Yes, Doctors Are Performing Surgeries on Minors. We Oppose This.
Many people are surprised to find out that the so-called “gender-affirming care” model for youth includes breast amputation (mastectomy) for girls who want to be boys and genital surgery (vaginoplasty) for boys who want to be girls. In the US, these surgeries are allowed under eighteen in some states but banned in others. In certain states, children as young as thirteen can get these surgeries legally without their parents’ permission, with laws forcing insurance to cover the costs.1 Some Western countries permit surgeries underage, and others do not after their systematic reviews found there is not enough proof that they improve mental health.2
How old are the patients undergoing surgeries?
The youngest recorded age for a mastectomy is twelve.3 The youngest recorded age for vaginoplasty is fifteen.4
What are the complications and side effects?
Mastectomy
Complication rates for mastectomies range from 4.7%5 to 35%6 depending on the study criteria. The complications include nerve damage,7 hematomas,8 and scaring. Women who have detransitioned and had babies have expressed regret for not being able to breastfeed their infants.9
Vaginoplasty
A vaginoplasty10 is a surgery that involves castration and dissects and inverts the penis to mimic the genitalia of women. But it does not function as a vagina. The male body wants to treat it as a wound and the person must dilate it with an insertion device regularly. Many things are likely to go wrong with the surgery, and losing the ability to orgasm is a common side effect.
“Fancy a vaginoplasty? Think again”11 is an article discussing the lack of medical ethics and high complication rates of vaginoplasty:
I have seen horrific unethical practices by surgeons who lie about their experience and horrific results surgically as a result of that. We are using trans-gender people as guinea pigs and the medical profession allows this to happen,” said one doctor.
The situation is worse if doctors gave the child puberty blockers.12 This stunts the growth of their penis and destroys their ability to have an orgasm as an adult.13 Doctors then do not have enough tissue to invert it. They must create a canal using skin grafts and the colon or the lining of the abdominal cavity.
These surgeries are more dangerous, and doctors have treated under 18s as experimental surgical subjects. One young adult patient from the original group medically transitioned in the Netherlands died from a serious infection called sepsis.15 Jazz Jennings, a child labeled as transgender at a very young age and made into a TV celebrity was also subjected to this surgery. The vaginoplasty collapsed and required multiple additional surgeries.16
We know this will hurt gay youth. It already has. At the time the US was ramping up these surgeries on under-18s, Thailand had to raise their age of consent laws due to transition regret among young gay men.17
Thai gay rights campaigner Nathee Teerarojanapong said the greater legal protections are necessary to guard against gender swaps that too often backfire on those who make an irreversible choice. “I got so many calls where they said they are so sorry that they did a sex change,” says Nathee. “They make a big mistake and they want to come back and be the same. But they cannot!”
“Surgeries are rare so it’s ok.”
The claim that surgeries on minors are rare does not make them ethical in any case, given minors cannot legally get tattoos, smoke, or vote.
How Many Minors Have Undergone Surgery in the US?
The exact number of minors who have undergone surgery is not known. According to a report from the Manhattan Institute, between 2017 and 2023, doctors performed breast amputation surgeries on 5,000 to 6,000 underage girls, with at least 50 of them being younger than thirteen years old.18 Vaginoplasty surgeries are less common but do occur.19
Conclusion
We oppose all surgery on minors. Many trans-identified adults make the choice not to risk certain surgeries and many wish to have children.20 Adults should help youth preserve opportunities for future choices and possibilities. These procedures are irreversible, have high risks of serious complications, they sterilize, and destroy sexual function. Minors do not have the capacity to consent to these decisions.21 They are dangerous for young adults and vulnerable adults of any age. There is no vigorous evidence these surgeries significantly improve mental health22 or reduce suicides and may increase these problems.23 Scrutiny of the benefits of these procedures is warranted despite efforts from the medical transition industry and LGBTQ lobby to market them as fixes to complex human problems.
