Mark Del Monte, J.D.
CEO / Executive Vice President
American Academy of Pediatrics
345 Park Boulevard 2055
Itasca, IL 60143
Dear Mr. Del Monte:
On December 30, 2025, the Department requested a timely and substantive response from the American Academy of Pediatrics (AAP) regarding its position on sex‑rejecting procedures for minors and any planned updates to its guidance materials. To date, the Department has received nothing. For an organization that rarely wants for words on this subject, the silence is telling—and deeply disappointing.
The Department’s landmark report “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” initially released on May 1, 2025, and finalized on November 19, 2025, documented substantial evidence of harm for minors from sex-rejecting procedures.1 The Department has since acted to end sex-rejecting procedures on minors, including by ending federal Medicaid and CHIP funding of sex-rejecting procedures on minors.2
One would expect that an organization holding itself out as a steward of national medical standards and claiming to place the health and safety of children above all else might have something to say when the evidence calls its guidance into question. Surely an association so confident in its position would welcome the chance to defend it. AAP’s refusal to engage is difficult to square with the principles it so frequently professes.
Others have chosen to engage. In February, the American Society of Plastic Surgeons (ASPS) followed the science by updating their position on sex-rejecting procedures on minors.3 ASPS found that the evidence base supporting sex-rejecting procedures to be “low quality/low certainty” and that “there is insufficient evidence demonstrating a favorable risk-benefit ratio for the pathway of gender-related endocrine and surgical interventions in children and adolescents.”4
As a result of AAP’s failure to respond, this letter serves as a final request for the following:
- A clear, current statement of the AAP’s position on sex‑rejecting procedures for minors;
- Identification of updates, revisions, or corrections to AAP’s position, guidance, or educational content;
- A concrete timeline for any forthcoming changes.
The Department expects your written response within 10 business days. Continued silence will speak for itself as a choice to place commitments to radical ideology ahead of evidence-based medicine and the children AAP claims to protect.
Sincerely,
/s/
Robert F. Kennedy, Jr.
Footnotes
1 U.S. Department of Health and Human Services, Gender Dysphoria Report, https://opa.hhs.gov/gender-dysphoria-report.
2 HHS Ends Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures for Children and Youth, https://www.hhs.gov/press-room/hhs-ends-medicaid-chip-funding-sex-rejecting-procedures-children.html
3 U.S. Department of Health and Human Services, HHS Leaders Commend the American Society of Plastic Surgeons for Disavowing Pediatric Sex-Rejecting Procedures, https://www.hhs.gov/press-room/asps-gender-dysphoria-statement.html.
4 American Society of Plastic Surgeons, Position Statement on Gender Surgery for Children and Adolescents, https://www.plasticsurgery.org/documents/health-policy/positions/2026-gender-surgery-children-adolescents.pdf.