Transgender Guidance Group Removes Age Minimums for Operations on Children

AP Photo/Armando Franca

A Transgender guidance group is tossing out age edicts.

In case you’re unfamiliar, the World Professional Association for Transgender Health (WPATH) — formerly the Harry Benjamin International Gender Dysphoria Association — is considered the top transgenderism health association for recommendations related to transgender surgery and chemical intervention.


What makes the Illinois organization the gold standard? That answer seems unclear. But hospitals and other medical institutions are now following the Association’s advice, dished via its Standards of Care for the Health of Transgender and Gender Diverse People protocol.

Concerning various procedures, WPATH’s rules have previously prescribed age minimums — September 6th’s Version 8 did just that. However, on September 15th, an edit was made. As noted by The Daily Wire, Sections for the “minimal ages for gender-affirming medical and surgical treatment for adolescents” were removed.

A confidential draft of the Eighth Edition was released for public review in December 2021 that lowered the recommended minimum age for minors to obtain cross-sex hormones — which cause permanent changes to the body — from 16 to 14, and irreversible chest, face, and genital surgeries to 15, 16, and 17, respectively.

No hard rules are now set; in their place are suggestions.

[W]hile WPATH no longer provides explicit minimum age recommendations in their latest official guidelines, a close reading finds that age suggestions for some procedures are woven into the text.

From Chapter Six:

[R]ecent guidelines suggest there may be compelling reasons to initiate [gender affirming hormone therapy] prior to the age of 16, although there are limited studies on youth who have initiated hormones prior to 14 years of age. … Chest masculinization surgery can be considered in minors when clinically and developmentally appropriate as determined by a multidisciplinary team experienced in adolescent and gender development.


What about vaginoplasties, which attempt to turn a penis into its sexual counterpart?

While the sample sizes are small…studies suggest there may be a benefit for some adolescents to having these procedures performed before the age of 18.

Puberty blockers may be allowed at the first signs of puberty. But to be clear, a maturity requirement is proposed:

[The child must demonstrate] the emotional and cognitive maturity required to provide informed consent/assent for the treatment. … The ability to reason hypothetical situations enables a young person to conceptualize implications regarding a particular decision.

It’s certainly not a standard held for other seismic situations across society. Puberty may start as early as nine for girls — not an age normally associated with “informed consent.” But this is the path America has taken, and there’s no sign of an about-face.

As the ages at which children are given irreversible drugs and operations have gradually lowered, what’s determined the changes? There doesn’t appear to be any clinical “science,” per se. And it would seem we’re simply on course for there to be no minimums applied whatsoever — as new ideas are accepted by the culture.

The new absence of any hard minimums was recently explained by Amy Tishelman, who identified herself as a lead author of the guide in a live stream:

What we didn’t want to do was create a chapter that would make it more likely that practitioners would be sued because they weren’t following exactly what we said. … We wanted there to be some clinician judgment without being at risk for being held in court for not sticking completely to these standards.


As we continue our social evolution, what’s on the docket next? As the notion of “nonbinary” increases in popularity, don’t be surprised if a more modern procedure finds its way to your nearest Children’s Hospital:


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