TALAHASSEE, Fla. – Amid outrage from the LGBTQ community and harsh criticism from many doctors and health professionals, the Florida Board of Medicine proposed a plan Friday that would ban doctors from providing treatments such as puberty blockers and hormone therapy to transgender people under the age of 18.
Friday’s decision came after the Florida Department of Health filed a petition last month asking the medical board to start a rule-making process on the controversial issue. The Board of Medicine also moved forward as the State Agency for Health Care Administration plans to prevent the Medicaid program from covering such treatments for gender dysphoria for adolescents and adults.
As his political presence on the national stage continues to rise, Governor Ron DeSantis is one of the Republican leaders across the country focusing on transgender youth treatment. The governor, who wants to be re-elected in November, says that children are being admitted prematurely to treatments that could have harmful lasting effects.
But many medical professionals — including numerous medical associations — reject the DeSantis administration’s moves, saying the state’s claims violate established standards.
People on both sides of the issue converged on the Board of Medicine meeting in Broward County on Friday, with supporters of the Department of Health’s proposal wearing “Let Kids Be Kids” decals. Opponents held a rally before the meeting and begged the board to reject the petition.
The health minister, Joseph Ladapo, addressed the board, acknowledging the “strong feelings on the matter” in the room.
But Ladapo, who serves as the state’s surgeon general, argued that current standards of care are a “substantial departure” from “the level of evidence and data on this matter.”
“It is very clear that … its effectiveness is completely uncertain,” argued Ladapo, who said his views on the subject had “evolved.” “I mean, maybe it’s effective, but the scientific studies published today don’t support that… Could that change in the future? It’s possible. I think it’s very unlikely given what I’ve reviewed, but it is possible. “
Quentin Van Meter, a pediatric endocrinologist who served as a state expert in the field, warned the council that an increasing number of children are seeking puberty blockers or other medical interventions.
“This is what we are dealing with. We are dealing with a monumental epidemic of increasing proportions,” said Van Meter, an outspoken critic of transgender treatment of young people. “This is a giant experiment on children from the United States.”
Van Meter also said that Sweden, Finland and the United Kingdom have discontinued treatment of transgender youth because “they felt there was far more harm than any benefit to these children from undergoing any medical intervention.” According to Van Meter, about 127,000 children in the US receive gender-affirming treatment.
But Michael Haller, a professor and chief of pediatric endocrinology at the University of Florida, disputed Van Meter’s comments, saying that fewer children are receiving sex-confirming hormones or other therapy than the public has led to believe and that the number is not growing.
Haller and other physicians have also argued that standards of care for trans youth were developed by professional medical associations after years of vigorous scientific debate.
Asked by Haller, board chairman David Diamond noted that other countries have changed their approach to treating gender dysphoria, which the federal government defines clinically as “significant distress a person can feel when the sex or gender assigned at birth is not.” the same as their identity.”
“Do you have any idea what the scientific backing might be, why they changed their mind, or is it your claim that it wasn’t a scientific decision, but rather based on other factors?” Diamond asked.
“I think it’s impossible to completely separate political decision-making from science,” Haller said.
Diamond, an oncologist, pointed to breast cancer treatments adopted in the 1990s that were later found to be harmful.
“The bottom line is that just because you think something works doesn’t mean it works,” the board chairman said. “The point is… we have to constantly judge what we’re doing and have the ability to say what we’re doing might be wrong. Maybe our beliefs are wrong. Maybe we can listen to the other person on the other end or the newer data and possibly make our position a little better, a little more refined, to better seek the truth.”
Diamond asked Haller and his UF colleague Kristin Dayton if they thought the board should adopt guidelines or rules for gender dysphoria.
Dayton, a pediatric endocrinologist who specializes in gender dysphoria, said such a plan would be “redundant” because standards of care already exist. But Haller indicated that he was not confident that the state would carry out its own plan.
“If the redundancy was such that it was in line with common practices and data, then I think it would be sufficient. But it’s clear that’s not the state’s intention,” Heller said. “They have given you a recommendation for a rule that conflicts with what almost all reasonable providers of gender affirming care and gender care in general would say as the standard of care.”
If the guidelines are final, Florida would be the only state in the country where a medical board has banned transgender treatments for adolescents, according to Meredithe McNamara, a professor at the Yale School of Medicine.
A handful of other states have passed laws blocking treatment, but McNamara, who specializes in adolescent medicine, this week told The News Service of Florida she has “never heard” of a state medical board banning such care.
“Healthcare standards don’t come from states, they don’t come from governments. They come from clinical research that is reviewed and vetted and discussed in relevant expert groups and published and widely distributed and adopted by people everywhere,” she said. .
Many Friday attendees urged the board to accept the health department’s petition, but Kaleb Hobson-Garcia said he made the seven-hour drive from Tallahassee to share his experience with the panel.
“I wasn’t always the 20-year-old man you see standing in front of you… I was an 11-year-old boy who just changed his name to Kaleb,” he said.
Hobson-Garcia, 20, said he and his parents consulted a doctor for a year before starting medical treatment. He said he started taking puberty blockers at age 12, hormone suppressants at age 13, and had “top surgery” at age 14. Despite his experiences, Hobson-Garcia said he agrees with current guidelines that recommend a minimum age of 16 for “top” surgery and 18 for “bottom” surgery, or penis removal.
“The medical treatment I received as a minor was integral to me in climbing out of my depression and becoming the happy and healthy person I am today,” said Hobson-Garcia. “My identity is not an epidemic. We cannot stand the advancement towards a happier, healthier future for all Floridians.”
Kevin Cairns, an interventional pain specialist who serves as vice chairman of the board, was the only board member to vote against granting the Department of Health’s petition to start the regulatory process.
Ernie Sauve was one of the people who asked the board to move forward with the plan. As someone who is fluent in Spanish, Sauve said he “could identify” as a Spanish person, but that doesn’t make him Spanish.
“Women used to be women. Let children be children…Let’s go back to reason, common sense and truth,” he said.