GENDER AFFIRMING CARE: Setting the Record Straight As Gov. DeSantis Continues Attacking Trans Youth and Sharing Misinformation About Gender Affirming Care

by HRC Staff

Florida Governor Continues Reckless Misinformation Campaign to Rile Up His Extremist Base and Justify Harmful Policies

WASHINGTON, D.C. — During last night’s gubernatorial debate in Florida, Gov. Ron DeSantis doubled down on attacking transgender youth, continuing his reckless misinformation campaign to rile up his extremist base and justify harmful policies that prevent transgender youth, in consultation with their parents and doctors, from being able to access age-appropriate, medically-necessary, gender affirming care.

Human Rights Campaign Senior Vice President of Policy and Political Affairs JoDee Winterhof released the following statement in response:

“Through his administration’s actions and his re-election campaign, Gov. Ron DeSantis is proving himself to be one of the most anti-LGBTQ+ governors in America. He is an existential threat to every LGBTQ+ Floridian. Politicians like DeSantis, who do not have an ounce of medical training, are interfering with our rights as parents and acting as if they know how to raise and support our children better than we do. More than 1.3 million U.S. doctors, represented by every major medical organization, disagree with Gov. DeSantis, recognizing that age-appropriate, medically necessary, gender-affirming healthcare for transgender adolescents and teens is critical, often life-saving, care. How someone transitions is their choice, to be made with their family and their doctor. Gov. DeSantis should focus on the real issues impacting Floridians rather than needlessly attacking transgender youth and their families for political gain.”

HRC-endorsed candidate for governor Charlie Crist defended the importance of gender affirming care, stating: “This reminds me of your position on a woman’s right to choose. You think you know better than any physician, any doctor, or any woman in a position to make decisions about their own personal health. You want to be the judge. You want to decide about what people should do with their own physical being, with the betterment of their health, with whether or not they want to make sure that they can practice their right to choose as a woman. That’s just not right. I don’t believe in that,” he said.

Below is background information to set the record straight on what is and isn’t true about gender affirming care.

THE FACTS ABOUT GENDER AFFIRMING CARE

Every credible medical organization calls for affirming care for transgender and non-binary people. Sexual orientation and gender identity are real concepts recognized by major medical and mental health associations — including the American Medical Association, the American Academy of Pediatrics, the American Psychological Association and the American Academy of Child and Adolescent Psychiatry — as part of the normal spectrum of human experience. Health care providers who work with transgender and non-binary people — including young people — are providing life-saving care, with many patients driving hundreds of miles just to get to their doctor’s office.

National medical, mental health and education organizations, and others have condemned Gov. DeSantis’s actions. The National Physicians Associations, American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, National Education Association, National Association of Social Workers, have all spoken out. More than 7,000 people, including parents of transgender, non-binary and cisgender children, have signed an open letter condemning state attacks on transgender and non-binary youth.

Transgender children are not undergoing irreversible medical changes. This is a fundamental misunderstanding about what transition looks like for kids, which is primarily about providing social support, using the right name and pronouns, and allowing them to present in a way that is consistent with their gender identity. Therapists, parents and health care providers work together to determine which changes to make at a given time are in the best interest of the child.

“Transition-related” or “gender-affirming” care looks different for every transgender and non-binary person. Some transgender and non-binary people may only socially transition, such as using a new name and pronouns, and dressing in a way that is consistent with their gender identity. Others may socially and medically transition, including undergoing hormone therapy and/or gender affirmation surgery. Each person’s journey is unique to them and their medical needs. At the same time, many transgender and non-binary people cannot afford gender-affirming medical treatment, nor can they access it. Hormone therapy and surgical care are not offered to young people, but reserved for those who can give truly informed consent.

Not all transgender and non-binary people who transition have surgery. Many transgender and non-binary people transition without surgery. Some have no desire to pursue surgeries or medical intervention. Transgender children do not undergo gender-affirming surgeries, but may receive fully reversible medications that put puberty on hold under the care of a licensed medical provider. More permanent medical interventions do not occur until a transgender person is of age to give truly informed consent.

