Consensus on youth gender surgery may be crumbling, according to a New York Times guest essay. The piece acknowledges the growing "cracks" in medical agreement regarding the treatment for minors as several U.S. health organizations update their policies.

The opinion essay by Jesse Singal, published Tuesday, highlights how the "settled" science surrounding these procedures may no longer be unanimous.

He argued that politics may have influenced medical organizations when they previously endorsed the treatments, adding that if they are not transparent, "there’s simply no good reason to trust them."

"I’ve been covering this controversy for about a decade from a left-of-center perspective, and I’ve found that anyone who questions these treatments, even mildly, is invariably accused of bigotry," Singal wrote in the piece, "Medical Associations Trusted Belief Over Science on Youth Gender Care."

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The American Society of Plastic Surgeons (ASPS) updated its guidance on Feb. 3, recommending medical professionals delay gender-related surgical procedures until patients are adults. The American Medical Association later followed the ASPS’s guidance.

The ASPS now recommends "surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old." The group said it found "insufficient evidence" that the procedures have a positive risk-benefit ratio. 

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The shift comes as the industry faces a major legal reckoning. In January, a New York jury awarded $2 million to a detransitioner who sued members of her medical team over the mastectomy she received at age 16.

Singal noted that the landmark ruling will "most likely give pause to hospitals and clinics that continue to provide these treatments without substantial guardrails." He added that the science behind the procedures no longer seems "so settled after all."

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"Policy statements like this one can reflect the complex and opaque internal politics of an organization, rather than dispassionate scientific analysis," Singal wrote.

"Should we ‘trust the science’?" he later added. "Sure, in theory — but only when the science in question has earned our trust through transparency and rigor."

The New York Times is among several outlets that have published pieces on the changing tide in the field of youth gender medicine.

An article published earlier this month in The Atlantic questioned whether medical organizations remain united on puberty blockers, hormone therapy and gender-related surgeries for young people.