Preamble

Transgender care ends up being care for autistic people far more often than in the broader population. The overlap between the two is considerable, with people who are transgender, nonbinary, or genderqueer up to six-fold likelier to be autistic than people who identify with sex assigned at birth. Likewise, autistic people are more likely than nonautistic people to be gender diverse.

For this reason, when it comes to gender-affirming care for transgender people, autistic people constitute a considerable portion of the referenced – and affected – population. That means that attacks on affirmative care for transgender minors by establishment boors like the New York Times doubly deserve our attention.

This entry is long, but I think it is important because the sleight of hand being attempted here is insidious dirty play. The outlet, reportedly because of top-down pressure and bottom-up willingness, wants to spin a story that medical societies are “evolving” in their positions on gender-affirming care for minors, putatively in response to new recognition of how “weak” the evidence is and to being forced to face some kind of lurking “ground truth” about the negative effects of these alleged weaknesses.

Background

The NYT has issued what it calls a “fact-check” about the outlet’s coverage of what the American Medical Association (AMA) has to say regarding gender-affirming care for minors. Risibly, the writers of the unsigned “fact-check” claim that a statement by the chair of the AMA board contradicts the AMA’s own statements. To be clear, the chair of the AMA board represents the organization, and statements that the chair of the AMA board makes are, in fact, statements from the AMA.

The NYT has repeatedly made clear that for its editors, the facts about gender-affirming care for minors are irrelevant to them as long as they can find a contrarian to highlight, a personal story to misrepresent, a rabid bigot to rely on, or data to skew. This “fact-check” of the AMA is no exception.

The Times claims that all of the information presented in two articles, one from February 3, 2026 (gift link) and one from March 16 (sorry, no gift link offered). Let’s take a look at those articles and one more on the American Society of Plastic Surgeons (ASPS) also published on February 3 and see just exactly what they claim.

Article the first: the ASPS

February 3, on the ASPS: The ASPS released a statement on gender-affirming surgery that has singled out trans people as not being good candidates for these surgeries until – wait for it – they are 19 years old. Not 18. Not just minors. NINETEEN.

To be clear, surgery for transgender minors has generally not been available until age 16 for top surgery (chest) and not at all for bottom (pelvic region) surgery in the United States. This ASPS statement draws a false dichotomy between physical pain that leads minors to seek breast reduction surgery and the psychological and unacknowledged physical agony a transgender person experiences when the development of their body mismatches what their brains tell them they are. The ASPS dismisses the latter as not compelling enough to warrant the same consideration for this population, the same grace, the same understanding, as for the population of minors that seeks breast reduction for other reasons.

Or the population that seeks breast augmentation, which isn’t mentioned at all in their “Statement on Gender Surgery for Children and Adolescents,” but gets the OK for those 18 and up in their “breast augmentation in teenagers” statement. It is just fine, apparently, for people who are 18 to undergo breast augmentation, presumably as long as they are not transgender.

ASPS relies heavily on the infamously cherry-picked Cass Report from the UK (see in-depth critique here) and a report from Robert F Kennedy the Lesser’s HHS. I hope I don’t need to mention that relying on reports from that quarter is like the frog relying on the scorpion not to sting it to death. If that mention is needed, well, then, here’s what the American Academy of Pediatrics (AAP) thinks about it.

A few notes: The ASPS statement explicitly says that it is “not a clinical practice guideline.” The position statement also states the reality that many recommendations for plastic surgery “rely on lower levels of evidence compared to those of other medical specialties.” The reasons for this are many, but among them are that certain types of studies (e.g., observational studies) are considered to yield evidence that is “weak,” and certain types of studies are considered to yield evidence that is “strong.” The latter, which often require randomized trials, are not necessarily ethical in the plastic surgery field.

So when you see the word “weak,” you should understand that it doesn’t mean “flimsy” or “nonexistent” but is related to the type of study design and numbers that can be included in a study, among other factors. It ius unlikely that studies will reach the “strong” threshold for the transgender population, which despite what MAGA wants you to think, remains a very, very small fraction of our species.

Back to the NYT and this particular article. The fellow who wrote about this statement doesn’t understand much of the above, or at least has sought effectively to conceal that understanding if he does harbor it. For example, he cites a 2019 statement from the ASPS as evidence that the society’s stance on surgery for minors has “evolved.” But the 2019 statement does not specifically address gender-affirming care for minors. Indeed, it is a press release that the ASPS published in response to government moves in some states to limit care for transgender adults, specifically in Colorado, Iowa, and Washington. It is not a position statement regarding gender-affirming care for minors.

