Florida’s Department of Health released guidance on Wednesday against providing “transgender” minors with “gender-affirming” care, including letting minors “socially” transition. The guidance comes as a response to a fact sheet released by the U.S. Department of Health and Human Services regarding transgender youth, which I covered last month.
The document outline the guidance, title “Treatment of Gender Dysphoria for Children and Adolescents,” advises against puberty blockers, hormone therapy treatments, sex reassignment surgeries, and “social gender transitions,” such as changing pronouns, name, and clothing.
The Florida Department of Health wants to clarify evidence recently cited on a fact sheet released by the US Department of Health and Human Services and provide guidance on treating gender dysphoria for children and adolescents.
Systematic reviews on hormonal treatment for young people show a trend of low-quality evidence, small sample sizes, and medium to high risk of bias. A paper published in the International Review of Psychiatry states that 80% of those seeking clinical care will lose their desire to identify with the nonbirth sex. One review concludes that ‘hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact is generally lacking.’
According to the Merck Manual, ‘gender dysphoria is characterized by a strong, persistent crossgender identification associated with anxiety, depression, irritability, and often a wish to live as a gender different from the one associated with the sex assigned at birth.’
Due to the lack of conclusive evidence, and the potential for long-term, irreversible effects, the Department's guidelines are as follows:
Social gender transition should not be a treatment option for children or adolescents.
Anyone under 18 should not be prescribed puberty blockers or hormone therapy.
Gender reassignment surgery should not be a treatment option for children or adolescents.
Based on the currently available evidence, ‘encouraging mastectomy, ovariectomy, uterine extirpation, penile disablement, tracheal shave, the prescription of hormones which are out of line with the genetic make-up of the child, or puberty blockers, are all clinical practices which run an unacceptably high risk of doing harm.’
Children and adolescents should be provided social support by peers and family and seek counseling from a licensed provider.
These guidelines do not apply to procedures or treatments for children or adolescents born with a genetically or biochemically verifiable disorder of sex development (DSD). These disorders include, but are not limited to, 46, XX DSD; 46, XY DSD; sex chromosome DSDs; XX or XY sex reversal; and ovotesticular disorder.
The Department’s guidelines are consistent with the federal Centers for Medicare and Medicaid Services age requirement for surgical and non-surgical treatment. These guidelines are also in line with the guidance, reviews, and recommendations from Sweden, Finland, the United Kingdom, and France.
Parents are encouraged to reach out to their child’s health care provider for more information.
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In a news release published Wednesday, Florida Surgeon General Joseph Ladapo said “the federal government’s medical establishment releasing guidance [failed] at the most basic level of academic rigor shows that this was never about health care."
“It was about injecting political ideology into the health of our children. Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18,” he added.
Several states such as Alabama, Arizona and Idaho, have taken steps to protect minors by outlawing "gender-affirming" care for this age group.
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