We, the undersigned, strongly condemn the Florida Board of Medicine’s recent decision to begin the rule-making process to create Florida-specific “standards of care” for gender-affirming healthcare for transgender, non-binary, and gender-diverse youth. Despite the Board of Medicine’s claims to be an apolitical body acting on behalf of all Florida residents, the board meeting on August 5th, 2022, revealed an explicitly political agenda. Governor Ron Desantis’ hand-picked appointees on the Board of Medicine initiated these proceedings as one of several policy attacks on LGBTQ+ people in Florida.

We condemn the actions of Governor Ron DeSantis, Surgeon General Ladapo, the Florida Board of Medicine, and the Florida Department of Health, for their intentional misrepresentation of scientific research, their deliberate exclusion of the vast body of scientific research that demonstrates the benefits of gender-affirming healthcare, and their assertion of the explicitly transphobic, scientifically debunked, so-called “social contagion theory.” We also condemn the Florida Board of Medicine’s decision to call on the overtly transphobic, biased, and discredited Dr. Quentin Van Meter. Van Meter’s “American College of Pediatricians” organization is an anti-LGBTQ+ hate group, not a medical authority.

For those involved who took the Hippocratic oath to ‘do no harm,’ we need you to know — this is harm.

We further condemn the actions of Florida Board of Medicine members during the meeting. Through intentionally intrusive and leading questions, they disrespected those opposing the rule-making petition, including respected clinicians and trans/non-binary youth and adults who shared personal testimonies. The Board of Medicine also failed to question or moderate public comment from those who spoke in favor of the petition, even when they employed dehumanizing, racist, and transphobic rhetoric and hate speech. And their calculated decision to end public comments 90 minutes early silenced dozens of trans activists and allies who waited hours to speak.

Additionally, we condemn the anti-trans violence that occurred before, during, and after the meeting. The Board of Medicine inappropriately chose to hold a public meeting concerning the health of citizens statewide on private property in South Florida, failing to provide safe restroom options for all people in attendance. Meanwhile, officers from the Broward Sheriff's Office (BSO) targeted, profiled, and arrested LGBTQ+ attendees, and security and building staff harassed them. Finally, attendees were subjected to targeting and intrusive surveillance by representatives of the extremist groups “Let Kids Be Kids Coalition” and “Moms for Liberty.”

Surgeon General Ladapo, the Florida Board of Medicine, and the Florida Department of Health have made myriad false claims about evidence-based gender-affirming care (pubertal suppression, hormonal and surgical treatments, and social transition support). Meanwhile, a robust body of research confirms the benefits, safety, and life-saving medical necessity of this care. A Cornell University meta-analysis of 55 primary peer-reviewed research studies published from 1991 to 2017 found that “gender transition, including medical treatments such as hormone therapy and surgeries, improves the overall well-being of transgender individuals.” Decades of literature indicate that the accessibility of both medical and social transition support contributes to a better quality of life for trans and gender-diverse people.

Last year, the American Medical Association (AMA) formally urged governors to oppose state legislation that would prohibit medically necessary gender transition-related care for minor patients, calling such efforts “dangerous governmental intrusion into the practice of medicine.” The AMA cited that “trans and non-binary gender identities are normal variations of human identity and expression” and that “evidence has demonstrated that forgoing gender-affirming care can have tragic consequences.” Furthermore, the AMA asserted that “Decisions about medical care belong within the sanctity of the patient-physician relationship.”

Additional policy statements and guidance from expert bodies of medical and mental health professionals, including the National Association of Social Workers, the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the Endocrine Society, the National Alliance on Mental Illness, and the United States Professional Association for Transgender Health recognize the evidence and myriad benefits of gender-affirming care and the importance and nature of the patient/provider relationship, which ensures clinically appropriate plans of care for each individual.

Existing international standards of care already offer clear guidance for providing these treatments in safe, affirming, and supportive ways. The Florida Board of Medicine’s decision to open rule-making on treatments that have not resulted in complaints or disciplinary hearings, and which impact a very small percentage of the population, further indicates a political agenda. Legislative attacks against trans and gender-diverse people, especially youth, are rising across the country. The Florida Board of Medicine’s decision serves not to protect ALL youth, but rather to harm trans and gender-diverse youth for political gain.

