US plastic surgeons’ group challenges ‘consensus’ on ‘gender transitions’ for minors

The American Society of Plastic Surgeons argued that ‘genital surgical interventions’ have not been proven an effective solution to adolescent gender dysphoria, adding that current ‘research’ backing medical intervention is of ‘low quality/low certainty.’

One of the most effective weapons that proponents of radical gender ideology have wielded in support of their cause has been “consensus.”

When pressed to explain how blocking a young boy’s puberty or removing a teenage girl’s healthy breasts provide any medical or mental benefit, they often cite “experts” or refer to a “consensus” of medical organizations and government agencies.

But there’s a problem with that strategy.

Recent research has shown the glaring flaws in the argument that transition drugs and procedures are appropriate or helpful for minors. European countries that had once embraced “gender affirming care” for minors, including the U.K., have begun to reverse these policies.

While American medical organizations and governments have been slow to respond, recent developments indicate that may be changing.

Earlier this year, City Journal reported that the American Society of Plastic Surgeons (ASPS) had not signed on to “any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

ASPS added 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.”

More recently, the president of that organization, Dr. Steven Williams, told a local media outlet, “I don’t perform gender-affirming care in adolescents, and the reason why is because I don’t think the data supports it.”

Prominent plastic surgeon Dr. Sheila Nazarian echoed that sentiment. “I think some physicians and some medical associations have been overtaken by a vocal minority and they are politicized,” she said. “This is 100 percent an American political issue. If we look at Europe, very progressive governments have backed off of these procedures in minors because they’re just analyzing the data – as we should with every procedure. Why is it that for this procedure, in this patient population, we just have to shut up?”

In addition, whistleblowers have come forward to reveal the damage being done to children. Evidence now shows that the World Professional Association for Transgender Health (WPATH) has exerted pressure on researchers. In fact, leaked files from WPATH show that some doctors understood many of the concerns about pushing such drugs and procedures on minors – but did so anyway.

A landmark review of the available research on the effect of these drugs and procedures by Dr. Hilary Cass “demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”

The Cass review, commissioned by the U.K. National Health Service, noted that “[t]he strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.”

In short, the “consensus” that our media, doctors, activists, and politicians rely upon is no consensus at all. It’s based not on proven science but on a commitment to ideology.

These cracks in the façade that advocates of gender ideology use as a shield provide hope to those who have long been advocating for the truth – in the courtroom and in the culture:

The truth that no amount of cross-sex hormones or permanently damaging surgery can change a person’s sex.
The truth that doctors have a duty to “do no harm,” and that includes being honest with patients about the facts regarding procedures that are mischaracterized as “gender affirming.”

It’s heartening to see prominent doctors from at least one major medical association speak the truth about the harm being done to so many children.

In the wake of Donald Trump’s election, we are hopeful that the new administration will follow through on promises to protect boys and girls from gender ideology.

And the issue of gender transition efforts for children has reached the U.S. Supreme Court too. On December 4, the court heard arguments in United States of America v. Skrmetti, in which the state of Tennessee is defending its law protecting children from these harmful and unnecessary procedures.

But we know that regardless of what happens in Washington, D.C., we will continue to face challenges in statehouses, government agencies, and school districts across the country.

The fight for truth isn’t over yet – but this is a big step toward achieving a lasting victory.

Reprinted with permission from the Alliance Defending Freedom.

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Addictions

The War on Commonsense Nicotine Regulation

Published on November 8, 2025

Todayville

From the Brownstone Institute

Roger Bate

Cigarettes kill nearly half a million Americans each year. Everyone knows it, including the Food and Drug Administration. Yet while the most lethal nicotine product remains on sale in every gas station, the FDA continues to block or delay far safer alternatives.

Nicotine pouches—small, smokeless packets tucked under the lip—deliver nicotine without burning tobacco. They eliminate the tar, carbon monoxide, and carcinogens that make cigarettes so deadly. The logic of harm reduction couldn’t be clearer: if smokers can get nicotine without smoke, millions of lives could be saved.

Sweden has already proven the point. Through widespread use of snus and nicotine pouches, the country has cut daily smoking to about 5 percent, the lowest rate in Europe. Lung-cancer deaths are less than half the continental average. This “Swedish Experience” shows that when adults are given safer options, they switch voluntarily—no prohibition required.

In the United States, however, the FDA’s tobacco division has turned this logic on its head. Since Congress gave it sweeping authority in 2009, the agency has demanded that every new product undergo a Premarket Tobacco Product Application, or PMTA, proving it is “appropriate for the protection of public health.” That sounds reasonable until you see how the process works.

Manufacturers must spend millions on speculative modeling about how their products might affect every segment of society—smokers, nonsmokers, youth, and future generations—before they can even reach the market. Unsurprisingly, almost all PMTAs have been denied or shelved. Reduced-risk products sit in limbo while Marlboros and Newports remain untouched.

