Coming on the heels of the “don’t say gay” law and one political attack after another across the country on LGBTQ+ youth, the Florida Department of Health piled on by releasing guidelines opposing all forms of gender-affirming care for the treatment of youth gender dysphoria, including social affirmation and transition.
In this despicable attempt to demonize potentially life-saving, gender-affirming care for youth, the state health department cited a few outdated, methodologically flawed studies published in low-impact journals and an opinion piece that contradicts formal medical guidelines and ignores an entire body of reputable research. This is commonly known as “cherry picking data.” These misleading claims try to hide the true harm of these “guidelines,” which will damage the well-being of transgender and non-binary youth and their families.
Transgender and non-binary youth are at high risk for self harm, with more than half contemplating suicide in 2021. Similarly, rates of self-injury and suicide attempts are much higher among youth with gender dysphoria. Multiple studies demonstrate improved mental health outcomes for youth, including reduced risk of suicide, after receiving gender-affirming care (social transition, suppression of puberty and/or hormone treatment). Social transitions, such as chosen name use are linked to reduced depressive symptoms, fewer thoughts of suicide and suicidal behavior among transgender teens.
Major medical entities, including the American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Academy of Pediatrics and the Society of Endocrinology have denounced the dangerous “guidelines” released by the Florida Department of Health.
The recent relentless attacks on LBGTQ+ youth, particularly in Florida, have already revealed devastating impacts on youth mental health and created a hateful, yet normalized, rhetoric among some Florida political figures. Focus on youth mental health is critical, but recent Florida legislative actions will negatively impact all youth and disproportionately affect minorities.
The American Academy of Pediatrics declared a national emergency in youth mental health in October 2021. We know that Florida’s teens are not spared. Just look at the Centers for Disease Control and Prevention’s Youth Risk Behavioral Survey, a unique source of data that allows examination of trends among youth health risk behaviors and supports the development of comprehensive public health policy.
According to this survey, from 2009-2019 the percentage of Florida high school students who seriously considered attempting suicide increased from 12 percent to 16 percent, and approximately 8 percent attempted suicide. It is concerning that Florida continues to rank as one of the lowest states in spending and access to mental health care. Suicide is preventable and, now more than ever, this data is vital particularly among racial, ethnic, sexual and gender youth who are all at increased risk for poor mental health outcomes.
And yet, Florida has recently quietly withdrawn from the very survey that has yielded these troubling insights. One may surmise that Florida’s leaders are attempting to hide the damage these new policies and laws will inflict on our youth.
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Youth mental and behavioral health data collection, LGBTQ+ inclusivity, access to gender affirming care and policies focusing on adequate mental health services for youth are paramount to address our mental health crisis. Recent legislative actions taken by the state and now the state Department of Health are reckless and will have reprehensible impacts on youth.
Natasha L. Poulopoulos is a pediatric psychologist in Miami. She teaches seminars regarding gender and sexual diversity and an affirming care approach across medical departments. She is a member of the Society of Pediatric Psychology and has co-authored several peer-reviewed publications and presentations.