Gender-affirming health care is lifesaving. For transgender people, being denied critically necessary transition-related care can extend and exacerbate the stress and discomfort caused by gender dysphoria, leading to increased incidences of depression and substance abuse, as well as health complications caused by delaying care. Ensuring that transgender and non-binary people have access to trans-affirming health care is lifesaving. A recent study from the Trevor Project provides data supporting this — transgender youth with access to gender-affirming hormone therapy have lower rates of depression and are at a lower risk for suicide. Another study, published in the Journal of the American Medical Association, agreed, saying, "receipt of gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with 60% lower odds of moderate or severe depression and 73% lower odds of suicidality over a 12-month follow-up." Additionally, the Trevor Project study shows that parental support is vital in ensuring transgender youth’s mental and physical health.

Detransitioning is very rare. Medical regret is even rarer. According to the National Center for Transgender Equality’s 2015 U.S. Transgender Survey, only 3% of respondents have detransitioned permanently at some point. The vast majority of respondents who detransition only do so temporarily. Detransitioning is often conflated with medical regret; however, detransitioning can include nonmedical parts of someone’s transition, such as changes in their gender expression or legal changes to their identity. One study found that less than one-half of one percent of trans patients who have received gonadectomy report surgical regret. Also, there is no scientific evidence showing that surgical regret would cause trans people to forego surgery in hindsight. Surgical regret could include trans patients who do not regret receiving surgery, but may be disappointed with one or more minor details relating to the outcome of their surgery. Trans people who also regret one or more parts of their surgery do not always detransition. When respondents detransition, it could include reasons beyond surgical regret. According to that same survey by the National Center for Transgender Equality, respondents who detransitioned cited a number of reasons for doing so, including facing too much harassment or discrimination after they began transitioning (31%), having trouble getting a job (29%), or pressure from a parent (36%), spouse (18%), or other family members (26%).

For more information, please visit hrc.org/transgender as well as these resources:

DESANTIS’S ATTACKS ON LGBTQ+ FLORIDIANS

In Florida, Gov. DeSantis and other extremist politicians have launched an unprecedented legislative assault on LGBTQ+ people, including:

  • Florida Board of Medicine is Considering Gov. DeSantis’ Politically-Motivated Proposal to Ban Affirming Care for Transgender Youth: Florida's Board of Medicine will be meeting on Friday, October 28 to take public comments about a proposed rule to restrict access to gender-affirming healthcare. The FDOH, an agency under the control of Governor DeSantis, has pressured Board members to reject their best medical judgment and impose political barriers to accessing life-saving care for transgender youth and adults.

  • One Week After DeSantis Banned Use Of Medicaid To Pay For Medical Treatment For Transgender Children, Data Showed Instances Were Rare: This summer, the Florida Agency for Health Care Administration, announced a rule change that will — contrary to all medical best practices — deny gender affirming care to Floridians of all ages who rely on Medicaid. One week after Florida banned the use of Medicaid to pay for medical treatment of gender dysphoria, newly released data showed the number of transgender children getting such aid remains rare in Florida.

  • DeSantis Attacks LGBTQ+ Youth: DeSantis’s shameful “Don’t Say Gay or Trans” law went into effect this summer, targeting LGBTQ+ youth and educators across the state by preventing them from having and providing a safe, inclusive classroom. The “Stop WOKE Act” also went into effect, another dangerous bill limiting protected speech in workplaces with more than fifteen employees and classrooms by censoring honest dialogue about systemic racism, gender, and race discrimination. It also changes Florida’s employment discrimination statutes to give employees the ability to file discrimination claims against an employer engaging in trainings or discussions about Black history, LGBTQ+ issues, and other concepts of injustice and discrimination. In 2021, the Florida state legislature passed a bill banning transgender youth from participating in school sports consistent with their gender identity.

  • DeSantis Vetoed Mental Health Funding For Pulse Victims: Gov. DeSantis continued his anti-LGBTQ crusade on the second day of Pride Month last year by vetoing all funding for LGBTQ programs from the state budget. Canceled funding included money earmarked for mental health programming to support survivors of the Pulse Massacre, to house homeless LGBTQ children, and for Orlando’s LGBTQ Community Center.

  • DeSantis’ Spokeswoman Called Opponents Of Don’t Say Gay Or Trans Bill “Groomers”: Gov. DeSantis’ main spokeswoman suggested the Parental Rights in Education bill could fairly be called an “anti-grooming” bill. The bill at issue would prohibit teachers in public schools from discussing issues of sexual orientation or gender identity with children in grades kindergarten through three.

The Human Rights Campaign is America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people. HRC envisions a world where LGBTQ+ people are embraced as full members of society at home, at work and in every community.

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Topics:
Transgender