Opinion | We Aren’t Failing Trans Kids by Giving Them the Freedom to Choose

Lately I have been asking people this question: Do you remember the first time someone informed you of your gender? It’s a nonsense question, of course. No one remembers. Mine was first declared to me, and everyone else involved, in the birthing room. Nowadays, for many people, gender is given to them well before they are born, and perhaps even heralded with cannons of pink or blue confetti at a gender reveal party. Maybe that’s what makes it seem so immutable? It’s an early, definitive declaration.

As children, we are given many things — some are biologically inherited, like hair and eye color, while other things, like names, religion and folkways, are bestowed upon us by our families and communities. Some people find these things they were given regrettable, and some, even children, change those characteristics.

According to the American Society of Plastic Surgeons, in 2020, more than 44,000 people between the ages of 13 and 19 got a rhinoplasty, the most common surgical cosmetic procedure performed on teenagers. Thousands of kids went under the knife for chest surgery — 3,200 girls got breast augmentations and 1,800 girls got breast reductions, while 2,800 boys had surgery to remove breast tissue from their chests, presumably to help them conform better to their gender identities. Indeed, many if not most of these often irreversible interventions on children’s bodies are designed, in one way or another, to help children feel better about their appearances in a way that is inescapably bound up with gender.

In all, roughly 230,000 cosmetic procedures were performed on teenagers in 2020, 15 percent fewer than the year before, presumably owing to the pandemic. That drop was smaller than I expected. It underscores just how desperate these children were to change their bodies that even in the first, terrifying year of a deadly pandemic, when most of us were avoiding medical settings like the literal plague engulfing us, teenagers had, with their parents’ permission, hundreds of thousands of mostly elective medical treatments. Many of these were adolescent girls seeking the small, cute noses that fill our television screens and fashion magazines, chasing an ideal of feminine beauty that feels forever out of reach.