Senior Biden administration health officials pushed an international panel of medical experts to rescind age limits for transgender surgery for minors, as per newly released court documents.

Extracts of emails from the World Professional Association for Transgender Health document on how the Assistant Secretary of Health in the Department of Health and Human Services Rachel Levine’s team demanded that the group drop the age requirement for minors to undergo gender transition surgery as part of the September 20, 2022 Standards of Care update.

The documents were uncovered as evidence in one of the numerous lawsuits filed across the nation concerning state-wide bans on medical treatments for gender transition for minors.

The emails were presented to the court in Alabama Boe v. Marshall case Boe in v. Marshall by James Cantor psychologist and an outspoken opponent of the gender transition process for minors.

A portion of an unidentified WPATH member relates an exchange with the chief of staff for Levine Sarah Boateng, in which she stated that Levine “is confident, based on the rhetoric she is hearing in D.C., and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care,” calling for the age limit to be eliminated from the final draft.

A number of other emails detail WPATH participants discussing the suggestion of Levine that age-limit recommendations be included in the form of a “less visible” document and worry that putting off the publication of this document would be “proving a barrier to optimal policy progress.”

Guidelines for drafts from WPATH released in 2021 suggested setting age-minimums of 14 for hormonal treatment such as mastectomies. 15 is the minimum for mastectomies 16 for breast augmentation, facial reconstruction and 17 for genital reconstructive surgery and the hysterectomy. These guidelines were eventually taken out of the final version.

Over 20 states since 2021 have enacted some form of age-restricted gender change to minors. They have cited the absence of long-term research evidence to support the effectiveness of this method in reducing negative mental health problems.

The majority of adolescents suffering from gender dysphoria that seek medically-induced transitions are treated with hormone replacement therapy or blockers of puberty However, there have been numerous prominent cases of teenagers who underwent surgical procedures to finish a medical transition only to be transitioned out of the process when they reached adulthood.

A lot of critics of gender change for minors, such as those who had medically transitioned in their teens, stress that teens haven’t yet reached the maturity age at which they can consent to potentially life altering surgical procedures. The critics also point out the fact that genital surgery and prolonged cross-hormone therapy may permanently affect fertility.

Levine who is a biological man who has a gender identity of woman, underwent a gender change in 2011 following being married and having two children. In the year 2019, Levine expressed having “no regrets” regarding the transition that occurred later in life, following having children.

The Supreme Court announced Monday that it will take on an appeal made by the Biden administration against Tennessee’s law, which restricts the use of hormone treatments and surgeries for minors. It is the first time the court weighs on medical changes for minors.