The American Society of Plastic Surgeons (ASPS) has quietly rejected the current consensus of medical groups in the United States on the issue of gender-transition care for minors.

According to City Journal, the ASPS became the first major medical association to break with other American medical associations when it stated in late July that it “has not endorsed any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

The ASPS, which represents 11,000 members and more than 90% of the field in the U.S. and Canada, told the Journal that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”

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