On the heels of Texas’s recent attempt to restrict access to gender-affirming healthcare, the Florida Department of Health released new guidelines on April 20 that attempt to prevent trans youth from transitioning in any capacity.
In a statement sent to licensed health and human services providers from the office of the state’s surgeon general Joseph A. Ladapo, the government states that minors should not be prescribed puberty blockers or hormone replacement therapy (HRT), that gender-affirming surgical procedures should not be made available to minors and that “social gender transition should not be a treatment option for children or adolescents.”
While other states have attempted to restrict youth access to gender-affirming care via both state house bills and guidelines, Florida is the first state to name social transition in such a restriction. Per federal guidelines, social transition can encompass anything from gender-affirming hairstyles and clothes, to changing one’s name or pronouns or using restroom facilities in alignment with one’s lived gender.
The Florida guidance also states that minors experiencing gender dysphoria should be provided with “social support” and “counselling.” But it’s unclear what form this support would take if providers are not allowed to support social transition—counselling for trans and queer youth that isn’t affirming, but rather designed to convince them that they are not trans or queer is generally considered conversion therapy.
“This guidance demonizes lifesaving, medically necessary care, and asserts that politicians know better than parents about caring for their children.”
The Department of Health’s move comes in response to a fact sheet recently released by the U.S. Department of Health and Human Services, intended to provide guidance on best practices for gender-affirming care for trans youth. The fact sheet notes that gender-affirming care can be crucial for young trans people, who are already at an elevated risk for mental health issues, substance abuse and suicide. It also notes that youth access to gender-affirming care is supported by most major medical associations in the U.S.—including the American Medical Association, American Psychological Association and the American Academy of Pediatrics, among others.
In a separate statement, Ladapo blasted the federal guidelines, saying that it was about “injecting political ideology into the health of our children.”
“Children experiencing gender dysphoria should be supported by family and seek counselling, not pushed into an irreversible decision before they reach 18,” he said.
While it’s unclear what impact the state guidelines will actually have on youth who are currently receiving gender-affirming care in Florida—the guidelines are not a law, and therefore not technically legally binding—advocates say that it will still contribute to the climate of fear that trans kids in Florida are already feeling.
Equality Florida executive director Nadine Smith accused Florida governor Ron DeSantis (whose name also appears on the guidance) of once again putting “political propaganda over science and the safety of young people” in a statement, referencing DeSantis’s signing of the state’s notorious “Don’t Say Gay” law earlier this month.
“This guidance demonizes lifesaving, medically necessary care, and asserts that politicians know better than parents about caring for their children,” Smith said in a statement. “Governor DeSantis’s runaway agenda of banning books, muzzling teachers, censoring history and pushing government control makes the state less safe for LGBTQ2S+ families, especially transgender children.”
The guidelines are also reminiscent of recent directives from the Texas department of health. In a widely condemned move that has been met with lawsuits, Texas governor Greg Abbott and attorney general Ken Paxton released letters in February that declared gender-affirming care to be “child abuse,” and ordered the state’s Department of Family and Protective Services to investigate parents and guardians who helped their kids access such care.
While the Texas directive was not technically legally binding, similar to Florida’s Wednesday letter, it did prompt nearly a dozen DFPS investigations. It was temporarily suspended by a judge via an injunction issued in March, and the case is expected to head to court in July.
The Florida directive does not go as far as to label gender-affirming care as child abuse, but it still represents an escalation of the attacks faced by trans youth in Florida this year. Florida is the first state to try and stop kids from socially transitioning. The state’s notorious “Don’t Say Gay” bill, which restricts education on sexual orientation and gender identity in grades K-3, or in any “manner that is not age-appropriate or developmentally appropriate” at any grade, was signed into law by Gov. DeSantis earlier this year. The bill has inspired other states, including Virginia and Tennessee, to introduce their own versions.
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