Board of Medicine votes to start writing rules for gender-confirming treatment of minors

The Florida Board of Medicine on Friday voted to initiate the rulemaking process for minors seeking gender-confirming therapy, hormones and surgery.

With the exception of Dr. Kevin Cairns, the board members present voted during their meeting in Dania Beach in favor of beginning the rulemaking process. The vote follows a petition from the Department of Health proposing rules that would ban doctors from performing gender-confirmation surgeries and prescribing puberty blockers for minors diagnosed with gender dysphoria.

Surgeon General Joseph Ladapo, who has previously advocated for rules banning gender-confirming surgery and hormones for minors, offered support for the Department of Health’s petition at the start of Friday’s discussion at the Marriott Fort Lauderdale Airport.

“Puberty is such an elaborate and confusing time,” Ladapo said. “On the safety, again, it is incontrovertible. There clearly is a level of risk with these procedures, both the hormone therapy and hormone blockers for individuals who are in puberty, and for the surgical interventions.”

The nearly three-hour public comment period, which board chair Dr. David Diamond inexplicably cut short by an hour, ended with crowd members chanting “shame” at the board and security ousting at least one person who attempted to speak once the public comment period concluded.

“You’re lapdogs for the governor,” one man yelled before exiting the conference room. “The surgeon general is a lapdog for the governor.”

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Many proponents of the rulemaking process were also in attendance, identifiable by stickers that read, “let kids be kids.” For the most part, they argued children are too young to make important medical decisions.

“I don’t believe that a child can give informed consent,” said Dennis Conklin, a Plantation resident.

Some tell their stories

But that viewpoint was contrasted with comments from speakers who are now adults and transitioned in their teenage years.

College student Kaleb Hobson-Garcia said he was 13 when he began taking testosterone, and 14 when he initiated the process for “top surgery.” He added that his doctor made him wait a year between each new major step in the transitioning process.

“My identity is not an epidemic,” Hobson-Garcia said. Diamond, the board chair, asked Hobson-Garcia to explain the concept of gender fluidity, and whether or not it means trans children will eventually de-transition.

“I am a binary male. My identity will not change — same as you,” Hobson-Garcia responded. “If that identity has not changed in a decade, I believe we should trust that person to know who they are.”

Currently, the state has no laws on gender transition treatment. However, Dr. Michael Haller, chief of pediatric endocrinology at the University of Florida, explained that medical institutions like the American Academy of Pediatrics have established a standard of care which dictates, for example, that puberty blockers should not be given to prepubertal children, that mastectomies should only be offered to children 16 and older, and that genital surgeries should only be offered to people 18 and above.

“This has been pushed to you, the board, as a political maneuver,” Haller said of the Department of Health’s petition. “Trans people have always existed. They will always exist. Whether you choose to acknowledge [them] doesn’t change that.”

Following Friday’s vote, the Department of Health will initiate rulemaking workshops with dates and locations to be determined. It is unclear what timeline, if any, the board has in mind for establishing these guidelines.

Board member Dr. Patrick Hunter said he was voting in favor of rulemaking in part because he doesn’t think the Department of Health’s proposed rules are nuanced enough.

“It sends a message that these kids don’t need care, and they do,” Hunter said. “The question is, what is the best care?

“I heard that there’s only one route to a trans identity,” he added, “and that’s being born that way.”