Florida lawmakers go further than medical board to ban transition care for transgender youths
The bill would also ban insurance coverage of transition-related medical care for adults.
When the Florida Board of Medicine voted in February to ban gender-affirming care for minors, the rule applied only to new patients seeking to go on puberty-blocking medication and hormone therapy.
When it came to children and teenagers who had already started such treatments, board member Dr. David Diamond acknowledged there would be "some harm" to stopping their care. The ban, which went into effect last week, ultimately excluded current patients.
But a bill that passed through a Florida House subcommittee on Wednesday would override that decision, prohibiting treatment for both new patients and children and teenagers currently undergoing treatment. House Bill 1421, sponsored by Republican Reps. Randy Fine and Dr. Ralph Massullo, would give current patients until Dec. 31 for the "gradual discontinuation" of that medical care. Doctors who violate the law could face a third-degree felony.
While the bill sponsors see the proposal as a measure to protect children, mainstream medical associations including the American Academy of Pediatrics and the World Health Organization support transition-related care for minors as a treatment for gender dysphoria, the distress one feels when their gender doesn't align with their sex assigned at birth.
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“This is a shameful bill, based on fringe theories and personal opinion, rife with cruelty and bullying," said Dr. Paul Arons, a Florida physician who spoke during the meeting's public comment period.
The bill would also bar insurance coverage of gender-affirming care for adults. Critics of the bill say that would effectively ban care for adults, who often rely on their insurance to cover the cost of their treatments. The committee sponsors refuted that.
"We're saying that other people don't have to pay for it," Fine said.
The youth care ban will force trans children and adolescents to cease their treatment, which studies and patient accounts show goes a long way in alleviating the depression, anxiety and suicidal ideations that come with gender dysphoria.
Snow Pastermack, 16, began hormone therapy in December. The treatment has been "the best antidepressant for me ever," she said. She'd tried traditional antidepressants to alleviate her symptoms, but they didn't help much.
"Before hormones I just kind of felt like I’d been placed in the wrong body, and I‘m just controlling something that isn’t mine, like you're playing a video game or something," said the high school sophomore from Oviedo. "I feel normal in terms of my own body as compared to how I felt beforehand."
Losing access to that care would undo all the progress she's made in the last few years on treating her symptoms, which included suicidal tendencies. Surveys show that transgender youth are at a higher risk of suicide than their peers, and studies show that transition-related medical care improves mental and emotional health.
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Rep. Kelly Skidmore, D-Boca Raton, filed an amendment that would allow current youth patients to continue their care, noting that minors make the decision with parental consent and in consultation with doctors. Trans youth who seek medical care typically start treatment just before or at the start of puberty.
"What this bill will do is force every person who is currently receiving care to detransition, to become someone that they are not," Skidmore said. "The decisions, the parental rights, the freedom, the things that we pretend to hold dear in this Legislature, I want those people, those children and those families to be able to hold them dear, too.”
The amendment failed.
In an interview with the USA TODAY Network - Florida, Fine noted that the version of the bill that passed the subcommittee was less restrictive than what he originally filed. His initial filing aimed to ban gender-affirming care for youth as soon as the bill goes into effect, but he amended the language after learning that quitting such treatments cold turkey would be harmful.
Fine, a former casino executive, said the Board of Medicine doctors are entitled to their opinions to exclude current patients, but he believes the ban should go further.
“I reject the premise that this is a good idea," Fine said. "So why would we say, 'Oh no, continue doing a bad idea'?”
However, trans advocates warned that stopping gender-affirming care at any point will cause harm.
"It’s not concern for children," said Kellan Baker, executive director of the Whitman-Walker Institute, an LGBTQ health center. "It’s a science experiment, and we all know how it’s going to end."
LGBTQ youth are four times more likely to attempt suicide than their peers "because of how they are mistreated and stigmatized in society," according to the Trevor Project, a suicide prevention and crisis intervention organization for LGBTQ youth.
To reach a Trevor Project mental health counselor:
- Text "START" to 678-678
- Call 1-866-488-7386 or
- Start a web chat at thetrevorproject.org/get-help
Kathryn Varn is statewide enterprise reporter for the Gannett/USA TODAY Network – Florida. You can reach her at firstname.lastname@example.org or 727-238-5315.