1 Rantz, J. (2023, February 10). Rantz: WA laws now allow teen gender reassignment surgery without parental consent. MyNorthwest.com. https://mynorthwest.com/jason-rantz/rantz-washington-laws-permit-teen-gender-reassignment-surgery-parental-consent/3296653
2 Gender Health Query. (2019). Articles Scrutinizing the Affirmative Model for Gender Dysphoric Children & Teens. https://thehomoarchy.com/affirmative-model-trans-criticize-minors
3 Tang, A., Hojilla, J. C., Jackson, J. E., Rothenberg, K. A., Gologorsky, R. C., Stram, D. A., Mooney, C. M., Hernandez, S. L., & Yokoo, K. M. (2022). Gender-Affirming Mastectomy Trends and Surgical Outcomes in Adolescents. Annals of Plastic Surgery, 88(4), S325–S331. https://doi.org/10.1097/sap.0000000000003135
4 Milrod, C., & Karasic, D. H. (2017). Age is just a number: WPATH-Affiliated surgeons’ experiences and attitudes toward vaginoplasty in transgender females under 18 years of age in the United States. The Journal of Sexual Medicine, 14(4), 624–634. https://doi.org/10.1016/j.jsxm.2017.02.007
5 Cuccolo, N. G., Kang, C. O., Boskey, E. R., Ibrahim, A. M., Blankensteijn, L. L., Taghinia, A., Lee, B. T., Lin, S. J., & Ganor, O. (2019). Mastectomy in transgender and cisgender patients: A Comparative analysis of Epidemiology and postoperative Outcomes. Plastic & Reconstructive Surgery Global Open, 7(6), e2316. https://doi.org/10.1097/gox.0000000000002316
6 Freedman, J. A., Franco, J. S., & Salzman, M. M. (2019). Chest contouring surgery in female-to-male transgender individuals: A comprehensive literature review. Plastic and Reconstructive Surgery Global Open, 7(5), e2212. https://pubmed.ncbi.nlm.nih.gov/31082837/
7 Dutta, V. (2015, January 1). The phantom breast after mastectomy, the homunculus and the hole in the cortical map. Document – Gale Academic OneFile. https://go.gale.com/ps/i.do?asid=f8502f40&id=GALE%7CA411293963&it=r&p=AONE&u=googlescholar&v=2.1
8 Hematoma. (2025, February 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/hematoma
9 Gribble, K. D., Bewley, S., & Dahlen, H. G. (2023). Breastfeeding grief after chest masculinisation mastectomy and detransition: A case report with lessons about unanticipated harm. Frontiers in Global Women S Health, 4. https://doi.org/10.3389/fgwh.2023.1073053
10 MTF vaginoplasty techniques: What patients need to know. (n.d.). MTFsurgery.net. https://www.mtfsurgery.net/mtf-vaginoplasty.htm
11 Cook, M. (n.d.). Fancy a vaginoplasty? Think again. BioEdge. https://bioedge.org/uncategorized/fancy-a-vaginoplasty-think-again/
12 Gender Health Query. (2019). Hormone blockers to cross-sex hormones stunt genital growth in males & may permanently damage sexual function. https://thehomoarchy.com/trans-youth-side-effects-hormone-blockers-surgery/#anchor-page2-section-a
13 RubbleOfEmpires. (2022, September 16). Puberty blockers are chemical castration. Marci Bowers (WPATH) casually reveals extent of damage. [Video]. YouTube. https://www.youtube.com/watch?v=kuwOx9YdHXY
14 Sex reassignment surgery by Colon graft technique – Dr.Chettawut- Sex reassignment and Facial feminization surgery center. (2024, July 8). Dr.Chettawut- Sex Reassignment and Facial Feminization Surgery Center. https://www.chet-plasticsurgery.com/colon-graft-technique/
15 de Vries, A. L. C., McGuire, J. K., Steensma, T. D., Wagenaar, E. C. F., Doreleijers, T. A. H., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696–704. https://doi.org/10.1542/peds.2013-2958
16 Diaz, J. (2020, January 22). A complication, ‘crazy pain,’ as South Florida trans teen Jazz Jennings gets confirmation surgery. Sun Sentinel. https://www.sun-sentinel.com/2019/01/30/a-complication-crazy-pain-as-south-florida-trans-teen-jazz-jennings-gets-confirmation-surgery/
17 Truscott, C. (2009, November 25). Thailand tightens sex change laws. The Telegraph. https://www.telegraph.co.uk/expat/expatnews/6669101/Thailand-tightens-sex-change-laws.html
18 Duggan, L. (2024, August 13). Report: thousands of US girls underwent trans ‘top surgeries.’ UnHerd. https://unherd.com/newsroom/report-thousands-of-us-girls-underwent-trans-top-surgeries/
19 Respaut, R., & Terhune, C. (2022, October 6). Putting numbers on the rise in children seeking gender care. Reuters. https://www.reuters.com/investigates/special-report/usa-transyouth-data/
20 Gender Health Query. (2019). Consequences & Permanent Side-Effects That Result From the Use of Hormone Blockers & Medical Transition Generally. https://thehomoarchy.com/trans-youth-side-effects-hormone-blockers-surgery
21 Gender Health Query. (2019). Are Children & Teens Old Enough to Give Consent for Medical Gender Transition? https://thehomoarchy.com/trans-youth-consent-gender-dysphoria
22 Society for Evidence-Based Gender Medicine. (2020, November 4). Largest dataset on sex reassignment: No mental health benefit found. SEGM. https://segm.org/ajp_correction_2020
23 Straub, J. J., Paul, K. K., Bothwell, L. G., Deshazo, S. J., Golovko, G., Miller, M. S., & Jehle, D. V. (2024). Risk of suicide and Self-Harm following Gender-Affirmation surgery. Cureus. https://doi.org/10.7759/cureus.57472