Florida surgeon general warns against youth transgender procedures in rebuke of Biden

Florida Surgeon General Joseph Ladapo said Wednesday that minors should not undergo gender transition procedures, along with puberty blockers and hormone treatments, and harshly criticized recent guidance from the Biden administration backing such treatments for children.

Ladapo issued a series of guidelines deterring gender transition procedures for children and adolescents “due to the lack of conclusive evidence, and the potential for long-term, irreversible effects.” The guidelines include discouraging social gender transitions, such as name, pronoun, and clothing changes, puberty blockers, and hormone treatments for people younger than 18, as well as encouraging social support by peers and family and counseling from a licensed provider.

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Ladapo also rebuked the Biden administration’s related guidance, the latest clash between Gov. Ron DeSantis’s administration and the federal government.

“The federal government’s medical establishment releasing guidance failing at the most basic level of academic rigor shows that this was never about health care,” Ladapo said. “It was about injecting political ideology into the health of our children. Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18.”

The guidelines were a response to the Department of Health and Human Services report that said gender transitions provide mental and physical benefits for youth dealing with gender dysphoria, that is, emotional distress due to a disconnect between gender identity and biological sex. The Florida Department of Health released a fact check of the federal government’s statements.

“Research demonstrates that gender-affirming care improves the mental health and overall well-being of gender diverse children and adolescents,” the HHS Office of Population Affairs said. “A safe and affirming healthcare environment is critical in fostering better outcomes for transgender, nonbinary, and other gender expansive children and adolescents.”

The evidence detailing the benefits and disadvantages of allowing children to begin working with healthcare professionals in the transition process is diverse. For instance, a 2008 report published in the Journal of the American Academy of Child and Adolescent Psychiatry found that only a fraction of youth who said they were transgender continued feeling that way as they grew older. Ladapo, in his announcement, also cited the risk of irreversible consequences to pursuing transition treatments in children, such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis.

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On the other hand, a 2020 study published in the academic journal Archives of Sexual Behavior of about 300 transgender youth found that providing transition procedures yielded lower rates of adverse mental health outcomes, built self-esteem, and improved the overall quality of life for transgender youth. The American Academy of Pediatrics has backed such procedures for minors.

“Gender-affirming care is creating space for children to be able to tell us their gender story, rather than filling in the end of the story for them. In that journey, gender-affirming care may draw on evidence-based medical tools — such as puberty blockers or hormone therapy — at developmentally appropriate ages,” said Dr. Brittany Allen, a member of the AAP Section on the LGBTQ Executive Committee.

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