Trans kids want ‘lives of dignity and acceptance’; DeSantis, surgeon general want bans on therapies

Thousands of comments have come in on the issue; state boards to decide the fate of trans youths

Students protesting on the 5th floor of the Florida Capitol Building. Mar. 3, 2022. Credit: Danielle J. Brown

James, of Central Florida.

Nov. 15, 2022:

“This rule cruelly and unfairly attacks vulnerable trans youth in our state by banning their access to gender-affirming healthcare. Young people who want only to be who they are and live lives of dignity and acceptance, something we ask for all people. In addition, as this rule does not adequately measure its economic impact, I request a hearing be held regarding it.”

James was referencing just one of thousands of comments related to the “Standards of Practice for the Treatment of Gender Dysphoria in Minors,” an issue that has created a swarm of attacks on transgender youths who want to undergo treatments such as puberty blocking, surgical procedures and hormone therapies.

Florida Surgeon General Joseph Ladapo and Gov. Ron DeSantis have been pushing to ban those measures, and there will be a joint meeting on Feb. 10, with board members expected to decide the fate of the minors’ lives.

The joint boards are the Board of Medicine and the Board of Osteopathic Medicine.

Here are the proposed rules related to the ban, according to the Florida Administrative Register in November 2022:

The following therapies and procedures performed for the treatment of gender dysphoria in minors are prohibited.

(a) Sex reassignment surgeries, or any other surgical procedures, that alter primary or secondary sexual characteristics. (b) Puberty blocking, hormone, and hormone antagonist therapies.

Minors being treated with puberty blocking, hormone, or hormone antagonist therapies prior to the effective date of this rule may continue with such therapies.

In addition, the Osteopathic Board wants to allow another provision: Nonsurgical treatments for the treatment of gender dysphoria in minors may continue to be performed under the auspices of Institutional Review Board (IRB) approved, investigator-initiated clinical trials conducted at any of the Florida medical schools set forth in Section 458.3145(1)(i), Florida Statutes. Such clinical trials must include long term longitudinal assessments of the patients’ physiologic and psychologic outcomes.

As part of the meeting agenda next week, Florida officials provided public records including more than 6,000 pages of comments, reports, letters, and other material and communications leading up to what likely will be a major decision.

The Florida Phoenix retrieved the lengthy document of public records and gleaned numerous comments in the material, showing the breadth of emotions and strong views connected to the issue.

The Phoenix randomly reviewed the comments within the 6,604 pages.

Keep in mind that all comments are public records that go back to at least July 2022. Citizens can look at the information published online at the Board of Medicine, where you can see what’s called the public book.

The Phoenix did not to disclose the full names of commenters, instead, using a first name. However, the Phoenix did use the names of public officials and attorneys.

/Michele. Miami-Dade County. December.

Michele is the a mother of a transgender daughter and wrote in opposition of the rule.

“Gender-affirming care saved our child and our family. We sought therapists and endocrinologists and consulted with our pediatrician. The care provided to Reia (Michele’s daughter) improved her mental health and well-being. And ours!”

Michele added: “The transgender population has always been in our community. But they have been hidden, scorned, rendered homeless, jobless, stigmatized, and even murdered. Gender-affirming care is not just for the child. It is also for the family. Our pediatric endocrinologist said it perfectly. He said, ‘These kids are not crazy. We make them crazy by heaping shame and stigma upon them.’”

/Rep. Anna Eskamani. Democrat representing part of Orange County. November.

“First, I want to address the alarming trend over the past decade of politicians increasingly politicizing the medical field. Medicine must of course be regulated to ensure safety of patients and providers, and we should also pursue policy solutions that provide greater access to care and eliminate health disparities. But regulations should be based on the best science and standards – not on campaign stump speeches.”

/Southern Legal Council. Alachua County. November.

“Southern Legal Counsel and Florida Health Justice Project urge the Florida Board of Medicine not to adopt Rule 6488-9019 because prohibiting medical providers from providing the appropriate, medically necessary treatment for gender dysphoria to their minor patients: (1) directly contravenes the widely accepted, authoritative standards of care and the consensus of every major medical and mental health association; (2) will cause significant harm to the individuals we serve by depriving them of critical medical care; (3) interferes with, and substitutes the state’s judgment in place of the doctor/patient relationship, the rights of the individual, and the fundamental rights of a parent to determine appropriate medical treatment for their child; and (4) is a shameful waste of resources, as similar exclusions have been enjoined and/or struck down by courts across the country, and the litigation that the state will certainly find itself embroiled in will waste valuable state resources that could be better utilized enhancing the lives of Floridians rather than attacking them.”

