The Biden administration has said that transgender surgeries should not be performed on children, in what appears to be a major pivot.
Revealing the stance in a statement today, a White House spokesperson said ‘deeply personal decisions’ like operations should be reserved for over-18s only.
They still support other forms of gender-affirming care for minors, including puberty blockers and hormone therapy.
It appears to be a departure from the White House’s former position, with Biden himself having previously slammed Republican states for restricting children’s access to surgeries.
Some LGBT groups were quick to blast the shift, calling it ‘flat wrong’ and accusing the President of being ‘wrong on the science and wrong on the substance’.
The White House has previously shown strong support for trans healthcare
The rate of children undergoing the procedure has risen 13-fold since 2013 (pictured left). Some patients were as young as 12 (show top right). The vast majority had no regrets about the surgery, with only two children saying they wished they had not gone through with it
The shift in view was first revealed by The 19th News, a news outlet that covers gender, politics and policy.
A White House spokesperson said in an email: ‘These are deeply personal decisions and we believe these surgeries should be limited to adults.
‘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.’
Gender-affirming surgeries are operations that aim to align a person’s physical body with their gender identity.
They include a mastectomy — or ‘top’ surgery — where breast tissue is removed to create a more masculine chest, and a breast augmentation, or the insertion of breast implants to create a more feminine chest.
At least 800 children aged 12 to 18 years old receive gender-affirming surgeries every year in the US, according to a study that analyzed data from nearly every state. The vast majority received breast or chest surgery.
At least 20 states have taken steps to restrict or fully ban transition healthcare for trans youth
Montoya, 27, has since been banned from the White House by officials after unhooking the top of her dress and grabbing her chest on the South Lawn. The above is from June last year
Many clinics refuse to carry out gender-affirming surgery for under-18s, while Arizona has brought in a ban on this type of surgery for minors.
The US is an outlier in the Western world when it comes to transgender care, with many European countries seeking to limit surgeries and hormone therapy for children because these are often irreversible.
They include the UK, where puberty blockers are now only prescribed in clinical trials, and Sweden, which began to restrict hormone therapy for minors last year.
This is amid a surge in reports that the effects of gender-affirming treatments are poorly studied, and suggestions that many children who identify as transgender have other conditions such as autism which may contribute to their diagnosis.
Slamming the White House’s statement, the president of the Human Rights Campaign — Kelly Rowland — said: ‘The Biden administration is flat wrong on this.
‘It’s wrong on the science and wrong on the substance. It’s also inconsistent with other steps the administration has taken to support transgender youth.’
Some medical organizations support the position, however, including The Endocrine Society — which recommends delaying genital surgery until a patient turns 18.
The White House’s statement comes just a week after reports that the team for Health and Human Services Assistant Secretary Adm. Rachel Levine, who is a trans woman, had urged an international group of medical experts to remove age limits for adolescent gender-affirming surgeries.
Email excerpts from the World Professional Association for Transgender Health (WPATH), which publishes guidelines on transgender care, and revealed by the New York Times, show Biden officials contacted their staff urging them to drop age limits for transgender care entirely.
They appeared to succeed because the final guidance — published in 2022 — did not include any age limits.
Previously, it had suggested lowering age limits to 14 for hormonal treatments, 15 for mastectomies, 16 for breast augmentation or facial surgeries, and 17 for genital surgeries or hysterectomies.
Biden also posed for photos with transgender activists on the White House lawn in June last year at a party that prompted backlash over an attendee bared her breasts.
The activist, Rose Montoya, was later banned from attending further events at the White House.
In October 2022, Biden also sat down for an interview in the White House with trans TikToker Dylan Mulvaney.
To date, 25 Republican-led states since 2021 have adopted laws banning gender-affirming care for transgender minors. The severity, however, depends on the state.
In Arizona, surgery is prohibited while other forms of care are permitted. But in Texas, laws prohibit doctors from prescribing any gender-affirming care to transgender minors.
