Transgender flags on the step to D.C.
Image via Ted Eytan/Flickr (CC BY-SA).

Florida Just Took a Violent Step Toward Blocking Transition for Trans Adults

Removing gender-affirming care from Medicaid will cause more death.

After months of attacking transgender children and their families, Florida’s Agency for Health Care Administration (AHCA) released a statement signaling their move to severely limit gender-affirming care for trans adults through weaponizing Medicaid. Gender-affirming care refers to medical care that helps limit gender dysphoria. For those under 18 (or 19 in Alabama), this means temporary puberty blockers, and for adults, this can include hormone replacement therapy and surgeries.

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In a letter to the Florida Board of Medicine, Florida Surgeon General Joseph A. Ladapo (a person still trying to say the COVID-19 vaccines aren’t safe) admitted that the American Academy of Pediatrics (AAP) and the Endocrine Society recommended utilizing gender-affirming care. However, he quickly (and incorrectly) stated that they “follow a preferred political ideology instead of the highest level of generally accepted medical science.”

So, Ladapo found six people to support his plan to discredit the medical community’s research in support of gender-affirming care in the scientific community, setting things in motion to eliminate gender-affirming care from the state of Florida’s Medicaid program, as well as potentially getting the Florida Board of Medicine to ban gender-affirming care for transgender youth entirely. But this won’t stop with kids and teens. Designating certain treatments as “experimental” or otherwise dubious/ineffective opens the door to barring everyone from accessing them. It’s only the first step, but they know exactly what path they’re going down.

Who are these “doctors?”

In many cases, going into the biographies of doctors and scientists is pointless because the critical part is the research. However, in cases where their views go against those of nearly all other professionals within their field, it’s essential to know who these people are. Take the pandemic, for example. Many of the “expert” papers arguing in favor of opening schools ASAP came from people whose background was in economics, not child psychology, public health, or anything related. Also, there’s that infamous video of American Frontline Doctors (organized by Tea Party Patriots Action) claiming hydroxychloroquine is a COVID-19 cure. Many people in lab coats making these statements weren’t accredited or actually doctors, or they were known frauds in the medical community.

This method is very reminiscent of Republicans’ attitude toward climate change. The six “experts” selected by the state of Florida included Romina Brignardello-Petersen, Wojitek Wiercioch, James Cantor, Quentin Van Meter, Patrick Lappert, and G. Kevin Donovan.

The first two (like their contributions state on the documents) have no ties to or research background in anything related to this work. Their job in this venture was solely to attempt to discredit published research about gender-affirming care. They seem to take no qualitative data into account, which would be just as important when data collection regarding how people’s mental and emotional health changes over time with or without care. They outright bash eminence-based evidence despite this evidence being based on practicing physicians and psychologists working with patients.

Cantor is interesting because while he explicitly supported transitioning for (at least) adults in 2009, but the last few years have been a series of “well actually” declarations that erode support for the trans community and even resulted in him leaving the Society for the Scientific Study of Sexuality in 2020 following the publication of a blog post regarding JK Rowling. What started as a transphobic-lite critique is now mask-off, supportive of Matt Walsh’s transphobic film. (Just like the woman he was defending.)

Van Meter is best known for grifting with the American College of Pediatricians (ACP), a group that broke off from the AAP in 2002. As president of the ACP, he supports “conversion therapy” and is vocal against same-sex parenting couples. Van Meter and Lappert supported controversial conferences that headline anti-abortion, anti-divorce, and anti-trans literature. When not touring the South to fight against the LGBTQ+ community, Lappert works as a plastic surgeon and a Catholic deacon in Alabama. Donovan is best known for being an outspoken critic of pro-choice policies, and Republicans go to ethicists to argue for pro-birth policies.

It will never be enough

Once established, copycats of any rules Florida ultimately institutes that bar gender-affirming care from Medicaid will pop up across the U.S. and eventually affect private health insurance, too. Similarly, with book bans and challenges (and LGBTQ+ books made over half of the top ten most banned books in 2021), they moved from banning books in school libraries to public libraries, and then to private booksellers. This is the same playbook, with things starting out with a review of treatments offered by Medicaid, and then moving to the state Board of Medicine once they’ve come up with a justification to discredit treatment.

While the types of care that will be barred are also used by cisgender people (like cancer patients and those seeking cosmetic surgeries like breast augmentation), lawmakers are seeking to target trans people. Establishing gender-affirming care as “experimental” will pave the way for this attack on low-income patients in other states and make it easier to limit this, in the private sphere, to those privileged enough to have robust medical coverage and/or lots of money. The fact that people on Medicaid won’t be able to access this deserves alarm bells of its own. The most vulnerable will constantly be attacked first, meaning children and the poor.

Despite these Florida officials and TERFs calling transitioning “irreversible damage,” the real irreversible damage will be done to transgender people who can’t access the care that actual doctors agree will improve their lives and health outcomes. These steps toward systemically eradicating trans people (there’s a word for this used in international law) will not stop unless people act now. I’m talking from the top (Mr. Someone Should Do Something About This Joe Biden) down to you and me.

(via Twitter, featured image: Ted Eytan/Flickr (CC BY-SA))

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Author
Alyssa Shotwell
(she/her) Award-winning artist and writer with professional experience and education in graphic design, art history, and museum studies. She began her career in journalism in October 2017 when she joined her student newspaper as the Online Editor. This resident of the yeeHaw land spends most of her time drawing, reading and playing the same handful of video games—even as the playtime on Steam reaches the quadruple digits. Currently playing: Baldur's Gate 3 & Oxygen Not Included.