Former President Donald Trump attends a luncheon hosted by the Economic Club of Chicago on October 15, 2024, in Chicago.
CNN  — 

Former President Donald Trump continues to repeat his lie that US schools are sending children for gender-affirming surgeries without their parents’ consent — even though his own presidential campaign could not find a single example of this having happened.

Trump debuted the tale in late August. It was debunked by CNN and others in early September. But Trump, whose campaign has spent tens of millions of dollars on late-campaign attack ads related to transgender people, has revived the story in October as Election Day draws near.

Trump made the claim again last week while discussing education policy during a New York City barbershop discussion filmed by Fox News: “No transgender, no operations — you know, they take your kid — there are some places, your boy leaves for school, comes back a girl. Okay? Without parental consent.” He added, “At first, when I was told that was actually happening, I said, you know, it’s an exaggeration. No: it happens. It happens. There are areas where it happens.”

Trump didn’t name these supposed “areas.” But he made the claim once more during his Friday interview with prominent podcast host Joe Rogan: “Who would want to have — there’s so many — the transgender operations: where they’re allowed to take your child when he goes to school and turn him into a male — to a female — without parental consent.”

Facts FirstTrump’s claim remains false. There is no evidence that schools in any part of the United States have sent children for gender-affirming surgeries without their parents’ approval, or performed unapproved gender-affirming surgeries on site; none of that is “allowed” anywhere in the country. Even in the states where gender-affirming surgery is legal for people under age 18, parental consent is required before a minor can undergo such a procedure.  

Trump’s campaign and four conservative groups contacted by CNN in September about Trump’s claim were unable to find any evidence for it. Experts on health care for transgender people said the situation Trump described simply does not happen in this country.

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 September 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.”

“Of course everything in this statement is false,” Dr. Meredithe McNamara, an adolescent medicine physician at the Yale School of Medicine, said in a September 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.”

For minors, parental consent is also required in the US for non-surgical gender-affirming medical treatments such as 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 September 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 after consultation 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.”

Asked in September for any evidence for Trump’s claim that schools are secretly obtaining gender-affirming surgeries for children, Trump campaign spokesperson Karoline Leavitt provided none. Instead, she sent a series of articles on the broader debate over how schools handle gender identity issues.