Treatment ban stays for Florida transgender children

State health boards move forward with ruling, nix exceptions for studies

The Florida Board of Medicine and the Florida Board of Osteopathic Medicine on Friday refused to scrap new rules prohibiting doctors from using gender-affirming care for trans youths, after dozens of transgender men and women pleaded with them to reverse the treatment bans.

Also, at a joint meeting of the boards, the Board of Osteopathic Medicine unanimously nixed an exception to its rule that would have allowed trans children participating in studies conducted by state universities to receive medical treatment.

That brought the two boards’ rules into alignment.

The state Department of Health in July filed a petition seeking a rule-making process on the contentious issue of treatment for gender dysphoria, which the federal government defines clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”

The boards in November approved the DeSantis administration’s proposal to ban doctors from using puberty blockers, hormone therapy or surgery to treat gender dysphoria for transgender minors, with the Board of Osteopathic Medicine adding the exemption.

More than 150 people attended Friday’s meeting, where speakers overwhelmingly opposed the treatment bans. The critics repeatedly noted that most of the country’s medical associations have endorsed gender-affirming care for minors and adults.

Lola Smith, a self-described nonbinary 12-yearold, beseeched regulators to reverse the rules.

“The most embarrassing moment of my life is happening right now as I stand in front of a panel of strangers and publicly beg for my right to exist. Nothing is more humiliating and dehumanizing than pleading for one’s own existence. How did we get here? Politicians are using kids like me to get votes from people who hate us,” Smith said.

Lindsey Spero, a 25-yearold trans man from St. Petersburg, injected himself with a hormone shot as he faced the board. Spero said he attempted to end his life numerous times as he was growing up because he lacked access to gender-affirming care.

“My medication is lifesaving. Your denial of my need for this medication doesn’t make my existence as a trans person any less real,” Spero said.

Under the rules, minors currently being treated with puberty blockers or hormone therapies would be allowed to continue the treatment.

But parents of trans kids who are transitioning socially and haven’t begun such treatments or who are currently using medical treatment expressed concern about their children’s futures.

“This is a major infringement to my parental rights,” Emer Roy Mulcahy chastised the boards. “Stay in your lane. You don’t protect the children by removing health care from those same children. Those are easy to pick on, being a vulnerable group craving nothing more than acceptance and space in the world. Do the right thing. Reverse the whole thing.”

Simone Chriss, director of the Trans Rights Initiative at Southern Legal Counsel, argued that the treatments are necessary.

“We know based on the overwhelming weight of evidence and science that access to treatment for gender dysphoria is safe, effective and medically necessary … and stripping children in Florida … to that care harms them, in no way protects them,” said Chriss, a lawyer who was among the people who requested Friday’s hearing.

Board of Medicine Chairman Scot Ackerman pushed back, arguing “there’s not adequate evidence to support the use” of the treatments.

“What the board has sought to do is protect our children from therapies that have irreversible harm. … So it’s a very limited set of therapies that have been restricted, but this board still wants these patients cared for, absolutely,” he said.

But Jacob Eleazar, a transgender man who is a clinical psychologist, questioned what type of care that would be.

“There are no evidencebased psychological treatments for gender dysphoria.

So that makes me wonder, is the implication that the treatment should be sexual orientation or gender-identity change efforts, which we know … are incredibly harmful?” he said. “I’m sick of cleaning up the mess.”

Gov. Ron DeSantis, who is widely seen as a top contender for the Republican presidential nomination in 2024, has elevated the issue of treatment for transgender youths. The governor frequently refers to surgeries on transgender minors as “genital mutilation,” though experts have said the surgeries are exceptionally rare.

Board of Medicine member Hector Vila said the boards, which regulate physicians, thoroughly explored the issue before concluding the therapies are not supported by the evidence.

“I’m sorry it’s uncomfortable. We’re in an uncomfortable situation. I feel like there’s a lot of the public thinks I dislike them. Not at all,” he began, interrupted by jeers from the audience. “We can’t even make a sincere comment, and it’s hurtful to us … This isn’t about politics. This is about the information we reviewed, the testimony we’ve listened to, and the narrow set of circumstances in which we’re trying to protect the children.”

Urging the Board of Osteopathic Medicine to strip its rule of the exception for clinical research, Department of Health general counsel John Wilson said having different standards for the medical boards “is both illogical and confusing.”

“The department believes that the record does not support any reason that an osteopathic physician can complete these treatments or conduct this research with greater safety than their allopathic counterpart,” he said. “The department is also concerned that the exception threatens to undermine the purpose of the rule.”

The osteopathic board voted unanimously to remove the exception, with no discussion.