DeSantis-Stacked Medical Boards Ramp Up Bans on Care for Trans Youth

“Everyone has an embarrassing moment from their childhood. A defining embarrassing moment,” said 12-year-old Lola Smith, standing before members of the Florida boards of Medicine and Osteopathic Medicine in Tallahassee last Friday.

“That moment for me is happening right now, as I stand in front of a panel of strangers and publicly beg for my right to exist,” said Smith, who is nonbinary. “Nothing is more humiliating and dehumanizing than pleading for one’s own existence.”

Smith was the youngest person among dozens of Florida residents who spoke out at the hearing, which was ostensibly convened as a forum for public feedback on the boards’ newly proposed trans health care regulations. But after Smith and other attendees decried the medical boards’ decision to deny necessary gender-affirming health care to trans youth, board members responded with a unanimous vote for even tighter restrictions. The event amounted to little more than cruel political theater: a grim performance of medical expertise in service of fascistic ends.

Last November, both medical boards voted to approve a new set of regulations, which would ban the treatment of gender dysphoria with puberty blockers and hormones for anyone under 18. The rule changes, based on spurious claims, cherry-picked data, and widely discredited pseudoscience, run counter to the recommendations of every major medical association, including the American Academy of Pediatrics, the American Psychological Association, and the Endocrine Society.

Florida’s new medical board rules are the first example of a health care ban enacted directly through a state agency — and yet another case of Republican Gov. Ron DeSantis aggressively weaponizing administrative appointments to bend the state’s institutions and policies to his far-right agenda. Members of both the Board of Medicine and the Board of Osteopathic Medicine are directly appointed by the governor for four-year terms.

Nikole Parker, director of transgender equality for the nonprofit advocacy group Equality Florida, noted that the governor is “strong-arming” state agencies and boards. “The Boards of Medicine and Osteopathy are stacked with DeSantis political appointees, choosing to put their politics over peoples’ lives,” she told me. “These doctors do not care about trans people.”

No precise date has been given for when the ban will go into effect. Once it does, doctors found in violation will risk losing their licenses and incurring serious fines. Teens who are already prescribed gender-affirming medications will be able to continue receiving them, but any trans minors seeking to begin such treatments in the future — treatments recommended by a consensus of medical professionals nationally and internationally — will be unable to do so in Florida.

The hearing was the last opportunity Floridians had to comment publicly on the new medical regulations, which will put thousands more trans children at increased risk of severe depression, anxiety, and even suicide — already major problems for the majority of trans kids who lack access to the health care that Republicans are targeting.

For over two hours, trans youth and adults, parents of trans children, and mental health and other medical experts offered anguished pleas to the indifferent panel of cisgender and overwhelmingly white board members.

“How can you do this? Please do not do this,” said one father, breaking into sobs. “It’s criminally wrong.” The man recounted how his trans son had said he wanted to die from the pain of gender dysphoria at the age of 8, but was saved by gender-affirming medical treatment in his teens, including top surgery at 15 years old.

“I don’t want this board to make me bury my daughter or force me to have to leave this state,” said the mother of a trans girl. The woman added that her prepubescent daughter is so distressed by the prospect of going through endogenous puberty — which, unlike taking puberty blockers, is irreversible — that she can barely get out of bed.

“Gender-affirming health care saved my life,” said one young trans man, who had tried to take his own life three times before receiving appropriate medical care. His message to the boards was echoed by nearly every speaker: “You will have blood on your hands.”

Following the desperate appeals, the board members swiftly voted to make the health care bans even harsher. Before Friday, the proposed rules from the Board of Osteopathic Medicine included a slim exception to allow trans minors to receive nonsurgical gender-affirming treatments in the context of approved clinical research trials. That exception has now been axed, and both boards’ rules constitute total bans.

The very same board members who falsely cited a lack of clinical research as grounds to ban puberty blockers and hormone treatments for trans children voted unanimously to foreclose further such research in the state. The request to drop the clinical trials exemption came directly from a Florida Department of Health representative, who spoke at the public hearing.

However, cis children will continue to have access to puberty blockers and hormone treatments when deemed appropriate by medical professionals, such as in cases of precocious puberty. Similar carveouts for cis kids exist in every one of the trans health care bans that have swept red states in recent years — as if any more evidence is needed to prove that these bans are not about medical risk or untested drugs but about extreme anti-trans discrimination.

In 2022, more than 300 anti-LGBTQ bills were either passed or introduced in at least 36 states, the majority taking aim at trans youth. Florida is already one of more than 10 states in the country that blocks Medicaid from covering gender-affirming care for both adults and children — another policy that gives lie to Republican claims that these anti-trans measures are concerned with protecting children. The barrage of anti-trans legislation nationwide is eliminationist in intent; the invocation of imperiled children — who are assumed to be cis — is simply a well-worn, grimly successful conservative trope.

Many of the speakers at last week’s hearing, particularly the parents of trans kids, noted how the new rules constituted a violation of parental rights: the ability of a parent to make health care decisions with their child and medical professionals, without undue state interference. Parental rights are, after all, a current right-wing obsession — but only when they serve as grounds for banning LGBTQ, anti-racist, and historically accurate material from school books and discussions, or when they’re used to force teachers to disclose if a child has come out as trans or nonbinary in school.

During public comment, and at a press conference prior to the hearing, Simone Chriss, the director of the Transgender Rights Initiative at Southern Legal Counsel, a nonprofit law firm that plans to sue Florida over its ban, called it a “sublime irony” that the same state banning books in the name of parental rights is denying parents’ ability to make health care choices with their children. This comes as no surprise: Fascistic calls to “protect the family” have only ever had a certain type of family in mind (nuclear, traditional, cisgender, white).

The protection of trans kids should not hinge on a defense of parental rights; far too many gender-nonconforming children suffer under the strictures of unsupportive families. We shouldn’t fight with and for any children by asserting that they are their parents’ property. And highlighting Republican hypocrisy is a pointless exercise when the party has made clear where its consistent, undergirding commitments lie: the elimination of trans people.

The young trans people and their loved ones who spoke at the hearing knew that their pleas would likely fall on closed ears. Their appeals were desperate but never abject; they made clear that they are committed to collective resistance.

“We will rise up against you at every turn until you put every last one of us in the ground,” said one young speaker to the panel. “I hope that your conscience finds no rest.” It is on us all to ensure that those leaders and officials who deny the ability of trans children to live and flourish should be permitted to find no peace.