/Florida PTA. Orange County. December.

“Finally, we believe that this rule not only stands in violation of Florida’s Parental Bill of Rights that gives parents full authority to direct the health care and mental health of their children, but likewise unlawfully discriminates against a federally protected class of individuals who are entitled to equal access to medical care.”

/Jennifer. Miami-Dade County. December.

“The gender which adults or children choose to express is none of the government‘s business. There were already stringent and very costly ‘hoops’ in place that children and their families had to jump through to seek gender-affirming care; it is certainly not something that could have been done on a whim. An outright ban is government over-reach at its worst.”

/American Academy of Pediatrics. December.

The President of the American Academy of Pediatrics Moira Szilagyi and the president of its Florida chapter Thresia Gambon submitted a joint statement urging against the rule on Dec. 5, 2022. The statement defends various treatments for gender-affirming care that the DeSantis administration often vilifies, such as puberty blockers and hormone therapy.

“As written, the proposed rule would undermine expert clinical decision-making made in the context of the physician-patient relationship. The physician-patient relationship is guided by the evidence-based standards of care detailed above. The proposed rule relies on refuted studies and creates a prohibition on specific treatments for gender dysphoria that are recommended by the prevailing consensus of numerous medical organizations. The proposed rule will adversely affect the treating clinician’s role and ability to determine the medically necessary care for a patient, and it creates a confusing alternative to evidence-based care as established by leading medical bodies.

“More importantly, the proposed rule sets discriminatory standards regarding the care of transgender adolescents who already struggle with bullying and seek belonging and protection. Lastly, the proposed rule encroaches upon and erodes the sacred physician-patient relationship with serious detrimental consequences for medical practice and patient care.”

/Gwendolyn. Leon County. December.

“Gender-affirming care is not experimental. It leads to mental health and should be the decision of medical professionals, the parents of trans youth, and the young person. This is suicide prevention, and life-affirming. Please base your decision on facts not propaganda. Please listen to trans people and their parents and the national medical associations, not fear-based opinions. of politicians.”

/Linda. Pinellas County. October.

“There is, in fact, overwhelming evidence to support the positive mental health impacts of gender-affirming medical care for trans youth – including in some of the very studies cited by the DOH and Board of Medicine. Prohibiting social transition is clear government intrusion on personal and parental decision making. Numerous studies have found that after social transition, transgender youth report similar mental health levels to the general youth population, eliminating mental health disparities typically seen. When transgender youth are affirmed by people around them, reported rates of depression and suicidality drop significantly. This rule will deny them life-saving treatment. I call on this Board to provide truthful information based on science and data as opposed to false statements based on prejudice and political agendas.”

/Maryann. Brevard County. October.


/Pamela. Brevard County. October.

“Look, I understand the concerns here. We are talking about some changes that are permanent. But think about this – if drastically decreasing the suicide rate among trans teens is a permanent change, shouldn’t we be looking at that as well? I have countless hundreds of stories I could share about the positive impact medical transitioning has had, and not one negative. Not one. We are talking about health care that is necessary. Health care that parents are approving. Health care that follows a strict protocol. Health care that is literally life saving.”

/Amanda. Osceola County. October.

“Gender affirming healthcare saved our son’s life. We didn’t realize how unhappy and depressed he was until we saw the changes in him after surgery. It’s been 13 months and there are no regrets. He is living his best life as his true authentic self – thanks to gender affirming healthcare.”

/Pedro. Pasco County. November.

“There are numerous peer reviewed articles that easily debunk politically and religiously motivated academic publications found in the Department of Health’s report on gender-affinning care. Expert medical standards of care on the provision of gender-affinning care have been continuously maintained and updated for more than 40 years. These standards require providers to carefully evaluate each patient and make decisions in the patient’s best interest. Unfortunately, the guidance promoted by the Surgeon General and the cherry-picked studies by this board are nothing more than anti-transgender propaganda.”

/Maia. Broward County. November.

“The foundation of liberty in this country are based off of individual liberties, including our right to bodily autonomy. Every person deserves the right to decide what happens to their body, and this included transgender health care. This is decision that should be between parents, children, and their doctors. The government should not infringe upon these relationships. Please keep transgender healthcare accessible to all. Please keep Florida safe for all.

/Sophia. Alachua County. November.

