By Christy Santhosh
2月3日（路透社）- 美国整形外科医师协会周二发表声明，建议外科医生将与性别相关的乳房或胸部、生殖器及面部手术推迟至患者至少19岁，理由是缺乏支持该手术益处的证据。
代表超过11,000名从事美容和重建整形外科医师的美国整形外科医师协会（ASPS）表示，目前尚无足够证据表明儿童和青少年接受与性别相关的手术具有有利的风险收益比。
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根据ASPS的说法，关于心理健康结果的证据确定性较低，同时对发育脆弱人群中潜在的长期危害以及手术的不可逆性存在新兴担忧。
该协会指出，这一立场反映了英国、瑞典和芬兰等国家近期的政策转变，这些国家也转向对未成年人采取更严格或仅研究性的模式。
卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy, Jr.）称赞ASPS，称该组织“正在抵制过度医疗化游说，捍卫可靠科学”。
美国医学协会在一份声明中表示，关于未成年人性别确认手术干预的证据仍然不足，并同意ASPS的观点，即此类手术通常应推迟至成年后进行。
去年12月，美国卫生与公众服务部提议禁止提供此类护理的医院参与医疗保险和医疗补助计划，并禁止医疗保险和儿童健康保险计划为此类手术付费，此举将削减儿童获得性别确认护理的机会。
包括世界卫生组织、美国儿科学会和美国医学协会在内的主要医疗组织已正式反对这些规定，称其干扰了医患关系并忽视了既定的临床证据。
许多儿童医院和性别诊所已要求患者在接受手术前达到成年年龄，这类手术被视为性别确认护理的最后一步，且18岁以下人群中较为罕见，因其具有不可逆性和更高的并发症风险。
报道：Christy Santhosh和Siddhi Mahatole（班加罗尔）及Julie Steenhuysen（芝加哥）；编辑：Vijay Kishore
US plastic surgeons group advises delaying gender surgery until age 19 due to insufficient evidence
By Christy Santhosh
Feb 3 (Reuters) – The American Society of Plastic Surgeons issued a statement on Tuesday recommending surgeons delay gender-related breast or chest, genital and facial surgery until a patient is at least 19 years of age, citing a lack of evidence supporting the procedure’s benefits.
The ASPS, which represents more than 11,000 physicians in cosmetic and reconstructive plastic surgery, said there is currently insufficient evidence showing a favorable risk-benefit ratio for gender-related surgeries in children and adolescents.
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According to ASPS, there is low certainty of evidence regarding mental health outcomes, along with emerging concerns about potential long-term harms and the irreversible nature of surgeries in a developmentally vulnerable population.
The association noted this position reflects recent policy shifts in countries such as the UK, Sweden, and Finland, which have also moved toward more restrictive or research-only models for minors.
Health Secretary Robert F. Kennedy, Jr. commended ASPS and said the organization was “standing up to the overmedicalization lobby and defending sound science”.
The American Medical Association in a statement said evidence on gender-affirming surgical intervention in minors remains insufficient, and agreed with the ASPS that such procedures should generally be deferred to adulthood.
In December, the U.S. Department of Health and Human Services moved to cut children’s access to gender-affirming care when it proposed rules barring hospitals that deliver such care from Medicare and Medicaid programs, and prohibiting Medicaid and the Children’s Health Insurance Program from paying for it.
Major medical organizations, including the World Health Organization, American Academy of Pediatrics and American Medical Association, have formally opposed the rules, stating they interfere with the patient-physician relationship and ignore established clinical evidence.
Many children’s hospitals and gender clinics already require patients to be adults before undergoing surgeries, which are considered the final step in gender-affirming care and are rare in those under 18, due to their irreversible nature and higher risk of complications.
Reporting by Christy Santhosh and Siddhi Mahatole in Bengaluru and Julie Steenhuysen in Chicago; Editing by Vijay Kishore
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