The Florida Department of Health issued a guidance memo on the treatment of gender dysphoria for children and adolescents on April 20, 2022
In this memo, the Department of Health relies on outdated and poor-quality research to advise that transgender children and youth in the state of Florida should not have access to social or medical transition. Gender-affirming care saves lives. QueerDoc continues to stand in support of Florida youth.
This is cruel, unscientific, and not evidence-based medicine. In fact, current studies indicate that desistance among trans adolescents who receive care is extremely low. Other studies have shown improved safety and mental health, including suicidal thoughts (see our list of studies at the end of this article.)
The current body of evidence strongly supports affirming care for youth with gender dysphoria. Current clinical guidelines that support gender-affirming care have been endorsed by all of the major medical policy organizations in the United States, including:
- American Academy of Pediatrics
- The Endocrine Society
- The Pediatric Endocrine Society
- American Academy of Child and Adolescent Psychiatry
- American Academy of Family Physicians
- American Academy of Pediatrics
- American College of Obstetricians and Gynecologists
- American College of Physicians
- American Medical Association
- American Osteopathic Association
- American Psychiatric Association
- American Public Health Association.
For our patients in Florida, we want you to know that:
This guidance memo IS NOT LAW.
Gender-affirming care is STILL LEGAL in Florida for both youth and adults.
We are not changing our practices or our care at this time.
In the event that Florida (or any other state we see youth in) criminalizes gender-affirming care for youth,
we are working to create policies and procedures that will allow for continued care.
We intend to continue providing care.
If gender-affirming care for youth (or adults) is banned in any state we practice in, we will work to ensure that our patients can continue to receive care.
Our plans in progress:
Patients will need to be physically in a state where we are licensed to practice medicine for their appointments. For Florida youth, this will mean traveling out of state.
We understand that this may pose a significant financial burden to our patients and their families. For these patients, we will open up our scholarship fund to cover travel for the patient and one caregiver to attend appointments. Please contact your provider for more information.
Our work to provide uninterrupted care is dependent on funding. Please consider donating to our scholarship fund to support Florida youth and other patients with financial barriers to gender-affirming care. Note: our access fund is paused in October, 2024.
Current Evidence Supporting Gender-Affirming Care for Youth:
We have sorted roughly by date, with the most recent articles first.
Tordoff, D. M., Wanta, J. W., Collin, A., Stephney, C., Inwards-Breland, D. J., Ahrens, K. (2022) Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Network Open, 5(2), e220978.
Turban, J. L., King, D., Kobe, J., Reisner, S. L., & Keuroghlian, A. S. (2022). Access to gender-affirming hormones during adolescence and mental health outcomes among transgender adults. PLOS ONE, 17(1), e0261039. https://doi.org/10.1371/journal.pone.0261039
Carmichael, P., Butler, G., Masic, U., Cole, T. J., De Stavola, B. L., Davidson, S., Skageberg, E. M., Khadr, S., & Viner, R. M. (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLOS ONE, 16(2), e0243894. https://doi.org/10.1371/journal.pone.0243894
Grannis C, Leibowitz SF, Gahn S, Nahata L, Morningstar M, Mattson WI, Chen D, Strang JF, Nelson EE. Testosterone treatment, internalizing symptoms, and body image dissatisfaction in transgender boys. Psychoneuroendocrinology. 2021 Oct;132:105358. doi: 10.1016/j.psyneuen.2021.105358. Epub 2021 Jul 17. PMID: 34333318.
Green, A. E., DeChants, J. P., Price, M. N., & Davis, C. K. (2021). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health.
Nieder TO, Mayer TK, Hinz S, Fahrenkrug S, Herrmann L, Becker-Hebly I. Individual Treatment Progress Predicts Satisfaction With Transition-Related Care for Youth With Gender Dysphoria: A Prospective Clinical Cohort Study. J Sex Med. 2021 Mar;18(3):632-645. doi: 10.1016/j.jsxm.2020.12.010. Epub 2021 Feb 26. PMID: 33642235.
