Biden administration opposes gender-affirming surgery for trans youth

Yesterday, the Biden administration confirmed that it opposes gender-affirming surgeries for transgender minors.

“These are deeply personal decisions, and we believe these surgeries should be limited to adults,” a White House spokesperson told The 19th. “We continue to support gender-affirming care for minors, which represents a continuum of care, and respect the role of parents, families, and doctors in these decisions.”

Related:

New York Times publishes story based on edited emails put together by anti-trans activist

The story accused the Biden administration of wanting to remove age limits on gender-affirming surgery. But that’s not what happened.

The statement comes after the New York Times wrote a story by contributor Azeen Ghorayshi that alleged the Biden administration, at the behest of representatives of the Assistant Secretary of Health Admiral Rachel Levine, had pushed for no age limits on surgeries in forming the World Professional Association for Transgender Health (WPATH) clinical guidelines. This story, however, did not appear to independently verify those claims, which were based on partial emails that appeared in a document created by a Canadian opponent of gender-affirming care.

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In response to this article, a representative for the Department of Health and Human Services (HHS) spoke to the New York Times late last week to clarify Admiral Levine’s alleged actions during the email chain with WPATH officials.

“Adm. Levine shared her view with her staff that publishing the proposed lower ages for gender transition surgeries was not supported by science or research and could lead to an onslaught of attacks on the transgender community,” the HHS spokesperson said.

The final guidelines released by WPATH do not mention age minimums for gender-affirming care “to reflect that one-size-fits-all health care models, especially transgender care, are not accurate or appropriate for every individual person.”

The Biden administration has also clarified that it still strongly opposes bans on gender-affirming care for minors that have been proposed and passed in states across the country. These bans include limitations on surgeries for minors.

“As President Biden has repeatedly said, ‘It’s wrong that extreme officials are pushing hateful bills targeting transgender children, terrifying families, and criminalizing doctors. These are our kids. These are our neighbors. It’s cruel and it’s callous,’” said the Biden administration spokesperson while quoting a statement made by Biden last year. “Transgender children have been the victims of unacceptable bullying, hate, and partisan laws that target them for who they are.”

The White House echoed a statement made by the American Academy of Pediatrics that said that gender-affirming surgeries for minors are exceedingly rare. It’s estimated that only to a few hundred of these procedures are done each year.

They are performed on a case-by-case basis, and the vast majority of these procedures are mastectomies, also known as top surgery, meant to reduce or remove breast tissue to create a flatter, more masculine chest. Genital surgeries, also known as bottom surgery, are even more rare.

Surgeries on minors are only done in the most extreme cases where a youth has been stable in their identity for years and has already transitioned in other ways. Parents and doctors both have to agree that it is an absolute medical necessity for the youth to get gender-affirming surgery before turning 18.

In an article that appeared on Slate, a parent described having to push for a surgeon to provide care for her child, a transgender boy. It was only after finding one surgeon who was supportive that they were able to get care. The surgeon had to get approval from the hospital’s medical ethics board, which overwhelmingly approved the surgery after a case was made for its medical necessity.

This statement by the White House contradicts the Biden administration’s claims of support for transgender youth. The administration has previously backed transgender youth and adults in legal battles to protect transgender care and has issued statements stating its support for trans youth.

It is unclear how they will move forward with further actions regarding trans youth surgeries.

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