“I’d never consider myself an activist in that sense,” says Dr. Michael Haller, a medical school professor and head of paediatric endocrinology at the University of Florida. “But I’m sure as hell going to stand up for my patients.”
Although Haller’s primary focus is type 1 diabetes management, he has also treated transgender children and oversees other paediatric endocrinologists that specialize in their care. And those patients’ well-being is currently at risk, given how prominent Florida Republicans, especially Governor Ron DeSantis, are targeting trans rights. Experts of conscience like Haller have been vocal opponents to the politicization of patient care for authoritarian ends.
Trans people are now the primary target of political persecution within the Sunshine State (and other states). Republican-controlled states), just as November’s midterm elections loom. Haller is concerned by this development. He describes DeSantis as “willing to use whatever tools he needs to maintain power, even if it means trying to utilise policies that are not in the best interests of people he represents”.
DeSantis is widely viewed as a leading contender for the Republican Party’s 2024 presidential candidate, should that candidate be anyone other than Donald Trump.
For Floridians and other Americans concerned about the rights and welfare of marginalised people, that’s a worrying prospect.
Attacks on Trans Minors
Last September, DeSantis appointed Joseph Ladapo Florida’s surgeon general – the operational head of the state’s department of health. Ladapo has also been given a professorship at the University of Florida in what Haller, who has expressed concern over Ladapo’s lack of public health experience, describes as “a political process well outside the norms” of typical university hiring.
Ladapo has proved willing to use his office to pursue DeSantis’s anti-trans agenda, adopting the arguments of fringe groups and what Haller calls “cherry-picked” data to provide a fig leaf of cover to push for a sharp departure from both the US and international medical consensus regarding best practices for the treatment of transgender minors.
In April, Ladapo sent a memo to the state’s medical professionals claiming a “lack of conclusive evidence” for the benefits of gender-affirming care and advising that “social gender transition should not be a treatment option for children or adolescents.” It also read in part, “Anyone under 18 should not be prescribed puberty blockers or hormone therapy.”
The American Civil Liberties Union’s Florida branch issued a response. statement saying: “This non-binding guidance is in direct opposition to advice from every major medical organisation in the country.” The statement added that “the Florida Department of Health is attempting to demonise life-saving, critical, medically necessary healthcare for transgender youth. It is simply despicable and wrong.”
According to The Washington Post, Jack Turban, chief fellow in child and adolescent psychiatry at Stanford University School of Medicine, called Ladapo’s memo a “shocking” example of misinformation, observing, “There are false statements on nearly every line of this document.”
Brandon Wolf, press secretary for LGBTQI advocacy organisation Equality Florida, said Ladapo’s policy proposal is one of the most extreme in the country. “The surgeon general is asserting that the state government should dictate what haircuts and clothes kids receive.”
Haller states that the memo already has chilling effects. Some Florida doctors have stopped treating trans minors.
Ladapo’s guidelines for the ‘care’ of trans minors remain non-binding for now, but physicians, parents of trans kids and LGBTQI activists and advocates are concerned that this may change following a meeting of the Florida Board of Medicine, which oversees the licensing of medical practitioners in the state, set to take place in Fort Lauderdale today.
Transgender Floridians have been raising alarm about the session with their allies and transgender Floridians. calling it an attempt at a “backdoor” ban on gender-affirming care in Florida. If this happens, DeSantis will have made an end run around the state legislature in a fashion similar to Texas Governor Greg Abbott’s exploits of his power over state bureaucracy. redefine supportive parenting of trans children as “child abuse”.
The meeting’s agenda includes a “discussion” of a 2 June letterThe state surgeon general has been referred to the board concerning gender dysphoria in children or adolescents. The Florida Department of Health also has petitionedThe board will ban gender affirming care for anyone younger than 18 years of age, and discourage adults who are considering medical transition.
This isn’t the first time DeSantis has abused state bureaucracy in pursuit of far-Right social policy goals. For example, the agency that administers Medicaid in Florida – taking its cues from the governor and the surgeon general – has already moved to banNot just for trans minors but for all trans patients, coverage of gender-affirming healthcare
This would be most detrimental to poor Floridians (Medicaid provides low-income Americans with health insurance), but private insurers could follow the example of the state and drop their coverage for gender-affirming services.
