Florida Health Dept. advises against gender treatments for young people

ByAlyson R. Briggs

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ORLANDO, Fla. – New guidance rolled out Wednesday from the Florida Department of Health (FDOH) on the treatment of gender dysphoria for children and adolescents.

The American Academy of Pediatrics defines gender dysphoria as a “clinical symptom that is characterized by a sense of alienation to some or all the physical characteristics or social roles of one’s assigned gender.”

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The FDOH is going against the guidance released by the U.S. Department of Health and Human Services, as well as the American Academy of Pediatrics, regarding treatment.

The state claims there is a lack of evidence and potential for long-term irreversible effects.

These are the department’s guidelines:

  • Social gender transition should not be a treatment option for children or adolescents (includes gender-affirming haircuts, using pronouns and name changes)

  • Anyone under 18 should not be prescribed puberty blockers or hormone therapy

  • Gender reassignment surgery should not be a treatment option for children or hormone therapy

The department says based on the current 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.”

FDOH recommends children and adolescents be provided social support by peers and family. The state also suggests they seek counseling from a licensed provider.


The state notes the guidelines are in line with the guidance, reviews and recommendations from Sweden, Finland, the United Kingdom, and France.

The guidance from FDOH met with criticism on social media, including from Democratic lawmakers and LGBTQ groups.

Marnie Bialosuknia said she feels like the health department is turning its back on kids.

She has a transgender daughter. Even with a supportive family, she said her daughter experienced depression, anxiety and suicidal thoughts.

“If I were to say well, you can’t continue taking your hormones, we have to stop the transition, I don’t know what would happen,” Bialosuknia said.  “I can’t even bring myself to go there because it’s really scary.”

Dr. Jason Rafferty was the lead author for the American Academy of Pediatrics 2018 policy statement on care of transgender and gender diverse youth.


He said he is worried for kids who may feel out of place in the process of figuring out who they are.

Dr. Rafferty pointed out “inaccuracies” in FDOH’s guidance. He said the department is looking at treatment through a black and white lens.

“Using somebody’s name, allowing somebody to style their hair or wear certain clothes, are not irreversible interventions,” Dr. Rafferty said.

He said the department opposed what AAP is trying to foster as the standard of care.

“The guidance from FDOH is really a statement against really any form of gender affirmative care,” Dr. Rafferty said.

The AAP guidance urges families to seek medical care for their child, including from a pediatrician and from a licensed mental health professional who specializes in gender-affirming care. The guidance supports social affirmation, as well as reversible puberty blockers up to the age of 16.

Bialosuknia fears insurance companies will begin limiting coverage for these types of treatments. Other treatments that may not be reversible, such as surgery, are recommended only for adolescents on a case-by-case basis, and only with the guidance of medical professionals.


“If you take away their medical care, if you take away everything that’s going to make them feel like their true self, even with support it’s going to be very detrimental to their health,” she said.

Bialosuknia said she feels like this is a violation of rights and hopes this does not deter families from doing their own research and seeking quality care for their children.

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