Florida’s Department of Health said on Wednesday, contradicting a recent Health and Human Services (HHS) Department fact sheet, that minors should not be permitted surgery
or medications such as puberty blockers and hormones, nor “social gender transition” like name or pronoun changes.
Instead, Florida reaffirmed that the only correct treatment of gender dysphoria for minors should be professional counseling and social support from peers and family that does not include encouraging them to change their name or pronouns or wear “gender-affirming” clothing.
The guidance was in direct contrast to a fact sheet issued by the HHS that said “gender-affirming” care “improves the mental health and overall well-being of gender diverse children and adolescents.”
Florida Surgeon General Joseph Ladapo said in a news release that “the federal government’s medical establishment releasing guidance failing at the most basic level of academic rigor shows that this was never about health care. It was about injecting political ideology into the health of our children."
Dr. Ladapo’s guidance noted systematic reviews on hormonal treatment for young people show a trend of low-quality evidence, small sample sizes, and medium to high risk of bias. A paper published in the International Review of Psychiatry states that 80% of those seeking clinical care will lose their desire to identify with the on-birth sex.
One review concludes that "hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact is generally lacking."
He added that "children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18.”
Florida’s Health Department emphasized in its guidance that minors should not be permitted to access gender-affirming care, because the brain's prefrontal cortex – the section that carries out executive functions such as decision making – is not fully developed until a person is 25 years old.
Dr. Ladapo’s guidance was quite clear in stating “Gender reassignment surgery should not be a treatment option for children or adolescents.” Further stating that, “Based on the currently available evidence, "encouraging mastectomy, ovariectomy, uterine extirpation, penile disablement, tracheal shave, the prescription of hormones which are out of line with the genetic make-up of the child, or puberty blockers, are all clinical practices which run an unacceptably high risk of doing harm."
The state guidance also stated that giving “gender-affirming” medical treatments to those under 18 years of age boosts the risk of cardiovascular disease, osteoporosis, infertility, increased cancer risk and thrombosis.
In the statement released Wednesday, the FDOH said the U.S. Department of Health & Human Services' recent stance on the issue was an "unscientific shift," and we agree.
However, as Florida Department of Health Press Secretary Jeremy T. Redfern said in a post-guidance statement:
"Guidance, by definition, is not 'enforced' by the state. It is an official statement issued by the agency to inform the public of its recommendations and the evidence that informs those recommendations.
Physicians may use guidance from different authoritative sources, including government entities and professional associations, in determining the best course of treatment for their patients. The Florida Department of Health's guidance on the treatment of gender dysphoria for children and adolescents was published to help inform healthcare providers, patients, and families about what the evidence actually supports and doesn't support."
Unfortunately, because Florida Surgeon General Joseph Ladapo’s guidance is only guidance, and not a legally binding prohibition of the surgical mutilation of young children disguised as “gender-affirming care,” Florida’s children remain at risk.
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