Willie Underwood III, M.D.
President
American Medical Association
330 N. Wabash Ave., Suite 39300
Chicago, IL 60611-5585
Dear Dr. Underwood:
On December 30, 2025, the Department requested a timely and substantive response from the American Medical Association (AMA) regarding its position on sex‑rejecting procedures for children and any planned updates to its guidance materials or position statements. To date, the Department has received nothing.
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 and position into question. AMA’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) updated its 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 While AMA seemingly changed course on sex-rejecting procedures on minors in a statement made to The New York Times, the Association later reversed course saying that its position has not changed. AMA should be willing, as ASPS was, to engage with the evidence and state its position plainly.
Accordingly, this letter serves as a final request for the following:
- A clear, current statement of the AMA’s position on sex-rejecting procedures for minors;
- Identification of updates, revisions, or corrections to AMA’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 AMA 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.