Florida Board of Medicine opens rule-making process on gender-affirming care for children

Board to discuss how to implement restrictions for transgender treatments on children, possibly adults

The Florida Board of Medicine voted Friday to open the rule-making process regarding state guidelines recommending against gender dysphoria treatments for children and adolescents, with possible restrictions for adults.

During its Friday morning meeting, the board listened to and questioned physicians about the practice of gender dysphoria treatments, including hormone treatments, puberty blockers and social transitioning for minors.

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The meeting, which included public comment, stemmed from a letter by Florida Surgeon General Joseph Ladapo earlier this year, in which he asked board members to adopt state guidelines against those sorts of treatments.

Montrese Williams, the executive director of Divas and Dialogue — a non-profit working with trans women of color — said she feels “sorry for the younger generation.”

“I’m mostly afraid of them turning to black market silicone as a result of this,” Williams said. “I’m terrified of that happening because I’ve had trauma when dealing with sort of things, when for me there was a time these treatments weren’t available.”

According to state Rep. Anna Eskamani, there will be a 120-day process for the Florida Department of Health to craft rules around state guidelines.

FDOH’s guidelines state that gender dysphoria treatments can have long-term, irreversible effects on children. FDOH defined gender dysphoria as “a strong, persistent cross-gender identification associated with anxiety, depression, irritability and often a wish to live as a gender different from the one associated with the sex assigned at birth.”

FDOH The department’s guidelines are as follows:

  • Social gender transition should not be a treatment option for children or adolescents
  • Anyone under 18 years old should not be prescribed puberty blockers or hormone therapy
  • Gender reassignment surgery should not be a treatment option for surgery
  • Children and adolescents should be provided social support by peers and family and seek counseling from a licensed provider

FDOH stated these guidelines do not apply to children born with a genetically or biochemically verifiable disorder of sex development.

The department reported that practices such as a mastectomy, a uterine extirpation, a tracheal shave, prescribing hormones or using puberty blockers are clinical practices that run an unacceptably high risk of doing harm.

During the meeting, Ladapo stated, “We do know hormones that are active and changing during puberty affect brain development and other parts of the human body, physiology, the effects of that in terms of these therapies is completely unknown.”

Eskamani disagreed, saying, “There are so many other real-life problems people are facing... there was no local transgender person today who expressed concerns about the current standard or medical guidelines.”

Prior to the decision, Marnie Bialosuknia, the mother of a transgender child who began hormone therapy at 17 years old, told News 6 that adopting the guidelines could have a dangerous impact.

“It would be absolutely devastating, and you already are dealing with a community that’s marginalized; you’re dealing with a community that has a very high rate of suicidal thoughts, attempted suicide. The suicide rates amongst transgender youth is higher than any other aspect of the LGBTQ community,” she said. “I can only speak from my personal experience as a mother of a transgender child. If I had to say to my child, ‘You can’t continue with this therapy,” I don’t know that she would be here with us, and that’s really, really scary. You have to trust these parents that they know what’s best for their children that they’re going under the guidance of a physician.”

Bialosuknia said it takes several months of preparation and guidance from a physician and mental health expert prior to such treatments.

The Office of Population Affairs released a report declaring gender dysphoria treatments — also called gender-affirming care — as “supportive” and “crucial” for transgender children and adolescents.

FDOH released a “fact check” earlier this year on OPA’s report, saying that there is no reliable evidence about gender dysphoria increasing the risk of suicide.

The department added that there are no high-quality long-term studies about the effects of treatments for gender dysphoria, saying that most children who identify as transgender will detransition following the onset of puberty.

News 6 has attached the documents discussed during the board’s meeting, which can be viewed below.

Clarification:

In the headline of a previous version of this article, News 6 reported the Florida Board of Medicine had voted against gender dysphoria treatments for children. While the board voted to adopt state guidelines recommending against such treatments, board members have also opened rule-making processes to discuss the topic further with experts and determine how to implement these guidelines.


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