The American Society of Plastic Surgeons (ASPS) recommended delaying gender-related breast, chest, genital, and facial surgeries until patients are at least 19 years old, citing insufficient evidence that the benefits outweigh the risks for children and adolescents. The organization expressed concerns about uncertain mental health outcomes, possible long-term harms, and the irreversible nature of these procedures in young patients.
ASPS noted that its position aligns with recent policy changes in countries such as the UK, Sweden, and Finland, which have adopted more restrictive approaches for minors.
At the same time, recent U.S. government proposals seek to limit federal funding for gender-affirming care for minors. These rules have been opposed by major medical organizations, including the World Health Organization and the American Academy of Pediatrics, which argue they interfere with medical decision-making and disregard existing evidence.
Many hospitals already require patients to be adults before undergoing gender-related surgeries, which are rare among minors due to their permanent effects and higher risk of complications.
What This Means to You
CC Exclusive Analysis: In light of this new guidance by the ASPS and the common recommendation by many hospitals and other international organizations regarding permanent gender affirming surgeries under the age of 19, parents and young patients may be wondering: what options do exist for me or my child. Noninvasive aesthetic services for minors under 18 are widely available but strictly governed by parental consent laws and professional ethical guidelines.
For those 18 and over, noninvasive aesthetics can provide a number of options for those seeking gender affirming care.
Botox and dermal fillers are widely used as non-surgical, gender-affirming treatments to align facial features with a person’s gender identity, reducing dysphoria without surgery. These injectables offer temporary, customizable results for feminization (softening jawlines, adding lip/cheek volume) or masculinization, (defining angles, brow enhancement). These procedures address both aesthetic goals and, for many, severe gender dysphoria, making them part of a necessary, holistic care plan. It is highly recommended to seek clinicians with experience in transgender-affirming care to ensure desired, safe results. Tox and filler are commonly paired with other services, such as laser hair removal, for a comprehensive, non-surgical approach.
Tox in Gender-Affirming Care
Botox, Dysport, or Xeomin relax muscles to soften features.
- Feminization: Slims a square or wide jawline (masseter muscle reduction) and softens forehead lines.
- Masculinization: Can be used to create a more defined, angular jaw.
- Brow Enhancement: Lifts or shapes the eyebrows for a more traditionally feminine or masculine look.
Dermal Fillers in Gender-Affirming Care
Fillers (such as hyaluronic acid) add volume to contour the face.
- Feminization: Adds volume to cheeks, softens the chin, enhances lip shape, and fills in temples.
- Masculinization: Builds stronger, more defined cheekbones and a more angular jawline or chin.
- Refinement: Used for non-surgical rhinoplasty or to smooth out facial contours.
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