Experts and activists say a nonbinding statement released by the administration of Gov. Ron DeSantis in Florida on Wednesday urging medical providers to deny gender-affirming health care to young people is a baseless partisan attack that will have little impact on efforts to defend trans and LGBTQ rights in court. Although the statement doesn’t hold legal weight, it still has the potential to scare and intimidate trans youth and their families, activists said, and should be emphatically opposed.
Florida state health officials released “guidelines” on Wednesday that say children and adolescents should not receive potentially lifesaving gender-affirming treatments for gender dysphoria, including so-called “social gender transitions” such as changing pronouns and hairstyles that do not involve medication or medical procedures.
LGBTQ activists say the Florida Department of Health’s statement is a desperate and obviously partisan effort to spread lies about trans and nonbinary youth as Republicans attempt to whip their voters into an anti-LGBTQ frenzy ahead of the midterms. Legal experts stress that the so-called “guidelines” do not carry the force of law and are unlikely to impact legal challenges to any future anti-LGBTQ legislation passed in the state.
Instead, the “guidelines” appear to be nothing more than an empty and scientifically inaccurate political statement issued by far right ideologues within the Florida health department, according to Carl Charles, a senior attorney at the LGBTQ rights group Lambda Legal. Charles added that Florida’s constitution prevents state judges from deferring to opinions issued by state agencies in legal cases, and the statement would do little to bolster any future anti-LGBTQ laws passed under DeSantis and inevitably challenged in court.
However, that doesn’t mean the health department’s “guidance” will have no impact. News about the statement could add to the heightened sense of fear felt by young people and their parents as the rights of trans and nonbinary youth come under attack in Arkansas, Texas, Mississippi, Louisiana, Alabama, and other GOP-led states, Charles said. Activists and journalists should approach far right disinformation carefully.
“I don’t think it’s responsible to scare vulnerable families and children who are already scared about what is going on and trans youth being targeted,” Charles said in an interview.
Serena Sojic-Borne, an organizer with the Real Name Campaign who works with queer and trans youth activists in Louisiana, said anti-trans government advisories can be lethal considering the high rates mental distress among LGBTQ youth. It’s clear that the Florida “guidelines” could cause kids and teens to be more afraid of getting the care they need, she said.
However, many young people are organizing rather than living in fear. In New Orleans, for example, student activists recently staged a walkout at a high school in protest of anti-trans and anti-LGBTQ copycat bills that mirror legislation introduced in Florida and other red states, according to Sojic-Borne. Youth rallies are also planned outside of legislative offices.
“The point here is that kids aren’t being passive, youth are responding and youth are fighting back for their rights,” Sojic-Borne said in an interview.
The Florida statement is in direct response to a fact sheet and memorandum to state health agencies issued by the Biden administration on gender-affirming care for young people, which correctly states that trans and nonbinary youth face significant health care disparities and are at increased risk of mental health issues and suicide. Using cherry–picked data and rigorously debunked research, the Florida guidelines attempt to push back on federal health officials with what Charles called “off-the-cuff opinionating.”
Gender-affirming care encompasses a range of psychological and medical services. Conservatives, fueled by viral misinformation, are laser-focused on the use of puberty blockers and hormone therapy to promote physical development that is consistent with a young person’s identity, which is recommended by the American Psychiatric Association and the American Academy of Pediatricians for transgender youth when they reach an appropriate age. However, these treatments are only one part of a much broader model of care for trans, nonbinary and gender-nonconforming people.
Echoing experts across the country, the federal guidelines from the Department of Health and Human Services say that “social affirmation” of adolescents who adopt gender-affirming pronouns, hairstyles, clothing and restroom accommodations is critical for fostering better health outcomes. Social affirmation is indicated at any stage of a child’s development because social transitions are flexible, adapting to the child’s identity, wishes and expression as they grow.
Indeed, a social transition is the most common form of gender transition for people of any age. Research shows that 73 percent of transgender women and 78 percent of transgender men first experience gender dysphoria, a strong discomfort or distress often caused by a discrepancy between a person’s gender identity and their gender assigned at birth, by the age of 7.
Florida officials appear to conflate “social gender transitions” with medical and psychological treatment for young people diagnosed with gender dysphoria. However, acknowledging a social transition is crucial for providing adequate health care and is not a distinct medical intervention. It remains unclear whether the Florida Department of Health is discouraging doctors from using the correct names and pronouns for their patients and respecting their identities.
Jeremy Redfern, a spokesman for the department, said in an email that research on “social gender transitions” is “inconclusive.” Therefore the “precautionary principle” of medicine must be applied, and “the burden of proof falls on those claiming that there is a benefit,” Redfern wrote.
However, affirming a social transition is indicated “across the board” for transgender and nonbinary children, according to Charles. Affirming a patient’s identity is central to providing gender-affirming health care for any type of medical issue, from treating a sinus infection to healing a broken arm. It is, activists emphasize, a basic human right.
When asked “yes or no” whether the Florida Department of Health is discouraging doctors from affirming a young patient’s social transition and gender identity in the course of medical treatment, Redfern deflected, saying the guidance and evidence “speak for itself.” The guidance says adolescents should be “provided social support from peers and family” and seek counseling from a licensed provider, but it does not clarify what type of “counseling” is encouraged.
“I think this is really just a political talking point document that is not based in accurate and available science and data and was released to serve a partisan purpose,” Charles said, adding that civil rights attorneys are closely following anti-LGBTQ legislation in Florida and across the country.
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