“Get the tits out” has a whole new meaning.

A report from the Manhattan Institute this week revealed that “gender-affirming” mastectomies for patients under 18 are more common than previously believed.

While cross-sex genital surgeries are rare in the US for both adults and minors, mastectomies — also known as “top surgery” in the context of transgender medicine — are widely available to minors and are the most common transgender surgery for this population. Around 5,000 to 6,000 girls underwent “gender affirming” double mastectomies in the US from 2017 to 2023, according to the Manhattan Institute, and at least 50 of those patients were younger than 12-and-a-half years old.

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The actual prevalence of these surgeries is likely considerably higher than the latest estimate, since it relies on health insurance data and therefore does not include procedures obtained without using insurance.

“First do no harm” is so last millennium, ya know?