatric Gender Transition Surgeries

Senator Bill Cassidy, M.D. (R-LA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, issued a statement welcoming the American Society of Plastic Surgeons’ (ASPS) public stance against performing gender-transition surgeries on minors. He described such procedures as “dangerous” and “irreversible,” and characterized ASPS’s recommendation to delay such surgeries until age 19 as an overdue acknowledgment of medical risk.

“Dangerous, irreversible gender transition surgeries on children must end. ASPS is right to acknowledge this reality. Others should follow suit.”

Policy Framing

Cassidy framed the issue as one of protecting children from medical harm. He praised the ASPS for “acknowledging the dangers” and pledged continued cooperation with President Trump to prevent what he called “chemical and surgical castration” of minors.

Legislative and Executive Context

The statement reinforces Cassidy’s alignment with broader Republican legislative and executive actions, including:

• President Trump’s Executive Order: Prohibiting federal funding for gender-transition procedures in children.

• Recent HHS Policy Announcement: Joined by HHS Secretary Robert F. Kennedy Jr., which aims to block public funds from supporting these procedures.

• Cassidy’s Legislation: Cassidy introduced the “No Subsidies for Gender Transition Procedures Act,” which would prohibit Medicaid, Medicare, CHIP, and ACA plans from funding gender transition procedures for minors.

Enforcement and Investigations

Cassidy emphasized his ongoing investigation into medical organizations, provider groups, and insurers who promote pediatric gender-transition procedures without sufficient scientific evidence. He reiterated that these entities must comply with new federal directives or face consequences.

A Chapter Closes—And One Opens

This is not the end. But it is the end of impunity.

As malpractice verdicts loom, as federal dollars dry up, and as clinical institutions retreat under the weight of their own silence, a new phase of medicine begins—one rooted, once again, in first principles: do no harm, disclose all risks, and protect those least able to protect themselves.

We mark this moment not with triumphalism, but with the quiet hope that it came soon enough to spare thousands more from what cannot be undone.

It’s time to let kids be kids.

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IPAK-EDU is grateful to Popular Rationalism as this piece was originally published there and is included in this news feed with mutual agreement. Read More