The "Trans Kid Surgery" Myth

The big lie worked because it played on your protective instincts

When you hear the phrase "trans surgery for kids," what specific surgery comes to mind for you? For most people who have no personal connection with trans people and have only learned about us through the media, the thought that comes to mind is of a doctor cutting up a 5 year old's genitalia.

It's a visceral image meant to scare the hell out of you. It makes you look at trans people and see us as extremist and alarming. Those are understandable feelings if we were actually advocating to carve up the bits of literal children. It's also a complete myth invented by conservatives.

These surgeries never happen.

For many of you readers of mine, this is not a shocking revelation, but for those who are new to hearing about trans people, it might be a bolt in the dark. I am writing this not to provoke angry responses, but to educate those who think they have reasonable concerns about "trans surgeries for kids".

With the hotly contested midterms coming up, Democrats in red states are having to fend off hundreds of millions in attack ads claiming that those same Democrats support "trans surgeries for kids." Many Democrats are responding by frantically saying that actually they don't support such surgeries. But all of those backs and forths are really just a big political messaging shell game.

Republicans built their transphobic house of hate on vast and sweeping disinformation campaigns and the most egregious lie is that youth gender clinics are operating on kids.

There are numerous examples of this happening but perhaps the most prominent claimd came from conservative influencers Matt Walsh and Chaiya Raichek (better known as the person behind LibsOfTikTok), along with former US Congressperson Marjorie Taylor Greene, who accused numerous children's hospitals of the practice in 2022. Their followers followed suit by sending a bunch of death threats to these hospitals, prompting many national media headlines.

Boston Children's Hospital, one of the primary targets of the anti-trans mob, was forced to release a statement explaining that they never perform genital surgery on people under the age of 18. This is the policy of nearly every hospital system in the US.

WPATH, the organization responsible for setting best practices for gender affirming care for all ages has never encouraged the use of genital surgeries for minors, saying that it should be avoided unless not performing one would result in extraordinarily extreme distress for an older teen (think 16-18 years old minimum). The organization calls for individualized care plans rather than arbitrary age-based guidelines.

That's a far cry from the barbaric image of doctors carving up toddlers that Republicans have created in the minds of the general public. And now many Democrats are acting like that is a thing that is happening, even when their home state bans all gender affirming care for under 18s.

Unfortunately there is just enough ambiguity here for disinformation specialists to exploit. For some trans teens, it's not uncommon to get "top surgery," like a double mastectomy for trans boys. It's not a particularly unusual procedure, cis teenage boys with gynecomastia (a condition where cisgender boys grow small breasts due to a hormone imbalance) get the very same procedure all the time and studies show it results in a big reduction in body shame, reduced bullying, and increased confidence.

The procedure has similar effects on trans teens who have it, along with a big reduction in gender dysphoria. But because these teens are trans, people worry about them regretting it somewhere down the line. It's very rare for trans people to have regret about gender related surgeries in general. Any other surgery with as low of a regret rate as gender affirming procedures would typically be regarded as a medical miracle.

However, because these top surgeries are performed sometimes, conservatives have leeway to claim that all of these youth gender clinics are "performing trans surgery on kids," and that image from earlier of the looming doctor chopping up the crotch of a toddler comes flooding to the top of a lot of people's brains.

Then the politicians and special interest groups writing their legislation introduce a bill that features expansive bans on youth gender affirming care, like puberty blockers, which are designed to halt the development of secondary sex characteristics until a tween can mature enough to be sure of their decision, and those same politicians sell it to the public as a "ban on trans kid surgery," a thing that does not happen.

Then when Democrats take the reasonable position that expansive blanket bans on all gender affirming care is too harsh and extreme, Republicans can accuse them of wanting to operate on trans toddlers, a thing that doesn't happen.

Ironically in all of these bans, there's a specific carveout that does allow doctors to operate on newborns and toddlers as long as the baby's genitalia are ambiguous enough. The barbaric practice of operating on some intersex babies is all fine and dandy for the anti-trans movement and Republicans everywhere, even as they exploit that image to ban hormone treatment for older trans teens.

This is the disinformation two-step, taking a nugget of info and spinning it into something you can bludgeon your political opponent with.

That's why so many Democrats in the last two weeks have come out in opposition to "trans surgeries for kids," which again do not exist. This is just the political language we use now, apparently, as it was successfully put into place by Republican disinformation. Now you can't even appear to show any nuance or vague support for trans kids without getting hit with the surgery hammer.

I wish Democrats wouldn't cede the battlefield on the language side. I wish more would try to explain reality. I think a bunch of them and the consultants they hire to know things simply don't know anything about it at all.

We've gone from bomb threats to children's hospitals in 2022 to Democrats taking the same position as the guys who sent bomb threats to children's hospitals here in 2026. I think maybe we all need to take a step back and figure out how that happened.

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