Florida Health Dept. Attacks All Gender-Affirming Care for Trans Youth

The Florida Department of Health, headed by controversial Surgeon General Joseph Ladapo, has issued guidelines arguing against any gender-confirming treatment for minors, even social transition.

The guidelines, which are not legally binding, recommend that no one under 18 should be prescribed puberty blockers or hormones, or undergo gender-confirmation surgery. The latter was not generally performed on minors before the guidelines. The department also says that social transition -- which includes such things as gender presentation and use of one's preferred name and pronouns "should not be a treatment option for children or adolescents."

The Florida recommendations, released Wednesday and approved by Florida Gov. Ron DeSantis, are in reaction to a fact sheet issued by the U.S. Department of Health and Human Services' Office of Population Affairs outlining the benefits of gender-affirming care.

"The federal government's medical establishment releasing guidance failing at the most basic level of academic rigor shows that this was never about health care," Florida Surgeon General Joseph Ladapo said in a press release. "It was about injecting political ideology into the health of our children. Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18."

However, the effects of puberty blockers are reversible, and hormone treatment is at least partially reversible. Social transition is similarly, completely reversible. In the vast majority of cases, doctors do not recommend genital surgery for anyone under the age of 18.

The Florida document includes a claim that scientific evidence does not support any transition treatment for minors. It includes a link to an article written by psychologist David Schwartz, a longtime opponent of such treatment. It also links to an article saying more research should be done on the effects of hormone therapy, but that article, from the journal Pediatrics, concludes that studies offer "qualified support" for the therapy.

Florida's action follows closely on Alabama's adoption of a law making it a felony to provide gender-affirming care for minors, with violations punishable by up to 10 years in prison. Texas officials have decreed that parents who allow their children access to such care be investigated for child abuse. That directive is on hold due to a court order in a lawsuit challenging it. In Arkansas, legislators last year overrode Gov. Asa Hutchinson's veto and banned gender-affirming care for young peope, although its law provides for professional discipline rather than criminal penalties. It is also on hold due to a lawsuit.

LGBTQ+ rights groups are incensed at Florida's move, and they point out that most reputable medical groups support social transition, puberty blockers, and hormone treatment for transgender youth.

"The fact is that evidence-based, age-appropriate, medically necessary health care for trans youth -- as outlined in the U.S. Department of Health and Human Services Fact Sheet -- is supported by dozens of medical associations, including the American Medical Association, American Psychological Association, the American Academy of Pediatrics, and many others," Jay Brown, senior vice president of programs, research, and training at the Human Rights Campaign, said in a press release. "It's supported by the best available evidence. We will do everything in our power to stand with transgender young people in Florida and their families in this moment -- because facts and truth still matter."

"Governor DeSantis is once again putting political propaganda over science and the safety of young people," added Nadine Smith, executive director of Equality Florida. "This guidance demonizes lifesaving, medically necessary care, and asserts that politicians know better than parents about caring for their children. Governor DeSantis' runaway agenda of banning books, muzzling teachers, censoring history, and pushing government control makes the state less safe for LGBTQ families, especially transgender children."

DeSantis recently signed the state's infamous "don't say gay" bill into law; it bans instruction on sexual orientation or gender identity in grades K-3 and has a vague mandate that any such instruction in the upper grades be "age-appropriate." DeSantis, a Republican, is likely to seek the party's 2024 presidential nomination.

Surgeon General Ladapo has been much criticized since taking the office. Former colleagues at the University of California, Los Angeles, have disputed Ladapo's claim that he treated patients with virus at the center of the ongoing pandemic there. Ladapo has also been critical of vaccines and testing. He has a tenured position at the University of Florida along with being surgeon general, and a UF faculty committee report released in March found that the university did not adequately involve faculty members in his hiring. Some felt his UF appointment was fast-tracked due to his political opinions.