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How Florida clinics are treating transgender youth ahead of ban

Some providers have already stopped accepting new patients younger than 18.
 
New rules from the Florida Boards of Medicine and Osteopathic Medicine will bar doctors from prescribing puberty blockers, hormone therapy and surgeries to treat new patients younger than 18 for gender dysphoria. Kaleb Hobson-Garcia, a transgender man, drove from Tallahassee to speak during a press conference in front of the Marriott Fort Lauderdale Airport as the Board of Medicine met in August 2022.
New rules from the Florida Boards of Medicine and Osteopathic Medicine will bar doctors from prescribing puberty blockers, hormone therapy and surgeries to treat new patients younger than 18 for gender dysphoria. Kaleb Hobson-Garcia, a transgender man, drove from Tallahassee to speak during a press conference in front of the Marriott Fort Lauderdale Airport as the Board of Medicine met in August 2022. [ JOSE A. IGLESIAS | El Nuevo Herald ]
Published Feb. 15, 2023

While Florida’s pending ban on gender-affirming care for minors has yet to take effect, treatment has already become harder to find across the state.

Some providers have stopped accepting new patients under the age of 18 for hormone therapy, while others are continuing to do so.

“There’s a lot of fear, especially in the health care field,” said Lana Dunn, a transgender woman and office manager of Spektrum Health, an Orlando clinic.

Last November, the Florida Boards of Medicine and Osteopathic Medicine approved rules that will bar doctors from prescribing puberty blockers, hormone therapy and surgeries to treat new patients younger than 18 for gender dysphoria.

Related: Florida to ban care for transgender youth — even in clinical trials

The state Department of Health had urged the medical boards to enact the restrictions, arguing that the care was “experimental” and no evidence proved it was effective.

The rules are at odds with existing treatment standards that have been endorsed by major medical organizations including the American Academy of Pediatrics and the Endocrine Society.

Related: Florida just banned transgender treatment for minors. What now?

The restrictions on nonsurgical care won’t apply to children already being prescribed medications to treat gender dysphoria, the distress felt by someone who doesn’t identify with the sex they were assigned at birth. They will be grandfathered in.

Here’s what to know about the impact of the pending rules.

When will the ban begin?

That remains unclear. A Florida Department of Health spokesperson didn’t respond to a request for comment.

Southern Legal Counsel, a Gainesville nonprofit law firm, plans to sue the state over the ban, according to Simone Chriss, director of its Transgender Rights Initiative.

Who has stopped taking new patients?

Related: Florida medical board is full of DeSantis donors

Late last year, Johns Hopkins All Children’s Hospital in St. Petersburg stopped taking new patients who are minors for hormone therapy, according to a spokesperson. The hospital is still providing the treatment to youth who were already receiving it.

All Children’s does not perform gender-affirming surgeries. It offers behavioral health services and social transitioning support to existing and new patients, the spokesperson said in an email.

In Orlando, Pineapple Healthcare, which specializes in LGBTQ health, has taken a similar approach.

Even though Florida’s ban has yet to begin, the clinic feared it would come under fire if it continued to allow minors to start puberty blockers or hormones, said Ethan Suarez, the chief executive officer. The clinic is still treating up to 10 children who were already receiving such care.

“We didn’t abandon them,” Suarez said.

Last year, Metro Inclusive Health, an LGBTQ-focused health and wellness center in Tampa Bay, updated its website to say it provides hormone therapy to those 18 and up, according to a version of the page saved by the Internet Archive’s Wayback Machine.

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Before that, the website listed no age restrictions for gender-affirming care.

A spokesperson refused to confirm whether the nonprofit had stopped taking new patients younger than 18 for hormone therapy.

The Tampa Bay Times in August reported that Nicklaus Children’s Hospital in Miami had stopped accepting new patients to its gender program, and several pediatric clinics had either followed suit or had ceased prescribing puberty blockers or hormones, according to Michael Haller, chief of pediatric endocrinology at the University of Florida.

It’s unclear how many youth in Florida receive gender-affirming care.

Related: Some hospitals stopping treatment for transgender youth in Florida

Who is still taking new patients?

Planned Parenthood of Southwest and Central Florida is still taking new patients and sees about 60 to 70 minors a year for hormone therapy, a spokesperson said in an email.

Until the pending ban is “finalized,” Planned Parenthood will keep providing gender-affirming treatment to youth “to the fullest extent allowed by the state,” said Stephanie Fraim, president and chief executive officer, in a statement.

Once the restrictions are in place, the nonprofit will “continue to provide care to everyone we can” in accordance with the rules, Fraim said.

Related: DeSantis budget office requires universities to detail gender-affirming care

The Youth Gender Program at the University of Florida is also accepting new patients, a spokesperson confirmed. The clinic does not offer surgeries to minors.

Spektrum Health, of Orlando, plans to keep treating youth with puberty blockers and hormones “until we’re not legally” able to do so, said Dunn, the office manager.

It’s still unclear how the ban will affect Spektrum Health, if at all. Medical doctors and osteopathic physicians don’t provide gender-affirming treatment at the clinic — nurse practitioners do, Dunn said.

“We’ll have to seek clarification,” Dunn said.

Telemedicine providers QueerDoc and QueerMed, which prescribe puberty blockers and hormones, are also accepting new pediatric patients from Florida.