The American Society of Plastic Surgeons (ASPS) is the first major American medical organization to oppose sex-affirming surgery on minors[1][3]. The ASPS states that there is significant uncertainty about the long-term effectiveness of thoracic and genital surgery in adolescents with gender dysphoria, and the evidence is of low quality and low certainty[2][3][6]. The Society has not endorsed the recommendations of any organization for the treatment of adolescents with gender dysphoria[3][5]. The ASPS reviews initiatives to promote evidence-based gender surgery and emphasizes the need for comprehensive patient education and informed consent[3]. Statistics show that the rate of gender-affirming surgery is 5.3 per 100,000 adults, 2.1 per 100,000 for youth 15–17 years old, 0.1 per 100,000 for 13–14 year olds, and none for children 12 years and younger[1]. Of the 85 procedures performed on juveniles, 96.4% were chest procedures[1]. ASPS supports transgender patients' rights to dignity and humane medical care, but calls for higher quality research[3].