Medical Groups Reverse Their Position on Transgender Surgeries for Minors
Should Parental Rights Proponents Rejoice?
Human beings find it difficult to live within limits. For instance, a fully healthy Norwegian male—Jørund Viktoria Alme—lives out much of his life as a disabled woman in a wheelchair. Alme’s case offers a marked contrast with the life of Joni Eareckson Tada, a woman disabled by a diving accident at seventeen. Living as an actual quadriplegic woman for more than fifty years, Joni’s life and struggle have inspired millions with her faith and perseverance.
Whether Jørund Alme suffers from a flight from embodied reality, it is clear that a contentious debate regarding transgenderism and transgender surgeries for minors has surfaced. Reflecting a loss of an agreed-upon set of values among elites, experts, and the common folk, the contours of this debate were recently enlightened by Fox Varian, a de-transitioner, who was awarded $2 million to compensate for “gender-affirming” surgery she had as a teen.
While cause and effect remain hard to prove, recently, two expert groups, the American Medical Association and the American Society of Plastic Surgeons, for the first time, endorsed restrictions on gender-related surgery for minors. The medical groups now argue that their new position is grounded in the conclusion that irreversible surgery provides “insufficient evidence demonstrating a favorable risk-benefit ratio.” This move was hailed as a victory for biological truth by Deputy Health and Human Services Secretary Jim O’Neill.
Between 2016 and 2020, approximately 3,600 patients aged 12 to 18 received gender-related surgery. The move toward transgender surgeries, hormone therapies, and puberty-blocking drugs has surged during the past two decades. This surge has been sparked by identity movements, including New York City’s recognition of 31 genders. This movement is designed to accommodate the fracture between biological sex and gender identity, but, on scholar Brooke Laufer’s account, may lead to nihilism and the belief that life has no inherent meaning.
Identity movements have triggered a festering conflict between concerned parents and public schools, particularly parents who—following Laufer’s analysis—are concerned that transgender ideology has come to fill a void in their child’s life, which, in a notable subset of cases, can lead to violence. In opposition to the interests of concerned parents, an increasing number of public schools have sought to foster an environment where students are encouraged to express their subjective selves authentically. Consequently, many public schools have instituted policies demanding compliance with guidelines mandating that teachers must refer to students by their preferred pronouns while declining to inform parents of their child’s gender dysphoria.
The pertinent legal issue is whether the AMA's and the American Plastic Surgeons' decision strengthens parents’ legal claims against school board officials. Consider the following case, which was filed well before the two medical groups decided to reverse their position on surgical procedures for minors.
In Littlejohn v. School Board of Leon County, Florida, 132 F. 4th 1232, parents filed a lawsuit against the school board and school officials, after a school official met their child outside of their presence to discuss a support plan for the child’s gender confusion. More specifically, the parents alleged that school officials affiliated with the School Board of Leon County, Florida, violated their right to direct their child’s upbringing, medical and mental health decision-making, and their right to familial privacy.
Although the Court concedes that this dispute involves fundamental parental rights, there is no direct evidence that the Court of Appeals relied on the advice of medical or psychological experts in reaching its decision to deny parents relief. Instead of focusing on medical advice or the work of psychologists, the court held that the school official’s actions in creating a support plan for middle school students’ gender confusion and in permitting students to express their gender identity and social transition at school without their parents’ knowledge or input did not “shock the conscience” of the court. Therefore, the court found no violation of the parents’ substantive due process rights in guiding their child’s upbringing.
In future cases, the pertinent questions are whether the decisions by the American Medical Association and the American Plastics Surgeons to reverse their medical advice for minors and whether the work of psychologist Brooke Laufer should (1) inform and affect decisions by school boards to offer support plans for minors and socially transition students without parental input, and (2) whether school board decisions can pass muster with citizens, courts, and children in the long run. These two essential queries assume prominence in light of the U.S. Supreme Court’s decision in Mahmoud v. Taylor, which, via preliminary injunction litigation, upheld parental rights and required notice and an opportunity to opt out of LGBTQ+-inclusive storybook instruction pending completion of the parents’ lawsuit.
Future litigation, school board meetings, and medical advice may give us more in-depth answers. Until then, parental rights advocates should remain vigilant.