Common Ages Surgery Referrals Become an Option

gender affirming healthcare gender affirming medical care pediatric gender affirming care transgender transgender continuing education online transgender health transgender health education transgender health education online Dec 12, 2022

So many of the trans youth health bans are fueled by fear of surgeries on youth which is most often a very small (if even possible) part of care for youth. The recent Florida Medical Board proceedings had board members and expert witnesses implying that surgery is a mandatory part of care. Dr. Scot Ackerman of the board kept repetitively asking why Dr. Meredithe McNamara had not recommended surgery to patients. I wanted to jump through the screen and ask him if he recommended bilateral mastectomy for ALL of his patients with ductal carcinoma in situ. If so, patients please get a second opinion. Because there is a RANGE of treatment options available for DCIS similar to there being a range of treatment options in gender affirming care. As clinicians we offer our patients an overview of the options, exploration of the risks and benefits, and help support them in picking the treatment options best for them based on their pre-existing health, their goals, and their values. Options for patients with DCIS include lumpectomy, radiation treatment, hormone treatment, mastectomy, or even bilateral mastectomy, or some combination of these. Recommending bilateral mastectomy for every patient is NOT patient-centered care nor is it the ethical practice of medicine. Similarly, not all trans or gender diverse patients will feel gender affirming surgery is what is best for them nor will it be necessary to reach their goals or treat their dysphoria.


However, for some patients, gender affirming surgery will be a very important part of their journey. As referring clinicians it is important for us to know general ages surgeries might be available for appropriate youth. I recommend you contact your local surgeon’s and academic center to learn more about their age requirements. I actually had our public health student intern start a referral database for our practice which strives to include age requirements. It is available online. I can’t guarantee the accuracy or that your local surgeons will be on it, but I am always happy to update it if you send me additional info.


Please see all of the databases disclaimers:


  • Content note: anatomical and medical terminology utilized.
  • None of the surgeons listed here have been vetted. Inclusion in this database does not imply a recommendation by QueerDoc.
  • We share this database (which was developed by our practice for our providers) freely as a general resource for our community. It may be outdated or missing information and it may include physicians who have caused harm within the community. 

You can find the database here.

I refer to several surgeons primarily distributed throughout the west coast the most frequently. Pooling their feedback on age requirements for surgery I have developed this list:


Gender Affirming Surgeries


Minimum Age

Chest reconstruction with bilateral mastectomy

Chest reconstruction with breast augmentation

Facial surgeries

Genital Surgeries

For Consultation

14 years

15 years 

15 years

17 years

For Surgery

14-15 years

16 years + 2 years estradiol therapy (saline, fat grafting)

22 years + 2 years estradiol therapy (silicone)

at skeletal maturity approximately 18-20 for AMAB patients and 17-19 for AFAB patients

18 years


Most insurance plans will not cover surgeries until age 18 currently which may be a bigger barrier than accessing a surgeon. Although with the recent attacks several surgery centers and surgeons are ceasing youth surgeries for safety of staff. Which is so discouraging as someone who has watched so many youth quit activities they love like swimming or track due to chest dysphoria. I encourage you to connect with your local providers to learn more about your area.




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