Haller spoke on 8/7 at a Tallahassee meeting where the state presented its plan to cut funding for gender-affirming care. Calling the government’s move “well organised”, Haller described the meeting as “a political showpiece”, noting that it featured far more speakers who favoured the government’s plan, including many “faux-experts”, than those who opposed it.
The Sarasota Herald-Tribune called the meeting “raucous and rowdy”. It is possible that the sessions on gender-affirming medicine at the upcoming board meeting of medicine will be the same.
And it’s not just trans healthcare that’s under attack in Florida.
Ron DeSantis: Worse Then Trump
Manny Diaz Jr., the state’s commissioner of education, issued a statement last week. memo to education professionals to reject the Biden administration’s recently issued guidelines on non-discrimination for transgender students.
The memo states that the department of education “will not stand idly by as federal agencies attempt to impose a sexual ideology on Florida schools that risk the health, safety, and welfare of Florida students”.
Of course, there is nothing inherently ‘sexual’ about being transgender, and there is no evidence of any inherent ‘risk’ in allowing trans students to access the bathrooms and locker rooms that match their gender identity.
Haller describes DeSantis as “unfortunately, quite clever” at deftly manoeuvring within state politics and the bureaucracy he oversees, identifying means to persecute scapegoated communities in order to “stir a base that is scared of anything perceived as ‘other’”.
Jaime Jara is a high school teacher of American history. She is also a mother to three children, one of which is a transgender girl aged ten years old. “I thought Trump was bad,” she says. “But for me, DeSantis is even worse, because he’s smarter and more calculating. So it’s terrifying.”
The Florida Board of Medicine is composed of 15 members. They are appointed by the governor when vacancies arise. Most of the members were appointed to the Board by Republican governors. DeSantis appointed four. The DeSantis administration needs a simple majority to start the process of banning gender affirming care for minors.
This appears to be the most likely outcome – though Haller thinks the worst might be avoided. The 12 physicians on the board are supposed to speak in their professional capacity as doctors, not politicians – and Haller thinks there’s some chance, however small, that the majority could have enough integrity to declare that setting the standard of care for a field in which most of them have no experience, and in contravention to the consensus of that field, falls outside the board’s purview.
If they do toe the governor’s line, however, they will not make an instant decision but will set up a committee to determine the standard of care at a later date. It is highly probable that they will ban hormones and blockers of puberty, at least for minors.
“We’re Being Persecuted”
Jara states that her family will leave the state if this happens. When people ask if they plan to move, Jara insists: “Let’s call it what it is. It’s not moving, it’s fleeing. We’re being persecuted.”
And what happens if DeSantis wins the presidency? Jara believes that her family will find a way for them to leave Florida and the United States.
As a parent, her top priority is to protect her children. According to Jara, her daughter, Dempsey, has shown persistent gender non-conformity since she was 18 months old and at the age of five insisted, “I’m a girl in my heart and my brain.”
Although Jara receives hate mail and is often accused of somehow ‘making’ Dempsey trans, she says that no one ever pressured her child. In fact, Dempsey would throw tantrums when forced to wear boy’s clothing in public, and became increasingly withdrawn as a result.
Dempsey was able to socially transition once she was allowed. She thrived at school, too. Jara, who was recalled by her classmates as using different pronouns in kindergarten and dressing differently in kindergarten made a decision to work with the school (and another outside organisation) to provide an age-appropriate educational workshop to the class that included a puppet show that explained what it meant to be transgender.
“Nothing sexual at all, because it has nothing do with sex,” Jara explains, frustrated that so many people regard the topic as inherently sexual. Such workshops are now illegal under Florida’s recently passed ‘don’t say gay’ law.
Dempsey doesn’t need puberty blockers just yet, but she will fairly soon, which means a lot is riding on the board of medicine’s decision – for her, her family and similar families across Florida.
Jara and her husband moved from New York to Florida 17 years back. They wanted the affordability and the beautiful weather. “We still love Florida,” she tells me. But the hostile, anti-trans political climate has become unbearable. “The fallout is bad, it’s very real, it’s affecting families.”
Brandon Wolf from Equality Florida confirmed that “Florida has grown increasingly more hostile toward our community.” He places much of the blame on DeSantis: “We are being targeted by a governor desperate to be president someday and willing to traffic in all manners of hate and bigotry to get there.”
Equality Florida is a part of a wide coalition working to resist anti-trans policies. This includes gathering public comments urging the board of medicine not to adopt the anti-trans standard of so-called “care” proposed by the state’s health department.
This is a fact. This is what we know for certain.