The Association of Out Surgeons and Allies (AOSA) stands with our transgender and gender diverse members, colleagues, and patients to urge all healthcare institutions, policy makers, and communities to support access to comprehensive care for transgender people across the age spectrum. AOSA firmly opposes any legislation that prohibits the provision of best-practice care to transgender adults or youth. Such dangerous legislation has already begun to adversely affect the health of transgender individuals across the country and poses a fundamental threat to the integrity of the practice of medicine.

Transgender and gender diverse identities are normal parts of the range of human identity and experience. Decades of evidence demonstrate that, for transgender people who suffer from gender dysphoria, a serious medical condition recognized by every major U.S. medical association, treatment is essential and can be lifesaving. Well-established, evidence-based standards guide the provision of medically necessary care to alleviate gender dysphoria and affirm gender identity and expression. The care of minors with gender dysphoria is supported by strong evidence showing that individualized, age-appropriate care allows transgender young people to live safely and authentically as who they truly are.  Limiting or denying access to gender-affirming care, by contrast, increases transgender individuals’ risk of negative mental health outcomes, including depression, serious psychological distress, and suicidality. 

AOSA joins many major medical associations in the United States, including the American Academy of Pediatrics and the American Medical Association, in asserting that gender-affirming care is necessary to improve and sustain the physical and mental health of transgender people. All surgeons must be committed to equitable, comprehensive health care, and all surgeons may participate in the care of gender-diverse patients. Moreover, surgical care is a crucial element of gender affirmation for many transgender individuals. Ensuring access to this care is consistent with the values and mission of AOSA. We stand with our surgical colleagues who provide gender-affirming care and we call on surgical societies to increase support and protections for these surgeons. Threats against providers offering gender-affirming care constitute an impermissible assault on each patient’s right to make healthcare decisions in partnership with their providers. The highly trained, responsible, expert clinicians who provide gender-affirming care do not take their work lightly. Gender-affirming care is medically necessary and is entered into with great consideration and appropriate counseling.

Like all medical care, gender-affirming care can and does account for patients’ age, their long-term development, and the need to preserve the fullest range of future options in areas such as family planning. Contrary to alarmist reports, there is no epidemic of surgeries being performed on transgender people of any age, and especially not young people. Rather, distorted claims are propagated and exploited to raise public fears of transgender people and to propel legislation targeting gender affirming care. The standard of care for older adolescents allows consideration of surgeries only in rare circumstances. Legislation targeting transgender youth frequently contains clauses permitting early medical and surgical intervention for intersex children, violating their ability to make autonomous health decisions in the future. The AOSA firmly opposes any attempts to allow politicians to displace patients—particularly transgender and intersex people—and their providers in private medical decision-making. We urge our colleagues in surgery and medicine to stand with our community and our patients to oppose these bills, and we urge our state lawmakers to do the same.