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Medicaid care for transgender children is rare in Florida, data shows

Treatment of children with gender dysphoria is on the increase but numbers remain relatively low, a new report suggests.
Protesters hold cardboard signs shaped like tombstones in front of the Marriott Fort Lauderdale Airport when the Florida Board of Medicine met in early August 2022 to discuss a proposed rule by the DeSantis administration to ban doctors from performing gender-affirming surgeries or providing puberty blockers to transgender minors. The number of children treated for this by Medicaid is small.
Protesters hold cardboard signs shaped like tombstones in front of the Marriott Fort Lauderdale Airport when the Florida Board of Medicine met in early August 2022 to discuss a proposed rule by the DeSantis administration to ban doctors from performing gender-affirming surgeries or providing puberty blockers to transgender minors. The number of children treated for this by Medicaid is small. [ JOSE A. IGLESIAS | El Nuevo Herald ]
Published Aug. 30|Updated Sep. 1

TAMPA — One week after Florida banned the use of Medicaid to pay for medical treatment of gender dysphoria, newly released data shows the number of transgender children getting such aid remains rare in Florida.

A dozen children diagnosed with gender dysphoria underwent surgeries over a 12-month period through June 30, according to a report released by the Florida Agency for Health Care Administration on Monday.

The report lists only cases covered by Medicaid and omits those paid by private health insurance or other means. The actual number of children treated is likely higher.

Related: Some doctors stopping treatment for transgender youth in Florida

In the same year, 346 children were prescribed male hormones, 151 were administered female hormones and 55 were prescribed puberty blockers, the data shows. Just over 230 children received psychiatric or behavioral health treatment. That’s out of Florida’s population of about four million children aged 17 and under, according to the U.S. Census.

Florida’s Medicaid program defines children as those under 21, so the numbers include transgender adults aged 18 to 20.

Close to half of the children treated at the Youth Gender Program at the University of Florida were on Medicaid, officials there said.

Officials from the DeSantis administration, including Surgeon General Joseph Ladapo, began publicly criticizing the treatment of transgender children in April. Since then the state has banned patients from using Medicaid for medical treatment of gender dysphoria and Ladapo has asked the state’s Board of Medicine to issue new rules for treating transgender minors.

Related: Florida to ban Medicaid coverage for transgender health care

Michael Haller, chief of pediatric endocrinology at the University of Florida, said the new report shows doctors are providing treatment only to children who need it.

“This directly contradicts the state’s suggestion there is a pandemic of children receiving gender affirming care and specifically surgeries,” Haller said.

Related: Some doctors stopping treatment for transgender youth in Florida

The report does show that the number of children receiving treatment has increased from past years. Fifteen children were being treated with puberty blockers in 2018, 72 children were prescribed female hormones and 130 were given male hormones. Just over 143 children received psychiatric or behavioral health treatment that same year.

Agency for Health Care Administration spokesman Brock Juarez described the 159% increase of surgeries, puberty blockers and hormones from 2018 as soaring and questioned why this type of treatment had risen more than psychiatric and behavioral treatment, which grew by 61% over the same span.

“This is a concerning statistic and potentially indicative of a medical community increasingly focused on promoting treatments found to be experimental and investigational with the potential for harmful long-term effects, including brain swelling and aneurysm,” he said.

The U.S. Food and Drug Administration in July identified six cases of brain swelling in females between the ages of 5 and 12 who were taking blockers. It did not ban the drug but added a warning label.

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Haller said the drug can lead to increased pressure inside ducts in the brain but said he’s only seen one case in 25 years. Puberty blockers have been used for about three decades and are also used to delay puberty in very young children.

The increase in the number of children being prescribed blockers and hormones is likely the result of better access to care, Haller said. Doctors are seeing more children with gender dysphoria come forward because of increased awareness and acceptance of the condition.

Clarification: This story has been updated to reflect Medicaid’s definition of children.

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