Advocacy groups, legal organizations and health practitioners strategized fundraising campaigns, care plans and lawsuits Monday in response to Friday’s decision by a state medical board to eliminate the opportunity for minors to receive transgender treatment — even in clinical trials.
The rule still needs to be filed for adoption before it can go into effect. That could take at least 34 days after Friday’s decision. “This is contingent on no legal challenges to the rule,” a Florida Department of Health spokesperson said Monday.
Minors already receiving treatment will be able to continue it.
Simone Chriss, director of the Transgender Rights Initiative at Southern Legal Counsel, said her nonprofit law firm will sue the state in federal court over its ban, contending that it is unconstitutional and violates the rights of transgender children and their parents.
“We want a federal court to strike down this ban that denies children access to medically necessary healthcare,” Chriss said.
“The way the state has subverted the legislative process and is using appointed boards to change the rules is troubling,” she said.
Transgender health care has come under attack by Gov. Ron DeSantis’ administration, which since last spring has pushed for both the medical boards’ ban and the elimination of Medicaid coverage for gender-affirming care.
The Florida Board of Medicine and the Florida Board of Osteopathic Medicine approved rules last fall that bar doctors from prescribing puberty blockers, hormone therapy and other medical interventions to new patients diagnosed with gender dysphoria who are minors.
The Florida Board of Osteopathic Medicine had previously made an exception for minors participating in clinical trials but voted Friday to take it away. Friday’s decision to move forward with the ban with no exceptions sent the transgender community into action.
Dr. Robyn Schickler, chief medical officer of Planned Parenthood of Southwest and Central Florida, said her organization is preparing for the ban by informing patients of Friday’s decision and opening appointments for teens to get evaluated and start therapy before the ban goes into effect, if they so choose, so they can be grandfathered in and allowed to continue care.
Planned Parenthood of Southwest and Central Florida provides estrogen and testosterone hormone therapy to approximately 1,900 patients a year, including minors as young as 14 with parental consent after an extensive evaluation process, she said.
The number may have shrunk since Florida’s Medicaid program stopped covering gender-affirming care, she added. Planned Parenthood covered costs for these patients for a period after the ban but it no longer does.
Schickler confirmed there aren’t many funds that exist, currently, to help youth travel to other states to get gender-affirming care.
“I come from an abortion world, and I’m fairly used to a lot of abortion funds — even though even that’s not enough,” she said. “There just isn’t much for these patients.”
Chriss and others already are suing Florida’s Agency for Health Care Administration over its rule prohibiting Medicaid coverage for gender-affirming care. That rule, applied to people of all ages, went into effect in August, and the lawsuit in federal court in North Florida is ongoing. Chriss expects that case to go to trial in May.
In talking with Planned Parenthood providers from other states that have restricted gender-affirming care, she noted that several families decide to move out of the state in response to these bans.
Ashley Mayfaire, director of operations for TransSOCIAL in South Florida, said the state’s transgender community is moving quickly to work with national organizations to connect Florida families with out-of-state resources. “Once they turn 18, we can jump back in and connect them to care immediately in Florida.”
Mayfaire said her nonprofit organization has stepped up financially through its “small relief fund” to help some patients affected by the Medicaid cut with their out-of-pocket costs. “We can only help so many people though, and this affects thousands,” she said. “We are reaching out to other organizations to get those who need the care through until we can change the law.”
Marni Stahlman, president and CEO of the Mental Health Association of Central Florida, is concerned about the psychological impacts of this ban on an already-vulnerable group of teens.
She pointed to decades of research on LGBTQ youth that suggests when their identity is denied, mental health problems are elevated.
Multiple studies have suggested that transgender people who begin hormone therapy as teens experience lower rates of suicidality and depression.
The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health found 45 percent seriously considered attempting to kill themselves in the past year. Those who felt socially supported by their family and community were half as likely to attempt suicide.
“When a person’s identity or the identity of a loved one that they’re close with becomes politicized and point of debate, it is dehumanizing. It increases stigma and stress and it’s especially damaging for young people,” Stahlman said. “It’s viewed as an erasure of their identity and it is not about indoctrination. It’s about inclusion.”
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