Florida medical board to weigh blocking treatments for transgender youth

The Florida Board of Medicine is slated Friday to consider barring physicians from providing transgender youths with treatments such as hormone therapy and puberty-blocking medication, a proposal by Gov. Ron DeSantis’ administration.

The state Department of Health last week filed a petition asking the board, which regulates medical doctors, to start a rule-making process on the contentious issue. The move came as the state Agency for Health Care Administration also plans to prevent the Medicaid program from covering such treatments for gender dysphoria.

The petition, which is on the agenda for a Board of Medicine meeting in Broward County, proposes what is known as a “standard of care” that would prohibit patients under age 18 from receiving sex-reassignment surgery and puberty-blocking, hormone and hormone “antagonist” treatments. It also would require that older patients sign a consent form and then wait 24 hours before starting such treatments.

Signed by Department of Health General Counsel John Wilson, the petition pointed to what it said was a “lack of quality evidence and certainly no conclusive research to support the medical transition of children to the opposite gender as a treatment for gender dysphoria.”

“Children do not possess the cognitive or emotional maturity to comprehend the consequences of these invasive and irreversible procedures,” the petition said.

But in a July 14 letter to Board of Medicine Chairman David Diamond and other board members, a group of professors and clinicians from Yale University, the University of Alabama at Birmingham, and the University of Texas Southwestern disputed the state’s conclusions about treatments for gender dysphoria. The letter also said establishing a standard of care to prevent such treatments would violate legal protections “against discrimination and harm tens of thousands of Floridians.”

“We are concerned that any action by the Board (of Medicine) to ban or curtail standard medical care in Florida for individuals with gender dysphoria would set a troubling national precedent,” the letter said.

The federal government defines gender dysphoria clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”

But treatment for transgender people, and youths, in particular, has become a fiercely debated political issue in Florida and other states. Prominent medical groups and the Biden administration support treatments for gender dysphoria, while many Republicans such as DeSantis have argued the treatments should not be provided to people under 18.

Last week’s petition filed at the Board of Medicine was rooted in guidance that the Department of Health issued on April 20 that said treatments such as puberty-blocking medication and hormone therapy should not be used for transgender youths. Florida Surgeon General Joseph Ladapo also issued a statement at the time blasting federal directives that backed treatment for transgender youths.

“It was about injecting political ideology into the health of our children,” Ladapo said. “Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18.”

The Agency for Health Care Administration, which runs most of the Medicaid program, used the Department of Health guidance as a springboard to propose a rule that would bar Medicaid coverage for the treatments.

In turn, the Department of Health petition last week cited a report that the Agency for Health Care Administration has used to support its proposed Medicaid rule.

That report, whose authors included doctors and researchers who oppose medical care for gender dysphoria, said the Medicaid program “has determined that the research supporting sex reassignment treatment is insufficient to demonstrate efficacy and safety.”

But the Yale, the University of Alabama at Birmingham, and University of Texas Southwestern professors and clinicians issued a report last month sharply criticizing the report used by the Agency for Health Care Administration.

“We are alarmed that Florida’s health care agency has adopted a purportedly scientific report that so blatantly violates the basic tenets of scientific inquiry,” the professors and clinicians wrote. “The report makes false statements and contains glaring errors regarding science, statistical methods, and medicine.”

In preparation for Friday’s meeting, the Board of Medicine posted 1,113 pages of documents on its website related to gender-dysphoria treatment. Along with the petition, those documents include numerous studies about treatment.

The petition is an initial step in a process that would include drawing up the details of a proposed standard-of-care rule and taking public comment.