The organization does not have guidance for clinicians or a formal recommendations document regarding gender-affirming care for transgender minors. What it does have is position statements, and the one covered by the NYT as representing the ASPS as “having evolved” on the subject of gender surgery for minors does not demonstrate “evolution” of any kind. In fact, the ASPS seems to have conflicting positions (“gender-affirming care for me but not for thee”), and that’s not evolution, that’s just illogical. The statement is clearly a bending of the knee to political pressure, as the highlight of the Cass Report and the HHS report should make clear to anyone paying attention.

Article the second

February 3, again. This one claims that the AMA has joined with the ASPS to endorse restrictions on gender-related surgery for minors. Here are some highlights to note:

1. The ASPS statement is not a recommendation. And it doesn’t refer only to minors. People who are 18 are famously not considered minors. The ASPS position statement excludes adults from adulthood.

2. This article (by the same guy who wrote the ASPS piece) claims that “For the first time, two major medical groups have backed limitations on gender-related surgical treatments for minors in the United States. The American Medical Association, the nation’s largest organization representing doctors, on Wednesday said these procedures generally should be deferred until patients reach adulthood.”

3. Fact: The AMA has not changed its position, which is in broad agreement with other medical societies.

Notably, the AAP also has not changed its position. It has long held that surgery is reserved “typically for adults” but should be considered on a case-by-case basis for adolescents. Also of note, the AAP statement observes that access to hormonal therapy can, in fact, reduce the need for later surgery.

The fellow who wrote these pieces once again tries to demonstrate an evolution in how an association views gender-affirming care for transgender minors. I suspect that a motivation is a perceived vindication of the NYT’s incessant attacks on what should be focused, personal, private decisions for a patient and their clinicians. But a general call to defer procedures to adulthood is not remotely new.

It is exactly in keeping with the AAP’s guidance published in 2018 and reaffirmed in 2023, which stated that surgery is reserved “typically for adults” and considered for minors on a “case-by-case basis.” The AMA has not changed its stance on gender-affirming care.

Article the third

March 16. Charlatan-in-Chief Mehmet Oz pressured a bunch of medical societies to disregard ethics and best practice and do what he wanted, which is to deprive transgender people – not just minors, but all of them, in the end – of the care they need to live healthy, fulfilling lives. The author of this article was a different fellow, and phew, false premise alert!

Dr. Oz pressed on a question that hangs over the entire field: Why did these organizations recommend medical intervention for young patients — including hormone treatment, puberty blockers and surgery — when the research on whether it helped young patients in the long term, especially on mental health, was inconclusive?

The evidence is not inconclusive, and it is hog wild that a NYT journalist and a doctor who is best known for flogging quackery and snake oil would presume to know more about this than medical societies treating the populations in question. Indeed, the only society that caved to Oz was the ASPS.

I guess it’s not that wild, though, given that the editors of the NYT presume that they know more and understand better than the chairman of the board of the AMA what the AMA’s position is on this subject. What is the virus plaguing the NYT that makes them think that they have a deeper understanding of the specialist subjects of these societies than society members themselves? It’s a remarkable level of smug hubris.

So let’s return to the “fact-check” that the NYT just published. It says:

The Times has received no requests to correct, clarify or update our articles from the A.M.A.

Here’s the AMA on that:

In recent days, AMA communications to the New York Times have requested a correction on their part to reflect the actual language the AMA used in response to their inquiry. Additionally, a letter to the editor has been submitted requesting a public correction—this was neither a policy change nor was it an endorsement of a position taken by another medical society.

Fact check: AMA wins this one on two counts. They haven’t changed a thing, and corrections have clearly been requested.

The NYT:

After the board chair’s comments, Times reporters also confirmed with the A.M.A. spokesperson that the statements reflected in our previous reporting remain accurate in reflecting the association’s stated positions. The board chair’s claims are not based in fact, and are in contradiction to both the association’s own statements provided to The Times.

They then produce the quote from the AMA comms person in full:

Our colleagues at ASPS concluded that the evidence supporting gender-related surgery in minors is insufficient and of low certainty. The American Medical Association respects the expertise and dedication of surgeons who care for patients every day. The AMA supports evidence-based treatment, including gender-affirming care. Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.

Fact check: This is literally and exactly has been held by medical societies engaged with this population for years now. Not one thing has changed. But to admit that doesn’t fit the NYT’s desperate narrative that they will be right about transgender care, that societies are “evolving” in their attitudes about it and will vindicate the NYT, and that the world will come around to acknowledging the supremacy of the NYT in all things.

I want to give the AMA the final word here:

As noted above, AMA policy on gender-affirming care is unchanged. Our recent response to questions about ASPS’s position statement was intended to preserve — not diminish — access to gender-affirming care, and to clarify and reinforce what our policy has long reflected and standards of care. The AMA supports gender-affirming care as medically necessary per our policy.

Thanks for reading. News you can use and other departments will be back next round.