05/05/2024

Florida Gov. Ron DeSantis’ administration Thursday asked the state board regulating doctors to essentially ban transition-related care for transgender minors, according to a letter obtained by NBC News.

The state Health Department made the request hours after another state agency issued a 46-page report to justify banning Medicaid coverage for transgender people of any age who want puberty blockers, hormone therapies or gender-reassignment surgery.

The two-pronged effort, which ensures DeSantis can act quickly and without the need for legislative approval, drew instant opposition from activists and medical professionals. They have increasingly clashed with DeSantis, a Republican, as he seeks re-election and builds a national brand as a culture warrior and potential 2024 White House contender.

Leading the charge for DeSantis: Florida Surgeon General Joseph Ladapo, who oversees the Health Department.

In April, Ladapo issued guidance recommending against transgender treatments for minors who feel their bodies and their gender identities are misaligned. It contradicted guidance issued by the U.S. Department of Health and Human Services under President Joe Biden, and transgender rights activists and 300 state health care professionals accused Florida of cherry-picking evidence and performing incomplete research.

In a partial answer to the criticisms, Florida’s Agency for Health Care Administration issued its report Thursday questioning the science and safety of hormone therapies, puberty blockers and gender-reassignment surgery. Ladapo then asked the Florida Board of Medicine to “establish a standard of care” Thursday that could ultimately result in prohibiting doctors from prescribing the therapies for transgender youths. The process could take months, and it’s unclear how many people it could affect.

“While some professional organizations, such as the American Academy of Pediatrics and the Endocrine Society, recommend these treatments for ‘gender affirming’ care, the scientific evidence supporting these complex medical interventions is extraordinarily weak,” Ladapo wrote in his letter.

“The current standards set by numerous professional organizations appear to follow a preferred political ideology instead of the highest level of generally accepted medical science,” he wrote. “Florida must do more to protect children from politics-based medicine.”

But a host of other health care professionals, their organizations and activists have accused Ladapo and DeSantis of endangering the well-being of children who are at increased risk of suicide already.

“It’s unconstitutional for the government to step in and deprive youth — and especially trans youth — of getting the necessary medical care they need,” said Gary Howell, a psychologist in Tampa who has transgender youth and adult patients.

“This interferes with the rights of parents,” Howell said, drawing attention to DeSantis’ crusade for parental rights when it comes to teaching kids about race, gender identity and sexual orientation in the classroom.

Howell said doctors aren’t just prescribing puberty blockers or hormones without adequate safeguards or without the informed consent of caring and involved parents. He said that operations for children — mainly mastectomies for transgender boys — are exceedingly rare and that they occur only after multiple evaluations.

DeSantis’ administration notes that Sweden and Finland, which were among the first countries to engage in prescribing a broad range of transition-related care for transgender children, have severely curtailed their use now.

But his administration has gone a step further, experts say, by also seeking to ban what’s called “social gender transition therapy” — prohibiting therapists from encouraging children to change their pronouns, hair and dress in accordance with their gender identities.

Republican-led states have focused on transgender-related issues since Biden took office in 2021 and recommitted the federal government to expanding and protecting rights for transgender people. Biden appointed the first transgender assistant secretary of health and human services for health, Dr. Rachel Levine, whose office released a fact sheet promoting gender-affirming care, which Ladapo’s office criticized.