WASHINGTON " The American Society of Plastic Surgeons (ASPS) recommends that gender-affirming surgeries be delayed until a patient is at least 19 years old, the group announced in a statement Tuesday. The statement, made by the group's board of directors, represents a break from major U.S. medical groups that have supported the care, and applies to facial, chest, and genital procedures performed for transgender and nonbinary patients. The group, a professional association with more than 11,000 physician members, emphasized that the statement was not a clinical practice guideline but instead "professional guidance" for care the group said was "rapidly evolving and controversial."