Biden administration shifts again, appears to back sex-change surgeries for minors

transgender Credit: itakdalee/Shutterstock

President Joe Biden’s administration has shifted its position on sex-change surgeries for minors for the second time this month, now appearing to support surgical gender transitions for people under the age of 18.

Neera Tanden, the director of the White House Domestic Policy Council, sent an email to the Human Rights Campaign (HRC) — an LGBT advocacy group — confirming that the White House supports transgender medical interventions on minors and opposes state-level efforts to restrict them. The news was first reported by an LGBT magazine, The Advocate, which obtained the email from HRC.

In her email, Tanden said that sex-change surgeries “are typically reserved for adults, and we believe they should be.” However, she added, “above all, families should have the freedom to make the medical decisions that they and their doctors determine are best for them — which is why we oppose attempts to limit health care for transgender individuals in the courts or through legislation.”

“We will continue to vigorously fight categorical bans on gender-affirming care in the courts, including the Supreme Court, and we will fight back hard against partisan laws being pushed by extreme Republican elected officials that target Americans just for who they are,” the statement read.

The statement provided to HRC is a departure from a comment made by a spokesperson for the White House just last week, which said that sex-change surgeries “should be limited to adults.” In a rhetorical shift, the new statement instead says that sex-change surgeries are “typically reserved for adults” but that the administration opposes legal restrictions.

For girls, sex-change surgeries can include the removal of healthy breasts and ovaries along with genital surgery to add prosthetic genitalia that appear male. For boys, sex-change surgeries can include the addition of prosthetic breasts along with castration and genital surgery that makes the boy appear female. Some surgeries, such as castration and the removal of ovaries, render the person infertile.

A study published in August 2023 estimated that patients aged 12 through 18 accounted for nearly 8% of transgender surgeries between 2016 and 2020 in the United States — about 3,678 surgeries in total. This included more than 3,200 chest surgeries and more than 400 genital surgeries to facilitate a sex change.

Jay Richards, the director of the DeVos Center for Life, Religion, and Family at the conservative Heritage Foundation, told CNA there’s been a “massive increase” in transgender medical interventions on minors in recent years and disputed the administration’s claim that sex-change surgeries are “typically reserved for adults” under current practice. 

“We know that … a few thousand American kids have undergone these procedures already,” he said.

The Biden administration issued its statement following a weeklong campaign by HRC and other advocacy groups that requested the administration openly support the legality of sex-change surgeries for minors. HRC President Kelley Robinson welcomed the clarification on the White House’s support for those surgeries.

“We appreciate that the administration has clarified that its position on health care for the transgender community has not changed — that it opposes any and all bans on access to care and will continue to fight these bans both in the courts and at the legislative level,” Robinson said in a statement.

Mary Rice Hasson, the director of the Person and Identity Project at the Ethics and Public Policy Center, told CNA the White House’s email to HRC shows that “LGBTQ activists — not scientific evidence — dictate the Biden administration’s support for disfiguring, fertility-destroying hormones and surgeries for identity-distressed youth.”

“After initially appearing to oppose irreversible ‘transition’ surgery for minors, the White House faced huge pressure from powerful LGBTQ lobby groups to correct the record,” Hasson said. “Sure enough, the White House has reiterated its enthusiasm for sterilizing confused, troubled minors — under the deceptive label of ‘affirming care.’”

Similarly, Dr. Michael Artigues, the president of the American College of Pediatricians — which opposes gender transitions for minors — told CNA that the organization was “initially hopeful that the current administration had started to move in the right direction by opposing surgical intervention on minors, but this is apparently not the case.”

“We will continue to work with others in the medical community who understand what evidence-based medicine is and who truly want what is best for children,” he said.

Richards said he believes that the administration’s earlier hesitation on minors receiving sex-change surgeries was simply so “they can get headlines” because “the public overwhelmingly opposes these procedures.” He called the previous comments “half-hearted” and argued that the supposed shift on policy “wasn’t because [the administration] actually changed its mind.”

“Absolutely everything the Biden administration has done since it began has been in favor of the most radical transgender medical interventions [for minors],” Richards added.

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Doctors can legally perform sex-change operations on children in slightly more than half of the states in the country. Over the past few years, about two dozen states banned doctors from performing sex-change surgeries on minors, an effort that was mostly led by Republicans.

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