Thirty-five state legislatures have introduced more than 100 bills that limit or prohibit access to medically necessary gender-affirming care for transgender and gender-diverse (TGD) youth, resulting in poor mental and physical health outcomes.1 Approximately 300 000 adolescents between 13 and 17 years of age identify as transgender.2 Among TGD individuals experiencing gender dysphoria, gender-affirming surgery may improve functioning and mental health.3 However, there is a paucity of information regarding gender-affirming surgery in adolescent populations. Reconstructive genital surgery is typically not performed in adolescents, but masculinizing chest reconstruction (eg, mastectomy) and feminizing chest reconstruction (eg, augmentation mammaplasty) may be performed in outpatient and ambulatory surgery settings.4 We investigated the incidence, demographic characteristics, and spending related to ambulatory gender-affirming chest reconstruction in adolescents using nationally representative data from 2016 to 2019.