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Fact check: Trump falsely claims schools are secretly sending children for gender-affirming surgeries

By Daniel Dale, CNN

Washington (CNN) — Former President Donald Trump has been making false claims about transgender people – including an inflammatory and baseless claim on Friday that schools are secretly providing or obtaining gender-affirming surgeries for children.

“The transgender thing is incredible. Think of it. Your kid goes to school and comes home a few days later with an operation. The school decides what’s going to happen with your child,” Trump said in remarks to the conservative group Moms for Liberty.

Facts FirstTrump’s claim is false. There is no evidence that US schools have sent children into gender-affirming surgeries without their parents knowing or performed gender-affirming surgeries on site; Trump’s own presidential campaign could not provide a single example of this ever happening. Even in states where gender-affirming surgery is legal for people under age 18, parental consent is required before a minor can undergo such a procedure.  

“Of course everything in this statement is false,” Dr. Meredithe McNamara, an adolescent medicine physician at the Yale School of Medicine, said in a Monday email. “Of course surgery of any kind happens in a qualified medical center and not in a school. Of course parents are the medical decision-makers for their kids, especially when it comes to gender-affirming care.”

Landon Hughes, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health and a co-author of a recent study on the prevalence of gender-affirming surgery in the US, said in a Tuesday email: “There are no instances of children receiving surgeries or access to surgeries from their schools.” Hughes added: “No provider in the US would perform surgery on a minor under the direction of a school, let alone without parental consent.”

For minors, parental consent is also required in the US for non-surgical gender-affirming medical treatments, like puberty blockers and hormone therapy. Various guidelines and standards for medical care of transgender adolescents, from entities including the American Academy of Pediatrics and the World Professional Association for Transgender Health, explain that parental consent is needed.

“Any gender-affirming medical care or surgical care would legally require the consent of (both) parents/legal guardians and assent of an adolescent under 18,” Dr. Laura Taylor, medical director of the gender-affirming care program at the University of Southern California, said in a Tuesday email. “This includes puberty blockers, hormones, and surgery.”

There are no definitive national figures on the number of minors who receive gender-affirming surgeries, which include breast or chest procedures, often called “top surgery,” and genital reconstructive procedures, often called “bottom surgery.” But the limited available data makes it clear that the vast majority of such surgeries occur among adults.

Taylor outlined a lengthy process before a minor might undergo a gender-affirming surgery.

“In adolescents, the decision to start hormones and/or have surgery would happen afterconsultation with an interdisciplinary team for a psychosocial assessment,” she said, the bold type hers. “The assessment includes understanding the dysphoria related to gender incongruence (the distress caused by the physical characteristics that do not match the person’s identity), how long it has been present, excluding other reasons to account for the dysphoria, and making sure the adolescent and family can provide informed consent.”

Trump’s campaign can’t substantiate the claim

Trump, the Republican presidential nominee, regularly ad-libs false claims that his campaign is unable to substantiate. When CNN asked the campaign on Monday for any evidence of a school deciding to send a child into gender-affirming surgery without parental consent, the campaign could not provide any.

Instead, spokesperson Karoline Leavitt pivoted away from Trump’s specific assertion – emailing a series of articles related to the broader debate about transgender minors, schools, and parental consent. Some of the articles were about schools that do not notify parents if their child wants to identify as a different gender on school grounds.

Leavitt said: “I have personally spoken to several individuals whose children were undergoing transition, being called entirely different names at school and the parents were never notified. These cases don’t always make the news because parents fear backlash, but their stories are nevertheless truthful and very concerning.”

For the purposes of this fact check, the debate about how schools should disclose social transitions to parents is beside the point. Trump made an explicit claim that schools are approving gender-related surgeries for children without parental consent.

“I can’t imagine a scenario in which this is plausible and do not know of a single case where a decision like this has been made by a school,” said Lindsey Dawson, director of LGBTQ health policy at KFF, an organization that researches health policy.

Conservative groups also find no evidence

CNN reached out to four conservative organizations that monitor how schools handle gender issues to check if they had any evidence that might corroborate Trump’s claim. None of these organizations said they had – though the two that responded in detail defended Trump’s remarks nonetheless.

Tiffany Justice, the Moms for Liberty co-founder who conducted the public conversation with Trump, said in a Tuesday interview: “Are kids getting surgery in school? No they’re not.” But she continued that she was still “thankful to President Trump” for making the claim – since, she said, his remark has drawn attention to the important issue of schools facilitating children’s social transitions without parental consent.

Justice said of Trump’s claim: “It grabbed your attention, and we’re talking about it now, and that makes me very happy.”

Thomas Jipping, senior legal fellow at the conservative Heritage Foundation think tank, said in a Tuesday interview that “Trump’s point is completely valid” given how some schools are not notifying parents about their children’s social transitions. But Jipping said he is “not aware of a specific incident yet where it has gone that far, where it has gone from social to medical transition.”

Jipping said that if you “just change a couple words” in Trump’s quote – and make it about a child coming from school with a new gender identity rather than coming home “with an operation” – the claim “is 100% accurate and correct.”

But we don’t fact-check hypothetical alternative quotes. Trump used the words he used, and they were about surgery.

Another Trump false claim on the subject

At multiple events in August, including the Moms for Liberty event, Trump claimed that Olympic women’s welterweight boxing gold medalist Imane Khelif of Algeria “transitioned” to female.

That’s false, too. The International Olympic Committee (IOC), Khelif herself and her father have noted that Khelif was born and raised as female and has always competed as a woman. She did not transition.

Before her triumph in the Olympics, Khelif was disqualified last year from the world championships held by the International Boxing Association – an organization with extensive ties to the Russian government  that was stripped of official recognition by the IOC for a variety of problems, including a history of corruption. The authority has claimed that a gender eligibility test showed Khelif had “competitive advantages over other female competitors,” but it has never substantiated this assertion.

Regardless of the merits of the 2023 disqualification, there is simply no basis for claiming Khelif is transgender. IOC spokesperson Mark Adams said during the Olympics in August: “The Algerian boxer was born female, was registered female, lived her life as a female, boxed as a female, has a female passport. This is not a transgender case.”

CNN’s Jen Christensen contributed to this article.

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