Turban JL, King D, Carswell JM, Keuroghlian AS. Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation [published correction appears in Pediatrics. 2021 Apr;147(4):]. Pediatrics. 2020;145(2):e20191725. doi:10.1542/peds.2019-1725
Achille, C., Taggart, T., Eaton, N. R., Osipoff, J., Tafuri, K., Lane, A., & Wilson, T. A. (2020). Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results. International Journal of Pediatric Endocrinology, 2020(1), 1-5.
Becker-Hebly I, Fahrenkrug S, Campion F, Richter-Appelt H, Schulte-Markwort M, Barkmann C. Psychosocial health in adolescents and young adults with gender dysphoria before and after gender-affirming medical interventions: a descriptive study from the Hamburg Gender Identity Service. Eur Child Adolesc Psychiatry. 2021 Nov;30(11):1755-1767. doi: 10.1007/s00787-020-01640-2. Epub 2020 Sep 29. PMID: 32990772.
de Lara, D. L., Rodríguez, O. P., Flores, I. C., Masa, J. L. P., Campos-Muñoz, L., Hernández, M. C., & Amador, J. T. R. (2020). Psychosocial assessment in transgender adolescents. Anales de Pediatría (English Edition), 93(1), 41-48.
Anna I.R. van der Miesen, Thomas D. Steensma, Annelou L.C. de Vries, Henny Bos, Arne Popma,
Psychological Functioning in Transgender Adolescents Before and After Gender-Affirmative Care Compared With Cisgender General Population Peers, Journal of Adolescent Health, Volume 66, Issue 6,
2020, Pages 699-704, ISSN 1054-139X, https://doi.org/10.1016/j.jadohealth.2019.12.018.
Hodax JK, Wagner J, Sackett-Taylor AC, Rafferty J, Forcier M. Medical Options for Care of Gender Diverse and Transgender Youth. J Pediatr Adolesc Gynecol. 2020 Feb;33(1):3-9. doi: 10.1016/j.jpag.2019.05.010. Epub 2019 May 30. PMID: 31154017.
Kaltiala, R., Heino, E., Työläjärvi, M., & Suomalainen, L. (2020). Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria. Nordic Journal of Psychiatry, 74(3), 213-219.
Kuper, L. , L. E., Stewart, S., Preston, S., Lau, M., & Lopez, X. (2020). Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy. Pediatrics, 145(4).
Allen, L. R., Watson, L. B., Egan, A. M., & Moser, C. N. (2019). Well-being and suicidality among transgender youth after gender-affirming hormones. Clinical Practice in Pediatric Psychology, 7(3), 302.
Kimberly LL, Folkers KM, Friesen P, Sultan D, Quinn GP, Bateman-House A, Parent B, Konnoth C, Janssen A, Shah LD, Bluebond-Langner R, Salas-Humara C. Ethical Issues in Gender-Affirming Care for Youth. Pediatrics. 2018 Dec;142(6):e20181537. doi: 10.1542/peds.2018-1537. Epub 2018 Nov 6. PMID: 30401789.
Wiepjes CM, Nota NM, de Blok CJM, et al. The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): trends in prevalence, treatment, and regrets. J Sex Med. 2018;15(4):582-590.
Simone Mahfouda, Julia K Moore, Aris Siafarikas, Florian D Zepf, Ashleigh Lin, Puberty suppression in transgender children and adolescents, The Lancet Diabetes & Endocrinology, Volume 5, Issue 10, 2017, Pages 816-826, ISSN 2213-8587, https://doi.org/10.1016/S2213-8587(17)30099-2
Costa R, Dunsford M, Skagerberg E, Holt V, Carmichael P, Colizzi M. Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria. J Sex Med. 2015 Nov;12(11):2206-14. doi: 10.1111/jsm.13034. Epub 2015 Nov 9. PMID: 26556015.
De Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696-704.
de Vries AL, Steensma TD, Doreleijers TA, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011 Aug;8(8):2276-83. doi: 10.1111/j.1743-6109.2010.01943.x. Epub 2010 Jul 14. PMID: 20646177.
