Florida surgeon general seeks ‘standard of care’ that doesn’t offer transgender treatment to kids and teens

Florida Surgeon General Joseph Ladapo is asking the state Board of Medicine to “establish a standard of care” for the treatment of transgender children and adolescents, referencing state health department guidelines that said social gender transition and gender-affirming treatments should not be an option for youth and advised against puberty blockers and hormone therapy treatments for anyone younger than 18 years old.

Ladapo’s letter, dated Thursday, was first obtained and reported by NBC News.

The Department of Health’s guidelines issued in April came after a fact sheet issued by the U.S. Department of Health and Human Services that said, in part, that gender-affirming care is a “supportive form of healthcare” and that research shows “gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents.”

The fact sheet defines gender-affirming care as a way to align people’s “outward, physical traits” with the gender they identify with.

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Ladapo wrote that, despite the American Academy of Pediatrics and the Endocrine Society supporting the various treatments, that the “scientific evidence supporting these complex medical interventions is extraordinarily weak.”

“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,” the letter says. “Florida must do more to protect children from politics-based medicine. Otherwise, children and adolescents in our state will continue to face a substantial risk of long-term harm.”

The state health department guidelines say that social gender transition, gender-affirming surgery, puberty blockers and hormone therapy should not be used to treat children and adolescents “due to the lack of conclusive evidence, and the potential for long-term, irreversible effects.”

The surgeon general’s letter recommends the board review the department’s guidelines along with a review by the Agency for Healthcare Administration on whether the treatments are “consistent with generally accepted professional medical standards” and are “not experimental or investigational.”

Two doctors from the Agency for Healthcare Administration wrote in their review that there is “great uncertainty” with using puberty blockers and surgeries in gender-affirming care, the letter says.

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NBC News reported that asking the board to “establish a standard of care” could mean doctors cannot prescribe the treatments for transgender youth.

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

The Health and Human Services Department’s fact sheet says social affirmation can be used at any age and allows individuals to dress like their preferred gender, use the fitting bathrooms and adopt a name and pronouns that reflect their gender identity.

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Puberty blockers — which pause hormones developed during puberty — are reversible treatments and that hormone therapy is partially reversible. Gender-affirming surgeries are irreversible and are generally performed in adulthood or on a case-by-case basis with youth, the sheet says.

Sexual orientation and gender identity have been a hot-button topic this year after the “Parental Rights in Education” bill, called the “don’t say gay” bill by critics, became law. It prohibits instruction in Florida kindergarten through third grade classrooms about “sexual orientation or gender identity” or in higher grades if the instructions are not “age-appropriate.”

Sun Sentinel staff writer Anthony Man contributed to this report.