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Transgender community, parents fear fallout of Florida’s ban on gender-affirming care

Orlando Sentinel - 11/20/2022

Rebecca Davis drove two hours for a doctor’s appointment in Gainesville, hoping for reassurance that her transgender daughter would still be able to receive gender-affirming care.

Davis is the mother to a 16-year-old who has been on puberty blockers for a year and started hormone replacement therapy in July. Davis, an educator living in St. Augustine, said gender-affirming care has been life-saving for her daughter. But she worries that, under Florida’s current political climate, that may change.

Those concerns stem from the Nov. 4 decision of the FloridaBoard of Medicine and the FloridaBoard of Osteopathic Medicine to ban gender-affirming care for minors, which can include the administration of puberty blockers, hormone replacement therapy, or HRT, and gender-affirming surgery.

Although Davis’ daughter may continue her treatment, she said she is concerned that the medical boards made their decision without acknowledging the regulations already in place for minors dealing with gender dysphoria. She said her daughter had to go through processes and evaluations before receiving treatment.

“She had to socially transition for at least a full year before she was allowed to start medication at all, she had to be 16 years old before she was allowed to start HRT, she had to be examined by multiple disciplinary doctors, a team, to qualify for this treatment at all,” she said.

Davis’ took her daughter to the University of Florida Health Gender Youth Program Friday, where she said her doctor confirmed the teenager will be able to continue treatments, allaying her mother’s concerns.

For Davis, continuing the gender-affirming treatment that improved her daughter’s mental health is a priority. Her daughter has been diagnosed with Autism and has dealt with depression since elementary school.

“It was always at school where she would end up spiraling and she would say things like, ‘Everyone hates me, I should just kill myself and make everyone happy,’ and it would trigger the crisis team to come out,” Davis said. “I didn’t know what to do, I didn’t know how to help her.”

It wasn’t until a period during the COVID-19 lockdowns that Davis’ daughter came to her and opened up about her gender identity.

“She came to me and she said, ‘Mom, I am a girl and I need your help,’ and I said, ‘Okay, whatever it takes, I will do whatever it takes to help you,’ because I was terrified of losing my child,” Davis said.

Davis said supporting her child through her transition stopped her mental health from continuing to decline.

“When she started transitioning, it was like night and day,” Davis said. “She’s happy, she smiles, she has friends, she’s outgoing, she’s in clubs, she’s active and social. I don’t have to worry about her hurting herself anymore at all. It was like a miracle.”

Nikole Parker, director of transgender equality at Equality Florida, said she also worries for the future of transgender youth in Florida and fears they might end up accessing the care they need through dangerous practices. Parker, a transgender woman, transitioned at age 19 without access to the resources needed to live with gender dysphoria.

“I left my house, I fell into survival sex work, I was taking black market hormones because I didn’t know how to access healthcare and that’s the part that scares me so much,” she said. “… The thought of people having to go to black market hormones just to get what they need again scares me.”

Parker said the misconception that minors request and receive gender-affirming surgery without the proper evaluation fuels the stigma surrounding gender-affirming care. She said she needed letters from a therapist, a medical provider and a psychologist in order to receive gender-affirming surgery as an adult.

She also said, though the testimonies of people who have de-transitioned are important, they do not reflect the full experience of transgender people.

“While there are some who de-transition … that is not the typical scenario that you see when kids are able to be affirmed in their gender identity, you see them grow up to be happy adults living authentically,” Parker said.

Parker said she has received calls from parents fearful about the future of children who may need gender-affirming care and asking whether or not they should consider leaving the state.

Kat Duesterhaus, communications director of Florida Now, said despite the law not being in effect yet, Floridians are already uneasy about its implications.

“I have heard from a lot of trans folks, parents of trans kids that they are looking to move out of the state because it seems pretty sure that this rule will be approved and take effect very soon,” Duesterhaus said. “Right now we’ve got a lot of fear, a lot of anxiety, a lot of stress and we’re going to be losing people in our state that are contributing to our beautiful sunshine state, making it a more diverse and loving place.”

Duesterhau said the organization is pushing for public comment to speak against the ruling and working for a potential legal challenge of the decision.

Simone Chriss, a civil rights attorney and director of the transgender rights initiative at the Southern Legal Counsel, said her experience working with transgender youth and adults has shown her the need for this type of treatment.

“I personally watched the care being provided to these kids and it’s being provided according to evidence-based standards,” Chriss said. “The doctors that are providing this care are already following standards and the care works and all of the evidence shows that this care is effective, it is safe and it is medically necessary and it saves these kids’ lives.”

Chriss said the treatment ban infringes on Floridians’ rights.

“It substitutes the state’s judgment for that of the parent and interferes in the doctor-patient relationship and we are a state that holds itself out as caring about parents’ rights,” she said. “… Yet when it comes to making medical decisions for your child, which is one of the most deep-rooted fundamental protective rights in our constitution, suddenly parents don’t have rights anymore.”

Mel Turnage, a transgender woman and student at UCF, said gender-affirming care feels essential for young trans people. “For someone like me… going through a male puberty can be something traumatic and it makes a lot of changes to the body that for some people are just unwelcomed.”

Turnage transitioned at age 20, when she started feminizing hormone therapy. She said being on Estrogen makes her feel more aligned with her identity, more grounded mentally and physically.

“If I had started on hormone therapy or on puberty blockers in my teens, I would definitely feel better off than I am today,” she said.

Parents like January Littlejohn disagree with the approach of gender-affirming care. Littlejohn attended the Oct. 28 public meeting of the two medical boards and said she prevented her daughter from transitioning.

Littlejohn said her daughter expressed discomfort with her gender in the spring of 2020. She said her daughter, 13 years old at the time, only expressed discomfort with her gender identity after three other friends came out as transgender.

She said she worked with a licensed mental health professional to explore her daughter’s journey.

“We also gave her more one-on-one time, in-person activities away from trans influencers, limited her internet use and declined to affirm her newly-chosen name and pronouns,” Littlejohn said. “We set appropriate boundaries and allowed her to choose her hair and clothing but denied harmful requests such as breast binding, puberty blockers, cross-sex hormones and surgeries.”

Littlejohn said her daughter’s discomfort came from a fear of being sexualized, self-esteem issues and online influence. She said her daughter has now desisted from wanting to transition.

“I have spoken to many parents in Florida and they are not being informed of all treatment options when they seek help for their child, many times they are being convinced by medical professionals that affirmations and medicalization is their only option to avoid the impending suicide of their child,” she said.

Littlejohn said suicide is portrayed as a consequence of denying gender-affirming care rather than a risk, which she said pushes parents and children to make decisions they can later regret.

For Davis and her daughter, receiving gender-affirming care has been the only option and difficult to obtain, even before the new rules.

“Gainesville is the only place that it’s offering healthcare to these kids in the State of Florida, so we’re driving two hours for her to get her healthcare anyway… it’s already limited,” she said.

Davis said she will find alternatives to help her daughter if that care becomes unavailable, whether that is moving out of the state or finding medical providers online.

“All I know is I am not going to allow my child to be hurt by these ignorant people,” Davis said.

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