Florida begins rule-changing process to ban gender-affirming care for trans youth

Florida’s Board of Medicine has voted to consider a new standard of care for transgender youth in the state in conflict with major medical associations, federal guidance and urgent demands from LGBT+ advocates and health providers. The move is what critics have called a political attack against trans people by Governor Ron DeSantis and his administartion.

On 5 August, the board agreed to a request from Florida’s chief health official to reject what he falsely called “experimental” treatments that lack “quality evidence” after the state issued widely debunked guidance against affirming medical care, including “social” transitioning measures like changing pronouns or wearing different clothes.

The decision from the governor-appointed board initiates a formal rule-changing process that would deny trans youth from receiving such care and forcibly detransition them. The process could take several months and does not immediately institute a ban on gender-affirming care, such as puberty blockers and hormone replacement therapies.

Researchers cited in the Florida Department of Health’s April memo said their work was misrepresented in an attempt to justify denying gender-affirming care to Florida’s trans youth.

A report from Vice found that all 12 citations in the memo either distort the work that was cited or come from explicitly anti-trans sources, with Florida’s Department of Health claiming that it could not find any evidence indicating that such treatments are safe, labelling them “experimental” – despite the work they cited saying the opposite.

The health department under Surgeon General Joseph Ladapo asked state’s Board of Medicine to prohibit “sex reassignment surgery or any other procedure that alters primary or secondary sexual characteristics for the treatment of gender dysphoria” – including puberty blockers and hormone replacement therapies – for patients younger than 18 years old.

Current guidelines do not recommend gender-affirming surgeries for children under 18, and they typically are not eligible for surgical transition.

The board also said it has never received an complaint related to gender-affirming care, nor is there any history of such complaints in the state.

Adults seeking such care should also seek approval from the board at least 24 hours before treatment is provided, according to the health department.

The department also suggested that physicians who are already supporting patients who are receiving that care should stop – which would allow the state to forcefully detransition transgender people in Florida.

The guidance issued by Mr Ladapo pushes against federal health guidance that finds that gender-affirming care for young transgender people is “crucial to overall health and well-being as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the healthcare system.”

In June, Mr Ladapo told the state board that widely supported evidence from medical professionals supporting gender-affirming care is “extraordinarily weak” and said the state must “protect children from politics-based medicine”.

A joint statement from Lambda Legal, Southern Legal Counsel, Florida Health Justice Project and the National Health Law Program urged the board to “stop playing politics with people’s health care” and reject the state’s guidelines, which fly against guidance from the World Professional Association for Transgender Health, the American Medical Association, American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the American Academy of Family Physicians, among others.

“Existing, well-established, and evidence-based guidelines already guide health clinicians in prescribing treatments for gender dysphoria,” according to the groups’ statement.

Changing those standards for care “would make it more difficult or even impossible for doctors in Florida to provide transgender patients with what is widely acknowledged to be medically necessary care for gender dysphoria,” they wrote. “The proposal is based on clear animus towards transgender people as well as junk science.”

Sarah Warbelow, legal director with the Human Rights Campaign, said Governor DeSantis’ “assault on transgender Floridians” is an “effort to create a wedge between parents, children, and their teachers and doctors.”