Florida Medical Board votes to ban gender-affirming care for transgender minors

After five hours of tense testimony and protests, the Florida Board of Medicine voted Friday to begin drafting a rule that would bar all minors in the state from receiving puberty blockers, hormone therapy or surgeries as treatment for puberty. gender dysphoria.

The Florida Medical Board is the first in the nation to enforce such a rule, but Florida is among a wave of states where authorities have tried to restrict gender-affirming medical care for transgender minors.

At the end of Friday’s five-hour meeting, protesters began shouting “Shame!” to board members, and some of them staged a “die-in” in the lobby of Orlando International Airport, where the meeting was being held.

Protesters hold a “die-in” in the lobby of Orlando International Airport on October 28, 2022.Courtesy of Kat Duesterhaus

The vote is the latest update in a months-long effort by Gov. Ron DeSantis’ administration to restrict transition-related care for under-18s.

The effort to restrict that care began in April, when DeSantis and Florida Surgeon General Joseph Ladapo issued nonbinding advisories. tips through the Florida Department of Health which sought to ban both “social gender transition” and gender-affirming medical care for minors.

The advice drew backlash from LGBTQ advocates and medical experts. Accredited medical groups — including the American Medical Associationthe American Academy of Pediatrics and the American Psychological Association – supported gender-affirming care for transgender youth.

Despite this support, the Florida Agency for Health Care Administration published a report in June who “found that several services for the treatment of gender dysphoria – i.e. sex reassignment surgery, cross-sex hormones and puberty blockers – do not meet professional medical standards widely accepted and are investigational and experimental with the potential for long-term harmful effects.”

Just hours after the report was released, Ladapo sent a letter to the Board of Medicine and asked him to establish a standard of care “for these complex and irreversible procedures”.

The council held its first meeting on the issue in August, and on Friday it officially voted in favor of a proposed ban on certain gender-affirming therapies for minors. The meeting began with expert testimony in favor and against such care.

Dr. Michael Laidlaw, an endocrinologist in Rockland, Calif., cited often-criticized research that found that 50-90% of children whose gender identity does not match the sex they were assigned at birth disappear from the condition in adulthood.

“The fundamental problem with this treatment as I see it is, ‘What happens when you force a square peg into a round hole? “”, Did he declare. “You end up injuring or destroying the ankle in the process.”

However, Dr. Meredithe McNamara, an assistant professor of pediatrics at the Yale School of Medicine who treats transgender people between the ages of 10 and 25, told the council that the research cited by Laidlaw and the June report released by the Florida Agency for Health Care Administration are methodologically flawed.

“None of the state’s review authors are subject matter experts,” McNamara said. “An individual is a dentist. The other is a post-doctoral fellow in biostatistics. At the very least, the systematic review should be carried out by people qualified to assess the literature. I wouldn’t trust a literature review by a dermatologist on a neurosurgical procedure, for example.

After the expert testimony, the council began the public comment period, which was expected to last two hours, according to several participants.

The first nine participants who spoke were in favor of restricting gender-affirming care for minors. Eight of them said they had detransitioned or identified with their sex assigned at birth after previously identifying as trans. Only one of the eight had received gender-affirming medical treatment as a minor.

Chloe Cole, who described herself as an 18-year-old detransitioned woman from California, said she began transitioning at age 12 and had a double mastectomy at 15. At 16, she said, she realized she regretted her transition.

“All the talk of mental health, self-perception, pronouns and ideology lead me to the question, why isn’t a mental health epidemic treated with mental health treatment to get the causes why teenage girls like me want to reject their bodies?” said Cole.

The council also heard from parents of young transgender people. Hope McClay, who has a 9-year-old trans daughter, said she had to force her daughter to have her hair cut short before she became trans.

“At one point she came up to me, about three and a half years old, and cried and begged me and said, ‘Please don’t make me be like this anymore. It’s not who I am. I want to die,” McClay said.

She said she and her family consulted medical professionals about medical care for their daughter and found that allowing her to go through male puberty would be “psychologically damaging”.

“So we don’t make these decisions lightly, but these are the decisions that should be made by families, not by the state, not by a council,” McClay said.

Jude Spiegel, the only transgender person to testify at Friday’s meeting, read the names of 17 trans teens who killed themselves “for living in a world that refused to recognize or accept them.”

With about 45 minutes remaining in the public comment period, board member Dr. Zachariah P. Zachariah said only one more person would be allowed to testify. The crowd protested and he offered to provide an email where they could share their testimonies.

At one point, a member of the public shouted that young trans people would suffer if the council voted to ban care: “The blood is on your hands!” To which Zachariah replied, “That’s OK.”

Emile Fox, a non-binary trans person from Orlando who uses the pronouns “they” and “he”, said they had signed up to testify and were unable to do so, which left them frustrated after the first eight people who testified were all in favor of restricting care. , but none of them were from Florida.

“What was so appalling to me was how obviously this was all staged,” Fox said, adding that board members didn’t seem to know much about affirmation therapies. gender. “They were fed a narrative, and they ate it.”

A spokesperson for the board said the committee “heard from subject matter experts and allowed members of the public to speak on the issue during today’s workshop.”

“Public comment content is not ‘stacked’ by the guidance,” the spokesperson said in an email Saturday. “Any members of the public who were unable to provide feedback may submit written comments via email to BOMpubliccomment@flhealth.gov within 24 hours of the end of the workshop. These comments will be included in the Rules Development Record and considered like all other public comments.”

After the public comment period, the board attempted to propose a draft rule. Members initially considered exempting trans youth who were already receiving gender-affirming medical care from the ban if they went through an informed consent process, but decided to drop that proposal.

Then, in a rushed exchange that attendees called confusing, Zachariah pushed for a vote even as some board members demanded the proposal be read aloud once more. He then said the motion passed without saying what the final count was.

Florida Rep. Anna Eskamani, a Democrat whose district includes parts of Orlando, said there would be another meeting Nov. 4 at the Holiday Inn, Disney Springs, to discuss the drafted rule, and then there would be a 28-day approval. process that would include additional time for public comment.

She thinks the timing of the rule-making process – just before the election – is intentional.

“This is clearly intentionally designed to create a news cycle that further polarizes and politicizes gender-affirming care to distract from the affordable housing crisis, to distract from the impact of Hurricane Ian and property insurance rates,” she said. “We have real, real issues to address, big health disparities that we need to address and yet, instead of talking about those real concerns, trans issues are going to be front and center, and that’s really designed to continue. to divide us. .”

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