HomeHealthFDOH asks Florida Board of Medicine to prohibit sex reassignment surgery and puberty blockers for treatment of gender dysphoria in minors
FDOH asks Florida Board of Medicine to prohibit sex reassignment surgery and puberty blockers for treatment of gender dysphoria in minors
July 31, 2022
BY JENNIFER CABRERA
GAINESVILLE, Fla. – The Florida Department of Health (FDOH) has filed a Petition to Initiate Rulemaking that will establish standards of care for the treatment of gender dysphoria in the state of Florida if the Board of Medicine adopts the rule. The rule is on the agenda of the Board of Medicine’s August 5 meeting in Ft. Lauderdale.
The Petition asks the Board of Medicine, which establishes standards of care, to establish a rule that sex reassignment surgery should be prohibited under the age of 18; that puberty blocking, hormone, and hormone antagonist therapies for the treatment of gender dysphoria should be prohibited under the age of 18; and that if the above treatments are used to treat gender dysphoria in adults, informed consent must be in writing through forms approved by the Board at least 24 hours before treatment is provided. FDOH further proposes that the Board issue guidance allowing physicians to provide appropriate care for patients who are already undergoing hormone therapy or who enter the state after beginning hormone treatments.
Among the arguments in the Petition are statements that the available medical literature provides insufficient evident for these interventions; that puberty blockers are not approved by the FDA for treatment of gender dysphoria, are not efficacious for treatment of gender dysphoria, and have permanent side effects; that hormonal treatments in adolescents can achieve their intended physical effects, but quality evidence regarding their psychological and cognitive impacts are lacking, and that they can cause irreversible physical changes, including infertility and sterility; and that surgical interventions are not reversible and that the long-term mental health effects of the procedures are largely unknown.
If the rule were adopted, it would presumably limit the treatments available at programs like UF Health’s Youth Gender Program, which is “for transgender and gender-nonconforming, or TGNC, youth and their families.” Along with services that include consultation, psychotherapy, and assessment of medical readiness for cross-sex hormone therapy, the program includes resources that include this hand-out on “tucking” that is intended for “male-bodied” people but clearly shows a picture of a female body as an illustration of the expected result of the process.
The agenda backup material (proposed rule starts on page 870) includes a June 2 letter from FDOH to the Board of Medicine, explaining the Department’s stance that the evidence for use of surgeries, puberty blockers, and cross-sex hormones to treat gender dysphoria in children and adolescents is “extraordinarily weak”; the April 20 guidance from FDOH that recommends against the use of these therapies in minors; peer-reviewed papers on gender dysphoria in childhood, on puberty, and on the safety and efficacy of various treatments; literature reviews and guidelines from other countries; Florida Medicaid’s literature review of treatment of gender dysphoria; papers that discuss the ethics of informed consent in the use of these treatments; and a letter from a group of physicians, psychologists, and a law professor, opposing FDOH’s request to the Board of Medicine, stating that “standard medical treatments for gender dysphoria meet accepted professional medical standards and are not experimental or investigational,” along with their critical review of the Florida Medicaid Report.
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