US health authorities pressured the World Professional Association for Transgender Health (WPATH) to remove age restrictions for teenage surgeries from its guidelines published in 2022, the New York Times reported on Tuesday, citing newly unsealed court documents. 

According to the outlet, the administration of President Joe Biden, and specifically the assistant secretary of health, Rachel Levine, who is transgender, feared that age limitations could fuel the growing political opposition to the controversial treatments.  

In the first draft of the guidelines published in 2021, the WPATH initially planned to set the minimum age for hormonal treatment at 14, 15 for mastectomy, 16 for breast augmentation and facial surgery and 17 of genital surgery or hysterectomy. However, in the final version of the document, which was released a year later, the group mentioned no age limits at all.  

Emails obtained by the NYT have now reportedly shown that Levine’s staff had contacted the group and took issue with the guidelines, urging WPATH to drop the age limits.  

“[Levine] and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them,” one of the letters from a WPATH staffer was quoted as saying.  

Some members of the organization were reportedly concerned about the government’s intervention and insisted that the commission’s guidelines be based on science and expert consensus rather than politics.  

“I need someone to explain to me how taking out the ages will help in the fight against the conservative anti-trans agenda,” one WPATH member reportedly questioned.  

Sex change operations and other “gender-related treatments” for minors have become an increasingly controversial issue, particularly in the US, where positions on the topic generally split along party lines.  

Democrats and the Biden administration have been pushing for increased access to what they call “gender-affirming healthcare” for minors, while conservatives and Republican state leaders have been looking to restrict the practice.  

A number of US states, including Texas, Florida, Ohio, Georgia and others, have already introduced legislation banning gender-affirming care for transgender minors while some, such as Tennessee and Alabama, have threatened fines and prison sentences for medical workers who violate the restrictions.

The Biden administration has been challenging these legislative bans in court, arguing that denying transgender minors access to gender-affirming healthcare is a violation of guarantees of equal protection and due process under the Constitution’s 14th Amendment.

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