How many minors turned trans surgically

1. What the rigorous surgical studies show: very small numbers concentrated in older teens

Detailed peer‑reviewed analyses based on surgical registries and national procedure databases find that only a very small number of transgender and gender‑diverse (TGD) minors undergo gender‑affirming surgery: one ACS NSQIP Pediatrics study identified 108 TGNB minors who had gender‑affirming surgery between 2018 and 2021, with a mean age of about 17 and only two patients younger than 15 (13.9 and 14.5) ^[1], and a JAMA Pediatrics analysis reported roughly 85–2.1 per 100,000 total minors receiving gender‑affirming surgery in its sample period ^{[4] [5]}.

2. Larger national estimates and weighted counts: more minors if definitions broaden

Studies that use nationally weighted inpatient and outpatient procedure databases report larger counts because they include any procedure coded as gender‑affirming or inconsistent with recorded sex and span wider age ranges: one weighted analysis estimated 48,019 patients undergoing gender‑affirming surgery over five years and reported 3,678 patients aged 12–18 in that cohort ^[3], while media summaries of insurance‑claims analyses counted at least 776 mastectomies in 13–17‑year‑olds over a three‑year window ending 2021 ^[6].

3. Advocacy group tallies and media reports diverge—methodology matters

Non‑academic watchdog databases and some news outlets have reported much higher totals; for example, Do No Harm’s database conservatively identified 5,747 minor patients who received what it classifies as “sex‑change surgery” from 2019–2023 and 13,994 who had some gender‑reassignment treatment in that interval ^[2]. Those figures rely on hospital reports, varying CPT/diagnosis code groupings and exclusions, and are produced by an organization openly opposed to gender‑affirming care—an agenda that bears on interpretation and selection of what counts as a gender‑affirming procedure ^[2].

4. Why the numbers differ: coding, age ranges, and whether procedures were for gender dysphoria

Key sources of divergence are explicit in the literature: some studies count only procedures tied to a TGD diagnosis within a narrow window, others include surgeries that are identical in technique but performed for conditions like gynecomastia or congenital differences and thus may be coded without a TGD diagnosis ^{[5] [7]}. The Harvard summary and JAMA authors note that many chest procedures in minors are performed on cisgender boys for gynecomastia and that when restricted to TGD‑diagnosed patients the numbers fall dramatically ^{[8] [7]}.

5. Bottom line and reporting limitations

Answering “how many minors turned trans surgically” requires two clarifications: whether the question means “how many minors had any chest/genital/face procedures billed as gender‑affirming” or “how many minors with a documented TGD diagnosis underwent surgery.” If the narrower, diagnosis‑linked definition is used, peer‑reviewed surgical registries identify only on the order of tens to low hundreds of TGD minors over multi‑year windows (for example, 108 in NSQIP Pediatric, 2018–2021) ^[1]; if broader administrative or advocacy compilations are used, the counts rise into the thousands over several years (for example, 3,678 aged 12–18 in a five‑year weighted estimate, and Do No Harm’s 5,747 minors from 2019–2023), but those larger tallies reflect broader coding choices and advocacy group methodology ^{[3] [2]}. Available sources make clear that surgeries in minors are concentrated among older adolescents, overwhelmingly involve chest procedures, and remain rare relative to the population—yet exact national totals depend on inclusion criteria and cannot be pinpointed to a single undisputed number from the datasets provided ^{[1] [6] [4]}.