By: Bob Meister

The United States is confronting a medical and moral crisis that has unfolded with astonishing speed and unsettling secrecy. While the country remains polarized over countless social issues, one subject—youth gender surgery—stands apart for its profound ethical implications, its irreversible consequences, and the degree to which institutional actors have evaded accountability. Videos newly obtained from closed-door medical conferences in 2021 and 2022 reveal what many concerned parents, lawmakers, and dissident clinicians have long feared: leading American doctors have performed “non-standard,” experimental, and largely cosmetic genital surgeries on teenagers without adequate psychological evaluation, without long-term outcome data, and without the ethical safeguards that such life-altering procedures demand.

These admissions, made candidly among peers behind closed doors, shatter the carefully crafted public narrative promoted by major medical centers, including New York City’s highly influential NYU Langone. For years, elite institutions have portrayed youth gender surgeries as cautious, evidence-based, last-resort interventions. But the candid remarks now emerging from inside the profession show something far different: a culture of ideological zeal, professional groupthink, and market-driven opportunism that has placed vulnerable minors at risk under the banner of “affirmation.”

The leaked conference footage includes surgeons discussing unconventional genital operations on patients barely out of high school. One case involved “Sky,” an 18-year-old who identified as asexual, did not desire sexual relationships, and simply wanted to “look like a Barbie down there.” Doctors admitted that the procedure—removal of “all erogenous tissue”—was not tied to gender dysphoria in the classical clinical sense. It was cosmetic. It was experimental. And it was irreversible.

Other clinicians described providing Pinterest-style “menus” of surgical options for non-binary teens — procedures once considered fringe or ethically impermissible. They acknowledged that requests for “non-binary” interventions have surged in recent years, driven not by traditional diagnostic criteria but by the diffusion of gender identities through social media and highly online youth subcultures.

If any other category of irreversible bodily modification—say limb removal, extreme body modification, or sterilization—were requested by teenagers for cosmetic or identity-based reasons, clinicians would refuse and recommend intensive psychological intervention. But in the context of gender ideology, this normal clinical caution has been abandoned.

At the center of this troubling trend is a flawed doctrine popularized within progressive academic circles and aggressively adopted by medical bureaucracies: the “affirmation-only” model. Under this approach, clinicians are discouraged—sometimes outright prohibited—from challenging a young patient’s expressed gender identity, even when it appears sudden, inconsistent, or connected to underlying mental health struggles.

This model, now entrenched in elite institutions, collapses the distinction between treating distress and remodeling the body to align with a subjective identity claim. It is a doctrine that reduces complex human development to a consumer choice and treats the surgeon’s scalpel as a psychological panacea.

Nowhere is this trend more visible—or more troubling—than at NYU Langone, whose public-facing materials openly promote gender-affirming services for minors, including puberty suppression, hormone therapy, and eventual surgical transition. While NYU Langone insists that it follows established protocols, its own website boasts of being an LGBTQ+ Healthcare Equality Leader and describes a “holistic approach” in which teams of pediatric specialists help guide children toward lifelong medical pathways.

But what is presented as compassionate care is, in fact, deeply ideological. NYU Langone endorses a model in which children may be placed on puberty blockers—medications with documented impacts on bone density, neurodevelopment, fertility, and emotional regulation—and then advanced to hormone treatments with permanent effects. What follows, often before a young person’s identity has stabilized, is referral to adult services for irreversible surgical interventions.

The hospital’s proud claim of “transitioning children to adult transgender health services” reveals a pipeline mentality: once a child enters the system, the momentum inexorably points toward medicalization.

Most concerning of all is the growing advocacy—at NYU Langone and other progressive institutions—for reducing or eliminating parental consent barriers. In effect, these hospitals want the legal authority to override the most basic safeguard between minors and irreversible medical decisions.

Twenty-eight Republican-led states have now enacted bans or restrictions on youth gender interventions. This is not, as critics claim, the product of reactionary politics or moral panic. It is a response to a sprawling, lightly regulated medical experiment on minors—one that has continued despite mounting evidence of regret, detransition, mental health deterioration, and long-term physical harm.

These states, whatever one thinks of their politics, have stepped in where the medical establishment refused to: demanding caution, data, and a halt to irreversible interventions on vulnerable youth whose identities are still in flux.

The cultural environment fueling these trends cannot be ignored. Teenagers today—especially girls—are experiencing record levels of anxiety, depression, eating disorders, and social isolation. Many find identity exploration online, where gender ideology is omnipresent and militant. Algorithms reward vulnerability, and influencers glamorize “top surgery,” hormones, and aesthetic androgyny as pathways to belonging.

The result is a generation of young people who are not being encouraged to examine their identities with patience, reflection, or therapeutic support but are instead being fast-tracked into medical pathways they do not fully understand.

To question, to reflect, to seek therapy, to wait—these are treated as transphobic acts, even though they are standard practices for any other profound psychological struggle.

This is not a debate about adults. Adults can make their own choices. This is about children and teenagers—individuals whose brains are still developing, who cannot legally drink, vote, sign contracts, get tattoos, or undergo plastic surgery without parental consent. And yet, they are being allowed—and in many cases encouraged—to make irreversible decisions that will shape their bodies and fertility for life.

NYU Langone and institutions like it cloak this process in therapeutic language, but the underlying reality remains: these surgeries are experimental, controversial, often cosmetic, and unsupported by long-term data.

American medicine must return to first principles: do no harm. That begins with a complete halt to irreversible gender surgeries on minors, rigorous, long-term mental health evaluations prior to any hormonal or surgical intervention, full parental involvement and consent, transparency from hospitals and medical associations and a repudiation of ideological pressure in clinical settings

Young people deserve time—time to mature, reflect, wrestle with their identities, and seek non-invasive therapeutic guidance rather than being funneled toward irreversible interventions.

The emerging evidence is irrefutable: America’s youth gender surgery industry has expanded far beyond credible science or ethical medicine. NYU Langone and similar institutions have positioned themselves at the forefront of a movement that risks sacrificing the long-term wellbeing of children for ideological conformity and institutional prestige.

We must support young people not by affirming every impulse but by safeguarding their futures. A society judged by how it protects its most vulnerable cannot remain silent. It must demand accountability. It must demand transparency. And above all, it must demand that we stop treating children as subjects in a cultural experiment whose consequences they will carry for the rest of their lives.