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More and more Americans are opting to undergo life altering transgender surgeries – including minors. The numbers are now reaching alarming levels.

A new study published by the Journal of the American Medical Association shows that, between 2016-2019, more than 48,000 patients underwent so-called “gender-affirming” surgeries.

Most of these surgeries, 27,000, were breast procedures, but almost 17,000 patients received genital reconstruction surgery and over 6,000 patients received some form of facial or cosmetic treatment.

Most of the surgeries were performed on patients between the ages of 19 and 30. However, the study also documents that over 3,600 surgeries were performed on patients between 12 and 18.

And the numbers are growing, with surgeries nearly tripling between 2016 and 2019.