I was born in the mid-1970s, but if I’d been born 35 years later, I am almost certain someone would have told me I was “actually” a boy.
My best childhood memories include dirt, frogs, and scraped knees. I wasn’t indoors making crafts or playing with dolls. Rather, I was digging through drainage culverts on our street, rescuing tadpoles, and coming home covered in mud.
My sister, only one year older, wore dresses and carried books. I wore cut-off shorts and carried a fishing pole. No one told her she was “too girly,” and no one told me I was “actually a boy.” We were simply different girls.
My parents didn’t panic about my interests. They didn’t suddenly pretend they had one boy and one girl. They didn’t schedule a psychological evaluation because I preferred climbing trees over playing dress-up. They simply let me be a girl — a girl with grass-stained knees and a fort built in the woods next door.
No existential crisis. No identity clinic referral. Just a little girl who liked frogs more than frills. But here’s what chills me: If I were 12 today, I would almost certainly be flagged by a school counselor or an online algorithm as a child to “watch for gender incongruence.” I might have been offered puberty blockers at age 10, before I even got to discover what womanhood felt like in my own skin. I might have been told that some of my body parts were optional-and had surgery to remove healthy breast tissue as they tried to “affirm” who they thought I was.
In time, I grew up and grew into my body. I learned that my strong personality was perfect in an operating room, and I am now a board-certified gynecologist, specializing in surgical treatment of common health concerns, including endometriosis and fibroids. I am committed to caring for the needs of women of all ages. Time taught me I could love both muddy hiking boots, a sparkly dress, and high heels — sometimes all in the same day. Time turned my decadelong “tomboy phase” into a lifetime of womanhood that has also included the privilege of being a wife and giving birth.
Unfortunately, the stories of multiple young people are now coming to light that state they were fast-tracked through our current medical system. In the recently decided case of Fox Varian, the case reports that she underwent a double mastectomy at the age of 16. She explains that she now regrets this, winning an almost $2 million verdict in her malpractice case. A similar story is shared by Chloe Cole, who was also placed on puberty blockers and cross-sex hormones and underwent a double mastectomy at the age of 15. She is awaiting a trial in her malpractice case against the physicians who treated her.
Unfortunately, multiple physician organizations continue to support access to what is termed “gender-affirming” medical and surgical interventions for adolescents — interventions that suppress natural puberty, permanently alter endocrine development, and surgically remove healthy, functioning tissue in minors.
I applaud the American Society of Plastic Surgeons and their position statement released Feb. 3 that reads: “ASPS recommends that surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old”. I now call on the American Medical Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and other medical organizations to revise their position statements on adolescent care to make it clear that irreversible surgeries that remove healthy, anatomically normal breast, chest, or genital tissue in minors should not be performed.
The House of Representatives passed the Do No Harm in Medicaid Act on Dec. 18, 2025. The legislation would prohibit the use of federal Medicaid funds to pay for gender transition-related medical interventions, including puberty blockers, cross-sex hormones, and surgical procedures, for minors. I implore the Senate to bring this House-passed measure up for discussion. This generation of children cannot wait — they need protection now.
As physicians who believe that gender-affirming medical care for minors has gone too far, we must no longer stay silent. It is time to speak up on behalf of all children who count on us to lead them with wisdom – and to acknowledge when there is a lack of long-term evidence on medications and especially surgery. Our oath calls us to first, do no harm.
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If you share these concerns, speak up. Contact the medical organizations you belong to. Call your senators. Support colleagues who are advocating greater caution in adolescent medicine. Your silence is not neutrality — it is permission.
The medical and surgical transition of children deserves greater scrutiny — and restraint. Developing bodies deserve our protection — not irreversible surgical intervention. It is time for physicians to raise our voices and restore this area of medical care for minors.
Dr. Holly Miller is a board-certified OB/GYN with over 20 years of experience. She lives in Naples, Florida, where she is in private practice at A Woman’s Place. You can find her on socials @drhollymiller.