The American Society of Plastic Surgeons (ASPS) has quietly rejected the current consensus of medical groups in the United States on the issue of gender-transition care for minors.

According to City Journal, the ASPS became the first major medical association to break with other American medical associations when it stated in late July that it "has not endorsed any organization's practice recommendations for the treatment of adolescents with gender dysphoria."

The ASPS, which represents 11,000 members and more than 90% of the field in the U.S. and Canada, told the Journal that there is "considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions" and that "the existing evidence base is viewed as low quality/low certainty."

According to the Journal's report, the primary justification for gender-transition care for children in the United States has been that "all major U.S. medical associations" support it.

Critics have pointed to a lack of high-quality research and the absence of decades of honest debate among clinicians with diverse experiences and perspectives. The consensus is reportedly the result of a handful of "ideologically driven" physician-group members "who exploit their colleagues' trust."

The illusion of unanimity is maintained by silencing or distancing doctors with opposing viewpoints, the Journal reported.

Especially important to establishing this consensus on gender-transition care for minors was the World Professional Association for Transgender Health (WPATH) and the U.S. Endocrine Society. The United Kingdom's Cass Review found that these two medical groups cited each other's statements to forge the consensus, rather than conducting a scientific review of the evidence.

In her report to England's National Health Service, Dr. Hilary Cass said the "circularity" of this approach "may explain why there has been an apparent consensus on key areas of practice despite the evidence being poor."

Following the release of the Cass Review and a number of medical studies, several European countries abruptly stopped offering gender-transition surgeries for children.

In Belgium, Finland, Germany, Luxemburg, Sweden, the U.K., and three Canadian provinces, minors cannot undergo a double mastectomy. According to the Journal, countries that permit these procedures usually do so only in "rare cases," after age 16, and with parental consent.

The WPATH Standards of Care, Version 8, which is reportedly endorsed by the Biden administration, does not specify any age minimums for the majority of gender surgeries. According to court documents unsealed in June, WPATH did away with age minimums for political reasons under pressure from Assistant Secretary for Health Rachel Levine, who is a transgender woman.

Other medical groups could join the ASPS if additional research shows little to no medical benefit to minors who undergo such procedures and the threat of medical malpractice lawsuits continues to mount.

• Ohio Court Upholds Ban on Trans Treatments for Kids
• Dr. Haim to Newsmax: DOJ Silencing Transgender Surgery Dissent