MAGA: Hypocrisy & Terror
1. Legal Bans On Care? Nope!
As of February 5, 2026, there is no federal law prohibiting or banning the delivery of gender-affirming care to anyone, of any age.
What does exist are federal policy actions that restrict or functionally deter care, mainly through intimidation and extortion tactics that encourage pre-compliance, and conditioning federal funding/program participation (Medicare/Medicaid/CHIP/Grants) on discontinuing GAC.
Leveraging fear, disinformation, and anti-science against the best interests of clients/patients.
And yet, the number of transgender people in desperate need of gender-affirming care continues to rise (particularly among younger generations).
The number of family, friends, and allies passionately advocating for their access to gender-affirming healthcare is also exponentially increasing.
2. Saving Our Youth
Increasing numbers of adolescents and teens continue to suffer, desperately in need of access to life-saving gender-affirming care across all systems and specialties:
- Mental Health
- Primary Pediatric
- Pediatric Endocrinology
- Fertility Preservation
- Hair Removal
- Voice Therapy & Modulation, and
- Surgical Interventions
- Retransition-related Support
The 'bottom line' decisions being made by hospitals and care providers are neither easy or flattering:
Terminate life-saving gender-affirming care for youth in exchange for receiving grant/funding $$$ needed to serve cisgender clients/patients.
3. The Research
Staying The Course (as of February 5, 2026)
Though virtually every hospital and healthcare system in the United States has discontinued provision of gender-affirming surgery1 to anyone under age 19, several hospitals and clinics have indicated they intend to ‘stay the course’ by providing pubertal suppression (“blockers”) and gender-affirming hormone therapy (GAHT), as well as gender-affirming mental health counseling.
- While, as with any patient undergoing any procedure, there may be a medically indicated reason to not perform gender-affirming surgery on a specific adolescent (safety, capacity to consent, instability, lack of a support network, developmental timing, etc.), a blanket stop (moratorium) for all adolescents ages 13-19 is not supported by either universal medical contraindications, or by (with few exceptions) established professional body guidelines. Demands for across-the-board denial of access to gender-affirming surgery derive almost exclusively from oppressive, discriminatory, anti-trans ideology and politically driven factions. Capitulation is an overt rejection of the very foundations of medicine as a science.
Research supporting gender-affirming surgery in select youth age 13-19:
Chest (“Top”) Surgery:
- A JAMA Pediatrics study (Ascha et al., 2022) found top surgery was associated with improved chest dysphoria, gender congruence, and body image in this age group.
- A Journal of Adolescent Health prospective study reported chest reconstruction significantly improved chest dysphoria and related outcomes.
- A plastic surgery outcomes study reported low complication rates and high satisfaction, including in patients ≤18 (age-stratified).
“Bottom” Surgery:
- A pediatric-hospital case series from Boston Children’s Hospital reported 27 genital surgeries (phalloplasty-related stages, metoidioplasty, and 5 vaginoplasties) and provides peri-operative outcomes. In their table of genital surgeries, the vaginoplasty group age range included 18 (range 18–21, median 19) and they reported no recorded adverse events and a 20% readmission (1 of 5) for pain in the vaginoplasty group. Importantly, “patient a minor on date of surgery” was 0% for every genital surgery category—so this is supportive only for age 18, not <18.
- A national claims analysis in JAMA Network Open found that gender-affirming surgeries in minors are rare and overwhelmingly chest-related; it’s not designed to prove benefit, but it helps explain why there are few outcome cohorts for genital surgery in minors.
- There are small publications (eg, a 3-case report on penile inversion vaginoplasty with peritoneal flap approaches) focused on surgical technique in younger patients; these are not effectiveness trials and typically don’t establish mental health or long-term functional benefit in a way that would answer your question by themselves.
And Have It Too?
As used by Thomas Howard, Duke of Norfolk in 1538, “you can’t have your cake and eat it too”. Yet, despite that well-known, well-worn old saying, those who want to ban gender-affirming surgery (and, all GAC to be honest) do precisely that!
They argue that “sex-change surgeries are happening to minors all the time! It’s an epidemic!”, or words to that effect, while simultaneously arguing that “there isn’t enough high-quality evidence to support continuing to perform gender-affirming surgery on minors”.
Logic would indicate that if such surgeries were happening ‘willy-nilly’, there would be a plethora of data, outcome studies, and personal narratives from both providers and patients. It would, no doubt, produce a great deal of every kind of evidence.
On the other hand, if such surgeries are rarely performed, there would be a shortage of evidence to report (which there is). There isn’t a contagion of “sex-change” surgery being performed on minors.
“You can’t have your cake and eat it too.”
