Respect Equality

Florida health dept. says gender-affirming care should not be provided to minors

"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 Wednesday, criticizing a recent Health and Human Services Department fact sheet on gender-affirming care.
Florida Surgeon General Dr. Joseph Ladapo gestures as speaks to supporters and members of the media before a bill signing by Gov. Ron DeSantis on Nov. 18, 2021, in Brandon, Fla. (AP Photo/Chris O'Meara, File)

Story at a glance

  • Florida’s Department of Health on Wednesday said gender-affirming care should not be accessible to minors.

  • The department in its guidance condemned medications like puberty blockers and hormones, as well as social transition, which can include pronoun, name or clothing changes.

  • The department accused the federal government of “injecting political ideology into the health of our children” by releasing information on the merits of gender-affirming care.

Florida’s Department of Health on Wednesday said children younger than 18 years old should not be permitted to receive any form of gender-affirming care, including medications like puberty blockers and hormones and “social gender transition” like name or pronoun changes.

In new guidance released Wednesday, the state Department of Health said the treatment of gender dysphoria should be limited to professional counseling and social support from peers and family members that does not include encouraging young people to change their name or pronouns or wear gender-affirming clothing.

The department in its new guidance pushed back on evidence cited in a recent Health and Human Services Department fact sheet stating that gender-affirming care “improves the mental health and overall well-being of gender diverse children and adolescents.”

“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 Wednesday in a news 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.”

America is changing faster than ever! Add Changing America to your Facebook or Twitter feed to stay on top of the news.

The state’s new guidance recommends children under 18 years old be denied access to puberty blockers and hormone therapy – which are not irreversible treatments – as well as gender-affirming surgeries, which the World Professional Association for Transgender Health (WPATH) does not recommend for minors.

The guidance states that the efficacy of such treatments is not supported by current evidence, finding that 80 percent of young people seeking gender-affirming care “will lose their desire to identify with the non-birth sex.”

According to the 2015 National Transgender Survey, a small handful of respondents (8 percent) did say that they had at some point gone back to living as their sex assigned at birth but, importantly, the majority of those who did detransition did so only temporarily. More than 60 percent of transgender people who had detransitioned reported that they were currently living as a gender different from their gender assigned at birth, according to the survey.

Florida’s Health Department in its guidance said minors should not be able to access gender-affirming care because the prefrontal cortex – the part of the brain responsible for executive functions like decision making – is not fully developed until the age of 25. 

Providing gender-affirming medical treatments to minors also increases the risk of cardiovascular disease, osteoporosis, infertility, increased cancer risk and thrombosis, according to the guidance.

In response to a question on why Florida’s Health Department decided to include social transition – which could be as little as a haircut or a change of clothes – in its guidance, the department directed Changing America back to a study cited in the guidance.

LGBTQ+ advocacy groups on Wednesday condemned the department for spreading “dangerous misinformation” about gender-affirming care.

“Governor DeSantis is once again putting political propaganda over science and the safety of young people. This guidance demonizes lifesaving, medically necessary care, and asserts that politicians know better than parents about caring for their children,” Equality Florida Executive Director Nadine Smith said Wednesday.

In a statement, Human Rights Campaign Senior Vice President Jay Brown said the guidance threatens transgender youth and their families, comparing it to recent steps taken in Alabama and Texas to criminalize gender-affirming care.

“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,” he said.

“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.”

Sam Ames, director of advocacy and government affairs at The Trevor Project, said the new guidance had selectively cited one of the group’s studies examining the effects of hormone therapy in more than 9,000 transgender and nonbinary youth, ignoring a key finding that gender-affirming care was associated with nearly 40 percent lower odds of recent depression and a past-year suicide attempt among youth under 18 years old.

“Gender-affirming care can save lives,” Ames said.

Editor’s Note: This story has been updated with information from Equality Florida, the Human Rights Campaign and The Trevor Project.