Florida’s board of medicine has begun weighing restrictions on transgender health care in response to pressure from the state’s governor and health department. What the state health department is asking the board of medicine, which is fully staffed by DeSantis appointees, to do: ban gender-affirming care for trans youth and implement a 24-hour waiting period for trans adults seeking hormones or surgery — a significant step beyond what other states have sought amid a nationwide effort to restrict trans health access. 

Gender-affirming care remains unchanged in Florida right now, but the board’s action is just the latest move by state officials targeting transgender people, especially minors.

The board of medicine, which oversees licensing health care professionals, voted last week to begin creating a proposal in response to the state’s petition, but members said that they plan to seek out more experts in trans health care before making a decision — and that they do not intend to use the exact language given by the state.

Any sort of restriction that passes would apply to all medical providers who provide gender-affirming care. The state’s board of medicine has the authority to suspend or revoke doctor’s licenses, or otherwise penalize those who do not comply with rules it sets. 

The board’s move is separate from the state’s proposal to end Medicaid coverage of gender-affirming care for people of all ages, which is set to go into effect August 21 — and would harm low-income trans people. The Southern Legal Counsel, in coordination with Lambda Legal and other groups, plans to file a lawsuit against the Medicaid policy. 

Simone Chriss, an attorney with the Southern Legal Counsel in Florida and director of the organization’s transgender rights initiative, said the group is also watching the medical board’s actions and will file for a preliminary injunction to stop any potential restrictions from going into effect.

“I just want families to know … that they don’t need to panic at this moment, because nothing has been determined,” Chriss said. 

Although the restrictions may not include everything that the state’s health department is seeking, the nature of the proposal underlines to advocates that Florida has become a bellwether state for new anti-trans and anti-LGBTQ+ efforts. Florida is home to nearly 95,000 trans adults and about 16,000 trans youth, per the UCLA Williams Institute — more than most other states outside of Texas, California and New York (all populous states.)  

“What happens in Florida could become a model for similar attacks on the LGBTQ community and particularly the transgender community in other states,” said Jon Harris Haurer, Equality Florida’s public policy director. 

Anti-LGBTQ+ bills restricting sports and education have gone into effect across the country — including Florida, where advocates have mounted another lawsuit — while other states have recently unsuccessfully targeted gender-affirming care for trans youth. Alabama’s felony ban on doctors prescribing puberty-blocking medication or hormone treatment for trans youth was blocked by a federal judge this spring. Arkansas’ law banning gender-affirming care was also blocked in federal court before it could take effect — which the state appealed earlier this year. 

That Florida’s ask to the state’s medical board presents a new route to restrict gender-affirming care that circumvents the state legislature is especially worrying, said Robin Witt, vice president of Florida’s LGBTQ+ Democratic Caucus.

The proposal being weighed by the Florida board of medicine does not include the state’s initial nonbinding stance against trans youth being able to socially transition; any stricture against using a new name or new pronouns; or changing outfits or hairstyles to better match gender expression or identity. Such a rule would go beyond the board’s authority. 

However, in addition to banning all gender-affirming care for trans youth — including puberty blockers — the state is recommending the creation of a 24-hour waiting period for trans adults seeking gender-affirming care after they sign an informed consent form that advocates say is littered with dangerous misinformation. 

Those tactics to restrict care for trans adults are reminiscent of state-level abortion restrictions, Chriss said — and mark a departure from the typical restrictions on trans health care. If Florida’s recommendations were to go into effect, trans patients would face circumstances similar to states with 24 hour waiting periods after counseling to receive an abortion.

Witt worries that the state’s proposed consent form — and the disinformation threaded throughout the document as currently written — would turn trans people away from needed health care. The form describes hormone treatment therapy as not conforming to “generally accepted medical practices” and attempts to discredit research finding that transitioning can improve mental health and lower suicidality for trans people. 

 “Personally, I don’t want to sign that form at all,” she said. Trans adults who are already nervous about accessing care or going to the doctor’s office could be deterred from coming back, she said — while others may not want to sign a document that would allow the state to record them as a trans person accessing gender-affirming care. 

“Florida isn’t just the leader in trans discrimination, it’s a testing ground,” Witt said. “It’s terrifying.” 

Paul Arons, a retired family physician in Tallahassee who attended public testimony ahead of the board’s August 5 vote in Fort Lauderdale, said he was concerned that the state’s governor and legislature chose to attack trans health care. 

“It’s a violation of the relationship between individuals, their families, and their medical providers [who] should be making these decisions,” he said. “And it further stigmatizes a community that is already struggling.”

Michael Haller, a professor and chief of pediatric endocrinology at the University of Florida who lobbied the board to not take up rulemaking in response to the state’s petition, said that physicians don’t have much reason to trust the process right now. 

“Those of us who provide this care have no reason to trust the state or frankly the board of medicine at this point, because they did decide to go ahead and effectively bend their knee to the whims of the governor and the surgeon general,” he said. 

The state’s medical board voted to move forward on rulemaking for the health department’s proposal within 30 days — and after that, the timeline isn’t as firm, Chriss said, but it will likely follow similar steps as the state’s separate effort to end Medicaid coverage of gender-affirming care. Once the board issues a proposed rule, a public hearing and 21-day public comment period will ensue. 

Florida’s health department did not respond to a request for comment.