Only this January did the agency relent slightly, authorizing 20 ZYN nicotine-pouch products made by Swedish Match, now owned by Philip Morris. The FDA admitted the obvious: “The data show that these specific products are appropriate for the protection of public health.” The toxic-chemical levels were far lower than in cigarettes, and adult smokers were more likely to switch than teens were to start.

The decision should have been a turning point. Instead, it exposed the double standard. Other pouch makers—especially smaller firms from Sweden and the US, such as NOAT—remain locked out of the legal market even when their products meet the same technical standards.

The FDA’s inaction has created a black market dominated by unregulated imports, many from China. According to my own research, roughly 85 percent of pouches now sold in convenience stores are technically illegal.

The agency claims that this heavy-handed approach protects kids. But youth pouch use in the US remains very low—about 1.5 percent of high-school students according to the latest National Youth Tobacco Survey—while nearly 30 million American adults still smoke. Denying safer products to millions of addicted adults because a tiny fraction of teens might experiment is the opposite of public-health logic.

There’s a better path. The FDA should base its decisions on science, not fear. If a product dramatically reduces exposure to harmful chemicals, meets strict packaging and marketing standards, and enforces Tobacco 21 age verification, it should be allowed on the market. Population-level effects can be monitored afterward through real-world data on switching and youth use. That’s how drug and vaccine regulation already works.

Sweden’s evidence shows the results of a pragmatic approach: a near-smoke-free society achieved through consumer choice, not coercion. The FDA’s own approval of ZYN proves that such products can meet its legal standard for protecting public health. The next step is consistency—apply the same rules to everyone.

Combustion, not nicotine, is the killer. Until the FDA acts on that simple truth, it will keep protecting the cigarette industry it was supposed to regulate.

Author

Roger Bate

Roger Bate is a Brownstone Fellow, Senior Fellow at the International Center for Law and Economics (Jan 2023-present), Board member of Africa Fighting Malaria (September 2000-present), and Fellow at the Institute of Economic Affairs (January 2000-present).

Health

RFK Jr. urges global health authorities to remove mercury from all vaccines

Published on November 7, 2025

Todayville

From LifeSiteNews

By Charles Richards

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. is urging health leaders across the planet to stop including mercury in vaccinations.

“Now that America has removed mercury from all vaccines, I call on every global health authority to do the same — to ensure that no child, anywhere in the world, is ever exposed to this deadly neurotoxin again,” he said.

Kennedy’s comments came in a video he recorded for the Minamata Convention on Mercury. The event is an international gathering aimed at preventing human contact with mercury, which, according to the World Health Organization (WHO), is one of the top 10 chemicals of major public health concern. The treaty, backed by the United Nations (UN), was first signed in 2013 by over 140 countries.

Kennedy noted that while the group’s goal is no doubt praiseworthy, it has not gone far enough in its efforts.

“Article 4 of the convention calls on parties to cut mercury use by phasing out listed, mercury-added products. But in 2010, as the treaty took shape, negotiators made a major exception. Thimerosal-containing vaccines were carved out of the regulation,” he recalled.

“The same treaty that began to phase out mercury in lamps and cosmetics chose to leave it in products injected into babies, pregnant women, and the most vulnerable among us,” he noted. “We have to ask: Why? Why do we hold a double standard for mercury? Why call it dangerous in batteries, in over-the-counter medications, and make-up but acceptable in vaccines and dental fillings?”

This past summer, Kennedy’s Advisory Committee for Immunization Practices launched a study to research the vaccine schedule for children. Among other recommendations, the committee advised the removal of thimerosal, a neurotoxic, mercury-containing preservative that had been used in flu shots.

Kennedy noted in his video message that “thimerosal’s own label requires it to be treated as a hazardous material and warns against ingestion,” adding that “there is not a single study that proves it’s safe. That’s why in July of this year the United States closed the final chapter on the use of thimerosal as a vaccine preservative, something that should have happened years ago.”

“Manufacturers have confirmed that they can produce mercury-free, single dose vaccines without interrupting supply. There is no excuse for inaction or holding stubbornly to the status quo,” he exclaimed. “Now that America has removed mercury from all vaccines, I call on every global health authority and every party to this convention to do the same.”

“Let’s honor and protect humanity, and our children, and creation from mercury,” he concluded.

The Minamata Convention on Mercury went into effect in August 2017. It was initially approved by the Intergovernmental Negotiating Committee in Geneva, Switzerland, in January 2013. It was adopted in October 2013 at a Diplomatic Conference in Kumamoto, Japan. Per its website, it is named “after the bay in Japan where, in the mid-20th century, mercury-tainted industrial wastewater poisoned thousands of people, leading to severe health damage that became known as the ‘Minamata disease.’”