The rule was finalized on November 4 at the at the urging of Republican Governor Ron DeSantis and is set to take effect after a 21-day long public input period. The decision will not apply to transgender youth who are already receiving nonsurgical treatment. However medical professionals who violate the new rule with new patients could face severe penalties—including losing their medical license. The guidance of medical organizations including the American Academy of Pediatrics (AAP), the Endocrine Society, the United States Department of Health and Human Services, and the American Psychological Association the Florida Surgeon General’s view that gender affirming healthcare is medically unproven or potentially dangerous in the long term. They have all endorsed using puberty blockers and hormones for young people with gender dysphoria and multiple studies have found that these treatments can reduce emotional distress for transgender young people and even reduce the risk of suicide. “Our research team from Harvard Medical School and the Fenway Institute published a study showing that access to puberty blockers during adolescence is associated with lower odds of transgender young adults considering suicide,” Jack Turban wrote in The New York Times in February 2020, citing a study on puberty suppression. “Despite fearmongering, these are safe medications that doctors have been using for decades for cisgender children who go through puberty too early. They also are reversible — if the medication is stopped, puberty will progress.” The two boards did disagree on whether nonsurgical treatments for gender dysphoria may continue through Institutional Review Board-approved clinical trials. The Board of Osteopathic Medicine approved of that rule, but the state Board of Medicine rejected the proposal. In June, Florida health officials also banned state Medicaid insurance from covering gender dysphoria treatments and issued a report that said the treatments have not been proven safe or effective. The Yale School of Medicine followed up with a comprehensive examination of the report, saying that the document is misleading and doesn’t call into question any of the scientific foundations of the standard medical care for gender dysmorphia. Florida is not alone in attempting to use state legislatures to ban or limit gender affirming care. In 2021, Arkansas became the first state to enact a ban on gender affirming care when Republican lawmakers were able to successfully override Governor Asa Hutchinson’s veto of the legislation. This year, Republicans in Alabama approved legislation that outlaws gender-affirming medications for transgender youth. Both the Arkansas and Alabama laws have been paused amid unfolding legal battles. In October, Oklahoma Governor Kevin Stitt, signed a bill that bars federal funds earmarked for the University of Oklahoma Medical Center from being used for gender affirming treatments for minors, while calling for the state legislature to ban some gender affirming treatments when it reconvenes in February 2023. Additionally, Tennessee has passed legislation curbing trans healthcare, but it faces legal challenges. Arizona has passed four laws regarding transgender healthcare. While these pieces of legislation continue to be tangled up in courts, groups like the Human Rights Campaign and AAP say they will continue to fight for medical care for trans youth. “It is critically important for every child to have access to quality, comprehensive and evidence-based care — transgender and gender-diverse youth are no exception,” said AAP Immediate Past President Lee Savio Beers in a statement earlier this year regarding an increase in laws targeting trans youth. “As pediatricians, we will continue to speak up and advocate for our patients. We also want transgender and gender-diverse youth to know that not only do we care for them, we care about them, we value them and we will do all we can to ensure they have access to the care they need and deserve.”
