Biden officials pushed to drop age limit on trans surgeries for minors: report

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Health officials in the Biden administration urged an international transgender health nonprofit to omit the age limit in its guidelines for transgender surgical procedures for adolescents – and succeeded – according to recently unsealed court documents.

The documents, first reported on by The New York Times, revealed that staff for Rachel Levine, assistant secretary for the Department of Health and Human Services, pushed the World Professional Association for Transgender Health (WPATH) to drop the age minimum requirement altogether to avoid seeing conservative lawmakers work to put such age restrictions into law.

The 2021 draft guidelines suggested 17 for genital surgeries or hysterectomies, 16 for breast augmentation or facial surgeries, 15 for mastectomies and 14 for hormonal treatments. However, the finalized WPATH 2022 guidelines did not include any age limit, the Times reported.

After publication, the White House told Fox: "The Administration does not support surgery for minors."

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Assistant Secretary of the Department of Health and Human Services Rachel Levine. (Caroline Brehman-Pool/Getty Images)

Excerpts of emails within WPATH's advisory group were included in legal filings for a federal lawsuit challenging Alabama’s ban on transgender surgeries for minors, as released by the U.S. District Court for the Middle District of Alabama. The lawsuit was filed by the National Center for Lesbian Rights and the Southern Poverty Law Center on behalf of five transgender children and their families, the Times reported.

One email from a member of the WPATH guideline development group described a conversation with Sarah Boateng, then-Levine’s chief of staff. According to the email, Boateng was confident that specifying ages under 18 could lead to "devastating legislation for trans care." 

"She wonders if the specific ages can be taken out," the excerpt read.

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Transgender treatments for minors have become a major culture war in the U.S. (ALLISON DINNER/AFP via Getty Images)

Levine "was very concerned that having ages (mainly for surgery) will affect access to care for trans youth and maybe adults, too," another email read. 

"Apparently the situation in the U.S.A. is terrible and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them."

James Cantor, a psychologist and critic of adolescent transgender procedures, filed the excerpts from the emails as evidence in support of Alabama's federal lawsuit, the Times reported. No emails from Levine's office specifically were released.

These emails, part of his report, suggest that WPATH made decisions influenced by politics rather than science in developing its transgender guidelines.

The Times reported that the plaintiffs in the case are attempting to prevent Cantor from testifying. 

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Protesters of Kentucky Senate Bill SB150, known as the Transgender Health Bill, cheer on speakers during a rally on the lawn of the Kentucky Capitol in Frankfort, Kentucky, on March 29, 2023. (AP Photo/Timothy D. Easley)

Transgender procedures and treatments for children have become a hot button issue in the country's culture war. More than a dozen states in the U.S. have enacted bans on surgical procedures and hormonal prescriptions for transgender youth. 

Idaho, North Dakota, Florida, Oklahoma and Alabama have passed laws making it a felony to perform sex changes on children. Several blue states, meanwhile, have enacted "sanctuary state" laws in recent years shielding medical providers from facing penalties for conducting transgender procedures on adolescents. 

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