Florida bill prohibiting transgender care for youth moves forward

Florida legislators voted Monday to advance a bill that would make providing “sex reassignment” medical care to transgender minors illegal, would make providing that care a felony and would prohibit state funds from being used to cover such care for adults.

The legislation, sponsored by Sen. Clay Yarborough, R-Jacksonville, is the latest move from state officials targeting medical care for transgender children in Florida.

The state’s Board of Medicine and Board of Osteopathic Medicine in November banned the use of any puberty blockers, hormone therapies or surgeries to treat gender dysphoria for anyone in Florida under age 18. (Children who are already receiving treatment will be grandfathered in.)

The legislation adds language in the statute to codify the prohibitions on such care.

Doctors who provide gender-affirming care to new minor patients now risk losing their licenses because of the Board of Medicine rule. The Senate bill would go further, saying health care providers found to be in violation could face a third-degree felony. Yarborough’s initial bill, which he changed Friday, said that anyone who participated in providing gender-affirming care could face a third-degree felony, which had parents concerned they could be imprisoned. That language was removed.

Yarborough’s initial bill also included sweeping provisions that would have allowed treatment for gender dysphoria to be used to determine the outcome of custody agreements between parents.

The bill’s initial language had said that “subjecting or attempting to subject” a child to treatments such as puberty blockers and hormone therapies would be defined as “serious physical harm” when considered in a custody case, making it possible for a parent who does not support their child’s transition to take custody from another parent.

But the Senate’s Health Policy committee voted instead to take up a substitute that says Florida courts have the jurisdiction to alter child custody agreements “to the extent necessary to protect the child from being subjected to sex-reassignment prescriptions or procedures ... in another state.”

Yarborough said the new provision would allow for courts to consider a situation where a Florida parent doesn’t agree with the decision of an out-of-state parent in favor of care for gender dysphoria, but said the court is not required to act in any particular way.

Simone Chriss, director of the Transgender Rights Initiative at Southern Legal Counsel, said the legislation creates an opportunity for people in other states, where such care for transgender minors is allowed, to come to Florida and have the courts intervene in their custody agreement if one parent is in support of the treatment and one is not.

“The people that should be nervous are people in other states,” Chriss said. “It’s like a reverse safe haven.”

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Yarborough said that’s conceivably a possibility, but if the child was not present in Florida it’s “highly unlikely that the court would move forward to do anything because if they’re not a resident they’re probably not going to be here for a long period of time.”

Chriss said it’s unnecessary legislation because if two parents have legal rights over a child, they already have to both agree before beginning something such as puberty blockers.

Yarborough said that government intervention should be a last resort, but “if one parent is attempting to authorize drastic, life-altering gender dysphoria therapies and surgeries that would forever change the life of a young child, and would be illegal under other provisions of this bill, then by all means the other parent should have the ability to have a court review the custody agreement.”

Though some LGBTQ advocates and families were concerned the bill would allow the state to remove children from their families’ care, the legislation — then and now — does not mirror what’s happening in Texas, where the governor directed the state’s child welfare agency to investigate families who provided gender-affirming care to their children.

“The notion they can seize children from their parents is dead wrong,” Chriss said.

And though Chriss said the new legislation is still “horrific,” she said it’s better than the first draft.

Flatly prohibiting any form of care for gender dysphoria in minors contradicts the stance of major medical organizations, including the American Academy of Pediatrics, the Endocrine Society and the American Psychological Association.

Shane Mulcahy, a 16-year-old from the Orlando area, said if they don’t speak out against the bill and Florida’s crackdown on LGBTQ individuals, they’ll only cry.

Mulcahy, who is transgender and nonbinary, said they started taking estradiol, a form of estrogen, at 15 years old. They said finding care took a long time, and it wasn’t a quick process.

“There will be kids who kill themselves because of these things,” they said.

Later, speaking at an Equality Florida news conference celebrating “pride in the Capitol,” Mulcahy became emotional while their mom rubbed their back.

The news conference was full of impromptu chants and cheers headed into the afternoon’s bill hearing. But at the meeting, speakers — the vast majority of whom were against the bill — were given only 30 seconds to speak by the committee chairperson. Multiple parents of transgender children who spoke stressed the suicidal ideation their children faced before access to care.

“Criminalizing gender-affirming care is going to hurt my son more than a puberty blocker will,” one mother of a transgender child told the committee.

Yarborough’s legislation also says that any “governmental entity” cannot spend state funds on “sex-reassignment” health care. Gov. Ron DeSantis’ office recently asked state universities to detail their spending on various medical procedures for gender dysphoria. The bill also requires informed written consent for adults seeking gender-affirming care.

The Agency for Health Care Administration has prohibited Medicaid from being used for any kind of gender-affirming care procedures, like hormone therapies — affecting not only children, but also adults. That provision is being challenged in court by Chriss and other attorneys.

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