Florida Gov Ron DeSantis moves to ban transgender youth and Medicaid recipients from all transition care

The administration of Florida’s Republican Governor Ron DeSantis has asked a state medical board to effectively ban all transition-related healthcare for transgender young people, while another state agency issued a report to justify banning transgender people on Medicaid – the federal health programme for lower-income Americans – from accessing gender-affirming care.

The administration’s moves follows an advisory from Florida’s Department of Health to ignore federal health guidance and advise against all gender-affirming care for transgender minors in the state, including social transioning measures like changing pronouns or wearing different clothes.

Florida’s measures against transgender people in the state are among an unprecedented wave of GOP-led policies and legislation across the US restricting transgender healthcare and banning transgender athletes from school sports, among dozens of bills targeting LGBT+ Americans.

On 2 June, the state’s Agency for Health Care Administration released a 46-page report citing debunked research seeking to justify a ban on Medicaid coverage for transgender people of any age who seek puberty blockers, hormone therapies or gender-reassignment surgery.

Hours later, Florida’s Surgeon General Joseph Ladapo told the state board regulating doctors 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,” according to a letter obtained by NBC News.

The recommendations from the administartion fly against the positions from established medical groups, including the World Professional Association for Transgender Health as well as the American Medical Association, American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the American Academy of Family Physicians.

The latest guidance drew immediate backlash from medical professionals and LGBT+ advocates.

If the state rejects transition care for transgender people on Medicaid, Florida would become the 11th state to have explicit exclusions against gender-affirming care in Medicaid programmes, despite federal court precedents that such exclusions are violations of the Affordable Care Act and Medicaid Act, accordion to the American Civil Liberties Union.

The Human Rights Campaign estimates that denying Medicaid coverage for transition-related care would impact roughly 9,000 transgender people in Florida.

The organisation characterised the measures as a “transparent ploy to create controversy, ignore medical best practices, and refuse to provide age-appropriate, medically necessary care to some Floridians for purely partisian, discriminatory reasons.”

“Gender-affirming care is lifesaving – that, unlike the material in this report, is a fact – and this medical care is neither experimental, nor new,” said Cathryn Oakley, the Human Rights Campaign’s state legislative director and senior counsel.

“Banning gender-affirming care under Medicaid – and trying to ban gender-affirming care for youth – is incredibly irresponsible,” the National Center for Transgender Equality said in a statement. “This will only increase barriers for trans people seeking medically necessary care – and this decision is both deeply biased and anti-science”.

State Rep Carlos G Smith, among the first openly LGBT+ state legislators in Florida, said the administration is “trying to take the freedom of trans ADULTS to access healthcare and of parents to care for their kids.”

“There’s no consistent or conservative ideology here. Just cruelty and a willingness to use vulnerable people to advance his presidential dreams,” he said.

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health found that only one in three young transgender people consider their home to be gender-affirming.

Another report from the organisation, published in Transgender Health, found that acceptance of one’s gender identity from their parents was associated with 4 per cent lower odds of attempting suicide among transgender and nonbinary youth.

Recent polling from Morning Consult on behalf of organisation found that 85 per cent of transgender and nonbinary youth reported negative impacts to their mental health following recent debates over state legislation that impacts their care.

When asked about legislation that would ban physicians from prescribing gender-affirming care, 7 per cent of respondents said it made them feel angry, 57 per cent felt sad, 47 per cent felt stressed, 40 per cent felt scared, and more than one-third felt hopeless, helpless, and/or nervous, according to the report.