Advocates slam the Florida Department of Health’s guidance to discourage children from socially transitioning

• Advocates blasted the Florida Department of Health’s new guidelines for treating transgender children.
• The guidelines advise doctors against providing transgender people under 18 with puberty blockers or hormone therapy.
• The guidance also notably suggests that transgender children should not even “socially transition.”

The Florida Department of Health broke with the US Department of Health and Human Services on Wednesday, issuing guidance that seeks to limit the treatment options for transgender children in Florida.

The recent report, which is non-binding, suggests that anyone under the age of 18 “should not be prescribed puberty blockers or hormone therapy,” breaking with the American Medical Association and other leading experts’ guidance in treating transgender children.

The Florida Department of Health’s report also says that children or adolescents should not be eligible to receive gender reassignment surgery, which medical experts have historically not recommended for transgender people under 18.

In addition to the new medical guidelines, the Florida Department of Health also said that “social gender transition should not be a treatment option for children or adolescents.” The Department of Health and Human Services classifies a social affirmation/transition as simply “adopting gender-affirming hairstyles, clothing, name, gender pronouns, and restrooms and other facilities.” 

Experts and advocates told Insider that Florida’s new guidance could be the first of many restrictions that the state could roll out handicapping the transgender community and stressed that affirming a transgender child’s gender identity can directly lead to lower suicide rates among the group.

Some trans children experience gender dysphoria or “the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics,” according to the Mayo Clinic, and this can strain mental health.

According to a recent report from the Department of Health and Human Services, “Research demonstrates that gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents.”

Sam Ames, the director of advocacy and government affairs for The Trevor Project, an LGBT suicide-prevention nonprofit, told Insider in a statement that simply supporting transgender children’s identities can greatly reduce the risk of suicide.

“Decades of evidence demonstrates that affirming transgender and nonbinary youth in their identities contributes to positive mental health outcomes and can reduce the risk for suicide,” Ames said. “That’s why gender-affirming care is considered best practice by every major medical and mental health association and embraced by providers across the country.”

Erin Reed, a transgender advocate who tracks bills and government directives for the transgender community, told Insider that Florida’s directive is particularly heinous due to its inclusion that directs children not to socially transition.

“I can say that this particular directive in Florida, with the inclusion of the social transition restriction that they wish to place, if actually acted upon by other agencies within Florida, would be the worst that I’ve seen in any of the states,” Reed said. “This actually says that even if you make the decision not to medically transition as a teenager or as a child, you would also be restricted from expressing your gender identity.”

Reed said that the Florida guidance is part of a growing wave of directives and legislation from the Republican Party restricting transgender people in the public sphere, citing other legislation including a lawsuit in Massachusetts in part debating whether a teacher should be allowed to affirm transgender children in their classroom.

“A lot of people think that this stuff is happening far away, but this is part of a building movement on the right to eliminate transgender people from public participation in public life, especially focused on transgender youth,” she said.

Ari Drennen, the LGBTQ program director for the left-leaning Media Matters For America, spoke with Insider and said that conservative media has increasingly set its focus on the transgender community in recent years.

“I think anti-trans legislation has been a really major focus of the right-wing media in the last couple of years,” Drennen said. “And we’re seeing a pretty straight line between those attacks and anti-trans legislation in the states.”

Alejandra Caraballo, a clinical instructor at Harvard Law School’s Cyber Law Clinic and a transgender activist, told Insider that the guidance, while not binding, could hold “tremendous ramifications” for transgender people in the state and across the country. 

“Having the state come out and say that the existence of trans kids isn’t recommended by the state of Florida can increase substantial amounts of harassment and threats to kids in schools by other students, teachers, and administrators,” Caraballo said.

Both Caraballo and Reed told Insider that the guidance will likely also lead to an influx of transgender children and their families leaving the state. Caraballo said she thinks the state of Florida will likely issue even stricter guidance and legislation against gender-affirming care for transgender children.

“I honestly think a lot of people will see what’s happened in Alabama and Texas and realize that this is probably just the first salvo,” Caraballo said, “we haven’t seen another move by DeSantis, but I think the working assumption for most people should be is that he will likely weaponize this even further.” 

When asked for comment on the dissonance between the department’s new guidance and that of major medical associations, a spokesman for the Florida Department of Health told Insider the “department’s guidance and fact check both rely on a high standard of evidence, and we believe that it speaks for itself.”