There is no evidence of schools performing surgeries to change students’ gender

In late August, former President Donald Trump claimed schools are performing surgeries to change students’ gender without parental consent during an interview at the Moms for Liberty National Summit. Moms for Liberty is a conservative parental rights group that has spearheaded efforts to get mentions of LGBTQ+ identity and structural racism out of K-12 classrooms.

“The transgender thing is incredible. Think of it. Your kid goes to school and comes home a few days later with an operation. The school decides what’s going to happen with your child,” Trump said on Aug. 30.

The Republican presidential nominee has reiterated the same claim on the campaign trail.

“Can you imagine you’re a parent and your son leaves the house and you say, ‘Jimmy, I love you so much. Go have a good day in school,’ and your son comes back with a brutal operation,” Trump said at a campaign rally in Mosinee, Wisconsin, on Sept. 7.

Multiple VERIFY readers, including Alice, have asked if Trump’s claims are true.

THE QUESTION

Is there any evidence of schools performing surgeries to change students’ gender?

THE SOURCES

• American Academy of Pediatrics
• Association of American Medical Colleges
• Endocrine Society guidelines
• World Professional Association for Transgender Health Standards of Care 
• Human Rights Campaign
• A study published by researchers at the Harvard T.H. Chan School of Public Health
• An investigation published by Reuters and Komodo Health
• An article published by CNN
• Lindsey Dawson, associate director of HIV Policy and director of LGBTQ Health Policy at KFF
• Landon Hughes, Ph.D., a postdoctoral fellow at the Harvard T.H. Chan School of Public Health
• Brandon Wolf, national press secretary and senior director of political communications at the Human Rights Campaign

THE ANSWER

There is no evidence of schools performing surgeries to change students’ gender.

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WHAT WE FOUND

Despite former President Donald Trump’s claim, there is no evidence of schools performing surgeries to change students’ gender without parental consent or otherwise.

Gender-affirming care, which is sometimes referred to as transition-related care, is life-saving health care for transgender people of all ages, according to the Human Rights Campaign, an LGBTQ+ advocacy group based in Washington, D.C. Gender-affirming care can include a range of services, such as mental health care, medical care and social services.

In the United States, gender-affirming surgery for minors is extremely rare, according to multiple studies, and nationally recognized medical guidelines recommend patients be at least 15 years old to receive the surgeries with parental or guardian consent, and only then in special circumstances.

“There are no instances of children receiving [gender-affirming] surgeries or access to surgeries from their schools. No provider in the U.S. would perform surgery on a minor under the direction of a school, let alone without parental consent,” said Landon Hughes, Ph.D., a postdoctoral fellow at the Harvard T.H. Chan School of Public Health.

Lindsey Dawson, associate director of HIV Policy and director of LGBTQ Health Policy at KFF, agrees.

“This is false. There is not an imaginable scenario and I am not aware of a single case where a decision like this has been made by a school and no surgery is occurring at schools. Schools tend to be very limited in the type of care they can provide,” Dawson told VERIFY.

Gender-affirming surgery includes a wide range of procedures, from plastic surgery to change facial features to “top surgery” to change the chest or torso or “bottom surgery” to make changes to genitals.

Teens who are 16 to 17 years old are generally limited to receiving only “top surgeries,” and must be “consistent and persistent” in their gender identity for years, take gender-affirming hormones for some time and have approval from both their parents and doctors, the Human Rights Campaign says.

The World Professional Association for Transgender Health (WPATH), the Endocrine Society and the American Academy of Pediatrics all recommend this type of joint decision-making.

“Gender-affirming care is provided through a long, careful process and does not occur over a matter of days,” Dawson explained.

Hughes and other researchers at the Harvard T.H. Chan School of Public Health published a peer-reviewed study in June that assessed the rate of minors accessing gender-affirming surgeries using the most recent insurance claims data from across the U.S.

The researchers did not find any gender-affirming surgeries for minors aged 12 and under, and found “virtually 0 (0.1 per 100 000 minors) for those 13 to 14 years old,” according to Hughes.

“In this study, among those under the age of 18 who receive gender-affirming surgeries, 96% of these were breast reductions (only 82 total cases) and only 3 instances of other types of gender-affirming surgeries for those under the age of 18. The sample size for minors was 22,827,194 – so these rates are incredibly small,” Hughes said.

VERIFY asked the Trump campaign for evidence of schools performing gender-affirming surgeries on children without parental consent, but they could not provide any examples to substantiate the former president’s claim. Instead, a campaign official shared links to several articles related to the broader conversation about transgender minors, schools and parental consent, which they also sent to CNN. 

Karoline Leavitt, a Trump campaign spokesperson, told The Associated Press that the former president does not believe children should be allowed to have what she called “permanent gender mutilation surgeries.”

In early September, Moms for Liberty co-founder Tiffany Justice, who conducted the Aug. 30 interview with Trump, told CNN that kids are not getting gender-affirming surgery at school.

“Are kids getting surgery in school? No, they’re not,” Justice said, adding that she was still “thankful to President Trump” for making the claim because his remark has drawn attention to the important issue of schools facilitating children’s social transitions without parental consent, according to CNN’s report. 

VERIFY also reached out to Moms for Liberty for comment, and in an emailed statement Justice said, “The President is right to bring up this issue because public schools in America are the on-ramp for gender transitioning of minor children.”

“As soon as a school is legally allowed to assign a new pronoun without parental knowledge …. then students quickly go down the road from social transition of their gender to medical transition with hormone therapy, and then surgical transition with gender reassignment surgery,” Justice said.

But the Human Rights Campaign says gender transitioning is “a personal process that looks different for every transgender and non-binary person, and individual paths do not always follow the same order.”

“Gender transition is the process through which a transgender or non-binary person takes steps to live authentically in their true gender identity. Some people take medication, and some do not; some adults have surgeries, and others do not. For some people, it can include steps as simple as changing clothes, names and hairstyles to fit their gender identity. Regardless of the age at which a person transitions, how they do so is their choice to be made with their family and doctors,” the Human Rights Campaign explains.

The Associated Press contributed to this report.