“Growing up, I have continuously seen my transgender friends misunderstood and even demonized by the adults in their lives who were supposed to protect them. Some were denied any gender-affirming care until they were adults. I cannot tell you what the horror they went through during adolescence was since as a cisgender person, have never experienced gender dysphoria. What I do know is that it can be absolutely nightmarish. Some of my friends who were forced not to transition until they were adults spent their teenage years fighting suicidal urges when they Should have been focusing on school and making memories with their friends.

“I also know that my friends who bravely held out to adulthood transitioned and never looked back. I saw them begin to have hope for the future and find joy in life again. Yet the physical and psychological damage done by being forced through the Wrong puberty might never be fully healed. I also grieve to think of all the transgender kids who went through similar situations and just could not hold out long enough. I am horrified and angry to think of all those we might lose if their medical care becomes illegal.”

/Misha. Polk County. November.

“Ron DeSantis and his unqualified partisan ‘experts’ have no understanding of the transitioning process and every falsehood they put forward is easily countered by the truth and lived experiences of trans people and the doctors who provide them their care.

“Not only is he calling on you and the rest of the Board of Medicine to halt medical care prescribed by pediatricians and medical experts, but he’s calling on you to ban minors from socially transitioning. Social transition involves no medical treatment and serves /es zero physical risk, and clearly shows that his interest is not in the wellbeing of the youth in our state, but in controlling and oppressing others. This was made evident in August when DeSantis banned Medicaid coverage for gender-affirming care. This has done nothing except force low-income trans people out of financial stability and into detransitioning. As a community we can no longer sit idly by while our governor strips the rights of us, our friends, and our children away to suit his narrative. It is time to act.

/Sharon. No location given. December.

“There is overwhelming evidence to support the positive mental health impacts of gender-affirming medical care for transgender adolescents — including in some of the very studies cited by the DOH and Board of Medicine. Prohibiting social transition is clear government intrusion on personal and parental decision-making. Numerous studies have found that after social transition, transgender youth report similar mental health levels to the general youth population, eliminating mental health disparities typically seen. When transgender youth are affirmed by people around them, reported rates of depression and suicidality drop significantly. This rule will deny them this life-saving treatment.”

/Gabrielle. No location given. December.

“Transgender people are people, so transgender kids are kids. As people, transgender kids deserve the right to healthcare like anyone else. Transgender kids and people deserve gender-affirming care, which is health care. There‘s plenty of factual, scientific, and/or anecdotal research proving gender-affirming care is not only safe, but essential and life-saving to allow transgender people to live their lives authentically and fully. The state should not stand in between medical providers who know what‘s best for their patients, transgender youth, and their parents or families.”

/Lauren. No location given. November.

“I have heard, the Florida Board of Medicine recently voted to ban gender-affirming care for young people. If it goes into effect, this new rule would prevent individuals from being able to access gender-affirming care through healthcare providers, and any healthcare providers who choose to prioritize their patients’ lives by offering this care could lose their license to practice medicine. This would mean that youth in the state of Florida would be denied their right to health care by preventing them from delaying puberty, starting gender-affirming hormone therapy, or accessing gender-affirming surgery. This goes against decades of medical evidence…Please protect the rights of young people in Florida by reevaluating this vote and letting this go to hearing.”

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Issac Morgan
Issac Morgan

Issac Morgan is a 2009 graduate of Florida A&M University's School of Journalism, and a proud native of Tallahassee. He has covered city council and community events at the Gadsden County Times, worked as a sports news assistant at the Tallahassee Democrat, a communications specialist for the Florida Department of Agriculture and Consumer Services, and as a proofreader at the Florida Law Weekly.

Danielle J. Brown
Danielle J. Brown

Danielle J. Brown is a 2018 graduate of Florida State University. She has served as an editorial intern for International Program’s annual magazine and Rowland Publishing. She was born and raised in Tallahassee and reviews community theater productions for the Tallahassee Democrat.

Michael Moline
Michael Moline

Michael Moline has covered politics and the legal system for more than 30 years. He is a former managing editor of the San Francisco Daily Journal and former assistant managing editor of The National Law Journal.

Mitch Perry
Mitch Perry

Mitch Perry has covered politics and government in Florida for more than two decades. Most recently he is the former politics reporter for Bay News 9. He has also worked at Florida Politics, Creative Loafing and WMNF Radio in Tampa. He was also part of the original staff when the Florida Phoenix was created in 2018.