TALLAHASSEE — A key medical group on Friday signed off on a draft rule — pushed by Gov. Ron DeSantis’ administration — that would limit Florida doctors from providing treatments to people under the age of 18, setting up a final decision likely next week. to a legal challenge.
A joint panel of the Florida Board of Medicine and the Florida Board of Osteopathic Medicine heard five hours of intense testimony from experts, parents and the public — including transgender men and women who have transitioned — before approving the draft. rule
The proposal, scheduled for a final Nov. 4 vote by the full medical board, would ban doctors from prescribing puberty blockers, hormone and hormone “antagonist” treatments for patients under 18. The plan would also ban surgical treatments for minors. experts say it’s rare.
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Friday’s action comes after the Florida Department of Health filed a request in July for a rulemaking process on gender dysphoria treatment.
The petition proposed banning doctors from using medical interventions to treat minors diagnosed with gender dysphoria, which the federal government clinically defines as “significant distress that a person may experience when they do not match the sex or gender assigned at birth.” identity”.
The proposal, which received preliminary approval on Friday, would be prospective, meaning that children receiving hormone therapy or puberty blockers would be allowed to continue treatment. The committee discussed requiring parents to sign a consent form to continue such treatments, but did not finalize the guidelines.
The committee also added a provision that would allow minors to begin receiving treatments such as puberty blockers if they participate in a federally approved clinical trial at a university center. No such trials are being conducted in Florida, according to an initial review.
Chloe Cole, an 18-year-old from California, was among the detransitioners who recounted mental health issues, post-surgery complications and lax medical care during or after treatment.
Cole said she had a double mastectomy at age 15 and urged the board to approve the proposal.
“All the talk about mental health, self-perception, pronouns and ideology leads me to this question: why isn’t the mental health epidemic being treated with mental health treatment, to find out the reasons why teenage girls like me want to reject their bodies?” Cole said.
But Mary Flynn, a counseling psychologist whose 12-year-old daughter is transgender, advocated gender affirmation for children, when appropriate.
“It’s a joy to raise this beautiful baby, and everything we’ve heard before is nothing I’ve ever heard from any support group, any doctor, anything,” Flynn said. “If we didn’t have this medication, he wouldn’t be alive. … What you’re talking about is waiting until they’re 18. Well, they’re not going to be here. This group is suicidal.”
LGBTQ advocates said the rule, if given final approval, would be challenged in court.
“There will certainly be legal challenges,” attorney Simone Chriss, director of the Trans Rights Initiative at the Southern Legal Counsel, said at a news conference hosted by Equality Florida.
Sujatha Prabhakaran, a Sarasota physician who treats transgender patients, called the proposal “medically unsafe and cruel.” He said he is not aware of any clinical studies being conducted in the state, such as those described in the proposal.
“I’m not surprised, but as far as I can see right now, there’s no trial here in Florida and I think that, again, speaks to the stigma and discrimination that transgender people face here in Florida,” she said. .
Six experts invited to Friday’s meeting had conflicting views on gender-affirming treatment, with critics saying there is a lack of “high-quality evidence” to support it. Proponents, on the other hand, argue that years of research and practice show that treatment is safe and effective and that refusing treatment can be dangerous.
Opponents of treatment argued that gender dysphoria is a mental health problem that should be treated with psychological care.
“We’re talking about whether there are any randomized control studies that compare groups of patients who receive hormone therapy or puberty blockers with those who receive mental health treatment,” said California endocrinologist Michael Laidlaw. “We don’t have high-quality evidence based on that.”
But Yale School of Medicine professor Meredithe McNamara disputed Laidlaw’s findings.
“To put the matter firmly and positively, gender-affirming care for gender dysphoria meets generally accepted medical standards. It is not experimental or research-based. Gender-affirming care is accepted by all major medical organizations,” said McNamara, who specializes in adolescent medicine, adding, ” This consensus is based on strong evidence from more than 16 studies.”
The panel ran out of time before agreeing on how to seek “informed consent” from parents and children already receiving hormone therapy or puberty blockers.
“We recognize that there may be some harm in stopping it,” said David Diamond, a Winter Park oncologist who chairs the Medical Board. “These people are getting treatment. … The intention is just to say that it allows you to follow the rules, but please understand that you have to be aware of these complexities.”
Ed Tellechea, a longtime attorney for medical boards, said the state has informed consent requirements for medical marijuana treatment and cataract surgery.
“When we did the informed consent, we wrote these forms in several meetings, and we’re not getting that right now. We are getting the general outlines of what you want to see,” he said.
During Friday’s meeting, committee chair Zachariah Zachariah, a member of the Florida Board of Medicine, warned audience members who erupted into applause or jeers.
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For example, LGBTQ advocates erupted after Zachariah announced the end of public testimony and state representative Anna Eskamani, Orlando Dema, refused to speak.
Zachariah reprimanded Eskaman, who told the table that he is a legislator.
“You should know better. … You know how the House works in the state of Florida. So you have to follow the same rules,” he said.
The treatment of transgender people, and especially young people, has become a hotly debated political issue in Florida and other states. While major medical groups and the Biden administration support treatments for gender dysphoria, many Republicans like DeSantis, seen as a leading GOP presidential candidate in 2024, say the treatments should not be given to those under 18.
Also this year, the DeSantis administration issued a rule barring Medicaid reimbursements for gender-affirming care for transgender people of all ages.
That rule is being challenged in federal court.
At Friday’s news conference, Chriss, the attorney representing the plaintiffs in the case, tried to reassure transgender people in Florida and their families.
“We’ve got your back. We are actively challenging the Medicaid ban and will fight this too, and these things cannot stand. These people know it is unconstitutional. They know it’s wrong and they’re doing it,” he said.