August 26, 2024 Update:
A 3-judge panel of the 11th Circuit Court stayed Judge Hinkle’s injunction. Care restrictions in Florida are back in effect.
June 2024 Update:
On June 11, 2024, Judge Hinkle ruled in the Florida District Court in the case Doe v. Ladapo and struck down the majority of restrictions on transgender medicine in Florida. We expect the ruling to be appealed, but for the moment, the specific restrictions that are no longer in place:
- prescriptions must be made by doctors (MDs, not physician assistants (PAs) or nurse practitioners (NPs)
- annual hand x-rays for youth
- DEXA scans for youth
- mandatory mental health assessments conducted only by a licensed psychiatrist or psychologist
- in-person visits every 6 months
- suicide assessments every 3 months for youth
- labs every 4 months for youth
- State-created consent forms for youth and adults
- the State cannot prosecute providers for any of the above
We are awaiting analysis regarding the status of the requirement for an in-person informed consent discussion.
Florida seems to change up their requirements for obtaining gender affirming care every day. It’s exhausting! The Florida Board of Medicine and the Osteopathic Medicine Board had a joint meeting at the end of June, 2023 where they finalized the text of the consent documents for gender affirming care now required by law. We’re sharing those requirements and those state-developed consent forms with you.
Do not allow any of the below-described requirements to delay seeking gender affirming care, especially with QueerDoc. You and your prescribing clinician can discuss how to proceed ethically with your care utilizing informed consent. QueerDoc follows national standards of care. Florida does not collect these forms.
Note: individual prescribers may also utilize other consent forms in addition to the Florida state-approved ones.
We love access to information: we’re sharing the now-required Florida consent documents below. Content note: we find some of the language in the consent documents to be biased, medically inaccurate, and just plain gross. Proceed with caution.
We utilize an informed consent model and love discussing the risks, benefits, timelines, and expectations around starting hormones.
It’s a big reason why our adult initial medical intake visits are an hour long and we take two hours with new youth patients: we want you to have all the time and information you need to make decisions about your body and your healthcare.
For our current Florida patients: your clinician will review these requirements with you in detail at your next appointment.
Are you interested in becoming a QueerDoc patient? Book a free 15-minute introductory appointment to learn more about how we work!
CONTENT NOTE: we’re copying Florida’s official language below. There’s a lot of wording in the consent forms that is icky. Shields up!
To obtain gender affirming care utilizing estradiol (estrogen,) anti-androgens, progesterone, puberty-suppressing medication, or testosterone, Florida state law now:
REQUIRES FOR ADULTS:
(note – these were updated in August 2023)
- An in-person visit with a physician (MD or DO.)
- (NEW) A consent form signed by the patient, the physician, and a witness, while all are physically in the same room
(NEW) The consent form adds a new requirement: adults must undergo a thorough psychological and social evaluation performed by a Florida licensed board-certified psychiatrist or a Florida licensed psychologist and the clinician must submit a letter to the prescribing physician.This requirement to start care has been removed.- By signing the consent form, the physician, patient, and witness all agree that:
- The individual meets the criteria for gender dysphoria as per the DSM or ICD.
- Any mental or physical health conditions that could negatively impact the outcome of treatment have been assessed, with risks and benefits discussed.
- The individual has the capacity to consent.
- The individual does not have a psychiatric comorbidity that interferes with the diagnostic work-up or treatment.
- The individual has psychological and social support during treatment.
- The individual demonstrates knowledge and understanding of the risks and benefits
- The individual understands the effect of hormone therapy on reproduction and they have explored reproductive options
To CONTINUE care:
- THIS REQUIREMENT HAS BEEN REMOVED
EVERY 2 YEARS: adults must undergo a thorough psychological and social evaluation performed by a Florida licensed board-certified psychiatrist or a Florida licensed psychologist and the clinician must submit a letter to the prescribing physician. Florida requires a letter within the next two years if you are an established patient. - The language as of 8/2023 states that “the following may also be recommended by your prescribing physician”:
- An in-person evaluation by the prescribing physician or their designated covering physician every 3 months for the initial year and at least annually thereafter;
- Undergoes a suicide risk assessment by a licensed mental health care professional at least every 3 months for the inital year and at least annually therafter;
- Undergoes relevant laboratory testing at least every 6 months;
- Annual bone density scan (DEXA) once a year for the first 5 years to allow monitoring of your bone density (bone strength) during treatment, which can be altered by HRT;
- Annual mental health assessments by a board-certified Florida licensed psychiatrist or psychologist; and
- Continued counseling with a licensed mental health care professional during the treatment period, with the frequency recommended by the licensed mental health care professional.
Download the FLORIDA ADULT consent forms:
CONTENT NOTE: There’s a lot of wording in the consent forms that is gross and biased. Shields up!
REQUIRES FOR YOUTH:
- An in-person visit with a physician (MD or DO.)
- (NEW) A consent form signed by the youth, at least one of their adults (parent or legal guardian,) the physician, and a witness, while all are physically in the same room
- By signing the consent form, the physician, youth, parent or legal guardian, and witness all agree that:
- (NEW) The youth must undergo a thorough psychological and social evaluation performed by a Florida licensed board-certified psychiatrist or a Florida licensed psychologist and the clinician must submit a letter to the prescribing physician.
- (NEW) The youth must be seen by the prescribing physician or their designated covering physician at least every 6 months.
- (NEW) The youth must undergo a suicide risk assessment by a licensed mental health care professional at least every 3 months.
- (NEW) The youth must have bloodwork done at least every 4 months.
- (NEW) The youth must have a hand x-ray at least once a year if still growing.
- (NEW) The youth must have an annual DEXA (bone density scan.)
- (NEW) The youth must undergo annual mental health assessments by a board-certified Florida licensed psychiatrist or psychologist.
- (NEW) The youth must have continued counseling with a licensed mental health care professional during the treatment period.
- and
- The individual meets the criteria for gender dysphoria as per the DSM or ICD.
- The youth has pubertal changes resulting in an increase in gender dysphoria.
- The youth does not have a psychiatric comorbidity that interferes with the diagnostic work-up or treatment.
- The youth has psychological and social support during treatment.
- The youth has reached at least Tanner Stage 2 in puberty and this has been confirmed by a physician.
- The individual demonstrates knowledge and understanding of the risks, benefits, and expected outcomes of HRT as well as the medical and social risks and benefits of sex reassigment surgery.
Download the FLORIDA YOUTH consent forms:
CONTENT NOTE: There’s a lot of wording in the consent forms that is gross and biased. Shields up!
Other Resources For FLORIDA
Letters:
The Florida requirements specify that you’ll need a letter from a Florida-licensed board-certified psychiatrist or a Florida-licensed psychologist. These are MD, DO, PsyD, or PhD level providers.
Please see our State-Based Resources Page for mental health providers in Florida.
Are you an affirming board-certified licensed psychiatrist or psychologist in Florida? We’d love to talk to you about adding you to our resources page. Please contact us at info@queerdoc.com.
The GALAP is an incredible resource of mental health providers who have pledged to offer free or low-cost mental health letters to individuals seeking gender affirming care.
The Campaign for Southern Equality has funding for emergency support for youth and families.
Equality Florida’s TransAction resource guide.
Also see our blog Terrific Resources for Terrible Times.
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