2月3日（路透社）- 美国整形外科学会（ASPS）周二发表声明，建议外科医生将与性别相关的乳房或胸部、生殖器和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。
该学会代表超过11,000名美容和重建整形手术医生，称目前尚无足够证据表明儿童和青少年进行与性别相关手术的风险收益比有利。
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据ASPS称，关于心理健康结果的证据确定性较低，同时人们对发展脆弱人群中潜在的长期危害以及手术的不可逆性日益担忧。
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以研究为导向的模式。
卫生部长小罗伯特·F·肯尼迪（Robert F. Kennedy, Jr.）称赞ASPS，称该组织”勇敢对抗过度医疗化游说团体，捍卫可靠科学”。
美国医学协会在一份声明中表示，关于未成年人接受性别肯定手术干预的证据仍然不足，并同意ASPS的观点，即此类手术应一般推迟至成年。
去年12月，美国卫生与公众服务部提出规则，禁止提供此类护理的医院参与医疗保险和医疗补助计划，并禁止医疗补助和儿童健康保险计划为此类手术付费，从而削减了儿童获得性别肯定护理的途径。
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正式反对这些规则，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经要求患者在接受手术前年满18岁。这些手术被视为性别肯定护理的最后一步，由于其不可逆性和并发症风险较高，18岁以下患者中此类手术较为罕见。
克里斯蒂·桑托什（Christy Santhosh）和西迪·马哈托莱（Siddhi Mahatole）在班加罗尔报道，朱莉·斯蒂恩胡伊森（Julie Steenhuysen）在芝加哥报道；由维贾伊·基肖尔（Vijay Kishore）编辑
US plastic surgeons group advises delaying gender surgery until age 19 due to insufficient evidence
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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