We would like to address the following points that the Florida Board of Medicine misused to justify restricting access to gender-affirming care for minors:
- While Florida currently does not have state-specific standards for providing gender-affirming care, that does not mean that such care is unregulated in the state. Providers follow extensive Standards of Care set by the World Professional Association for Transgender Health (WPATH). Developed over decades (beginning with Version 1 in 1979, with Version 8 released just this month) on the basis of sound research, ethical principles, and accumulated expert knowledge, these guidelines offer safeguards and insights for providing gender-affirming care for minor patients.
- Several studies included in the August 5th public book of materials were intentionally misrepresented, and materials did not include recent and relevant research on the demonstrated benefits of gender-affirming care. Furthermore, researchers involved in several of these studies stated their findings were intentionally misconstrued and misused by Florida’s Board of Medicine.
- The politically-charged claim that young transgender and non-binary children are going through a temporary phase—that around 80% of them will spontaneously “desist” gender incongruence and identify as cisgender by natal puberty—is rooted in biased and scientifically flawed studies, and is not supported by sound scientific evidence. The studies cited by the Board were marred by sample bias, scooping up large numbers of gender nonconforming children never tested for clinical gender incongruence. One of these studies even misrepresented youth who missed follow-up interviews as “desistance.” Furthermore, the “80% desistance” myth is refuted by ongoing longitudinal studies of gender incongruent youth who socially transitioned in childhood. A 2022 article in the journal, Pediatrics, found only 2.5% (not 80%) reverted to their birth-assigned gender and identified as cisgender, five years after initial social transition.
- In recent years, a pseudo-scientific diagnostic label of “rapid-onset gender dysphoria” (ROGD) has been widely publicized. This myth posits that the rising visibility of trans and non-binary adolescents accessing medical services represents an “epidemic” of “social contagion” and “mental illness,” rather than the emergence of gender-diverse youth who had been forced to hide their existence in prior generations. “ROGD” is not a legitimate medical term. It is not recognized by any major professional association and is based on extremely biased surveys of members of known anti-trans hate organizations. The “ROGD” stereotype fails fundamental scientific principles by conflating correlation with causality. [This is analogous to the history of left-handedness in the U.S., which appeared to increase four-fold in the early 20th century because of growing social acceptance. Left-handed people in prior generations had simply not been allowed to exist in society and were repressed into invisibility.]

We will not remain silent as the powers that be in Florida attempt to strip rights from our youth. We demand the Florida Board of Medicine abandon all efforts to restrict access to gender-affirming care and ensure uninterrupted access to care for transgender and gender-diverse minors throughout the state. If Florida-specific standards of care are adopted, they must reflect the most current version of WPATH Standards of Care and be maintained and updated on an ongoing basis to reflect future updates to the WPATH Standards of Care.

We also demand that the Florida Board of Medicine do the following:
- Center the voices and experiences of trans and gender-diverse youth and their families in all future public meetings and decision-making processes related to this topic. Florida also has a wealth of dedicated and knowledgeable LGBTQ+ organizations and medical professionals who can provide informed counsel to the Board. Additionally, the Florida Board of Medicine should seek input and guidance from LGBTQ+ communities for the duration of this process.
- Prohibit Dr. Quentin Van Meter from participating in future discussions and decision-making related to gender-affirming care in Florida. Dr. Van Meter’s affiliations with anti-LGBTQ+ hate groups and the 2020 decision of a Texas judge to disqualify him from testifying on gender-affirming care demonstrate that he is not a “subject matter expert.” Van Meter aims to undermine care for transgender people and to spread anti-LGBTQ rhetoric under the guise of “science.”
- Conduct an unbiased review of scientific data related to gender-affirming care. If the Board of Medicine’s rule-making process is truly to be based on science, the Board of Medicine must examine all available and legitimate data, rather than cherry-picking and misrepresenting studies to support political agendas.
- Consult legitimate resources on transgender experiences and gender identity prior to holding future discussions of gender dysphoria. Comments from members of the Board revealed a lack of basic knowledge regarding transgender topics. There are reputable entities that offer introductory content on gender diversity and the experiences of gender-diverse individuals.
- Center the physical safety of transgender participants in all future public meetings. Meetings must be held at accessible public property venues with gender-inclusive restrooms. Failure to provide suitable accommodations for transgender and non-binary attendees at meetings of tremendous relevance to their health is unacceptable. It is impossible to equitably and meaningfully participate in discussions while simultaneously fearing repercussions and attacks.

We won’t be silent, and we won’t be silenced.

Sincerely,
The Undersigned