Rebecca Davis drove two hours to a doctor’s appointment in Gainesville hoping for confirmation that her transgender daughter would still be able to receive gender-affirming care.
Davis is the mother of a 16-year-old who has been on puberty blockers for a year and started hormone replacement therapy in July. Davis, an educator living in St. Augustine, said the gender-affirming care was life-saving for her daughter. But she worries that could change under Florida’s current political climate.
These concerns stem from the November 4 decision by the Florida Board of Medicine and the Florida Board of Osteopathic Medicine to ban gender-affirming care for minors, which includes the administration of puberty blockers, hormone replacement therapy or HRT, and gender-affirming surgery.
Although Davis’ daughter is able to continue her treatment, she said she was concerned that the medical boards made their decision without recognizing the regulations already in place for minors with gender dysphoria. She said her daughter has to go through processes and assessments before receiving treatment.
“She had to socialize for at least a full year before she could even start medication, she had to be 16 before she could start HRT, she had to be seen by multiple specialists, a team, to even commit to it qualify for treatment,” she said.
Davis took her daughter to the University of Florida’s Health Gender Youth Program on Friday, where she said her doctor confirmed the teen will be able to continue treatments to allay her mother’s concerns.
A priority for Davis is continuing the gender-affirming treatment that has improved her daughter’s mental health. Her daughter was diagnosed with autism and has dealt with depression since elementary school.
“In school, she would always get in a spiral and say things like, ‘Everybody hates me, I should just kill myself and make everyone happy,’ and that caused the crisis team to come out,” Davis said. “I didn’t know what to do, I didn’t know how to help her.”
It was only at a time during the COVID-19 lockdowns that Davis’ daughter came to her and opened up about her gender identity.
“She came up to me and said, ‘Mom, I’m a girl and I need your help,’ and I said, ‘Okay, whatever it takes, I’ll do whatever it takes to help you,’ because I’m scared of it had to lose my child,” Davis said.
Davis said having her child’s support during her transition prevented her mental health from deteriorating any further.
“Once she started the transition, it was like night and day,” Davis said. “She’s happy, she’s smiling, she’s got friends, she’s outgoing, she’s in clubs, she’s active and sociable. I no longer have to worry about her getting hurt at all. It was like a miracle.”
Nikole Parker, director of transgender equality at Equality Florida, said she is also concerned about the future of transgender youth in Florida and fears they could end up gaining access to the care they need through dangerous practices. Parker, a transgender woman, transitioned at age 19 without access to the resources needed to live with gender dysphoria.
“I left my house, I got into survival sex work, I took hormones from the black market because I didn’t know how to access health care and that’s the part that scares me so much,” she said. “…The thought of people having to go to the black market for hormones just to get back what they need scares me.”
Parker said the misconception that minors request and receive gender-affirming surgery without the proper evaluation fuels the stigma surrounding gender-affirming care. She said she needed letters from a therapist, a medical provider and a psychologist to have gender-affirming surgery as an adult.
She also said that while the testimonies of people who have made the transition are important, they do not reflect the full experience of transgender people.
“While there are some who are reversing the transition … that’s not the typical scenario that you see when kids can be gender-affirmed, you see them grow into happy adults living authentically,” Parker said.
Parker said she’s had calls from parents worried about the future of children who may need gender-affirming care, asking whether or not they should consider leaving the state.
Kat Duesterhaus, communications director for Florida Now, said while the law isn’t yet in effect, Florida residents are already concerned about its impact.
“I’ve heard from a lot of trans people, parents of trans kids, that they want to move out of the state because it seems pretty certain that this rule will be approved and go into effect very soon,” Duesterhaus said. “Right now we’re in a lot of anxiety, a lot of anxiety, a lot of stress and we’re going to lose people in our state who are contributing to our beautiful sunny state and making it a more diverse and loving place.”
Duesterhau said the organization is urging public comment to speak out against the ruling and is working on a possible legal challenge to the decision.
Simone Chriss, civil rights attorney and director of the Southern Legal Counsel’s transgender rights initiative, said her experience working with transgender youth and adults taught her the need for this type of treatment.
“I’ve personally observed how these children are being cared for and it’s being done to evidence-based standards,” Chriss said. “The doctors who provide this care are already following standards and the care is working, and all the evidence shows that this care is effective, safe, medically necessary and saving the lives of these children.”
Chriss said the treatment ban violated the rights of Floridians.
“It replaces the judgment of the state with that of the parents and interferes with the doctor-patient relationship, and we are a state that cares about the rights of parents,” she said. “…But when it comes to making medical decisions for your child, which is one of the deepest basic protective rights of our constitution, parents suddenly have no rights.”
Mel Turnage, a transgender woman and a student at UCF, said gender-affirming care for young trans people is essential. “For someone like me…male puberty can be traumatic and bring about many changes in the body that some people just don’t want.”
Turnage made the switch at age 20 when she began feminizing hormone therapy. She said that taking estrogen has made her feel more connected to her identity, more grounded mentally and physically.
“If I had started hormone therapy or puberty blockers when I was a teenager, I would definitely feel better than I do now,” she said.
Parents like January Littlejohn disagree with the gender-affirming nursing approach. Littlejohn attended the October 28 public meeting of the two medical boards and said she prevented her daughter from transitioning.
Littlejohn said her daughter expressed unease about her gender in the spring of 2020. She said her daughter, then 13, only expressed discomfort about her gender identity after three other friends came out as transgender.
She said she worked with a licensed psychologist to explore her daughter’s journey.
“We also gave her more personal time, personal activities away from trans influencers, limited her internet use, and declined to confirm her newly chosen name and pronouns,” Littlejohn said. “We set appropriate boundaries and allowed her to choose her hair and clothing, but denied harmful requests like breast ties, puberty blockers, cross-gender hormones and surgery.”
Littlejohn said her daughter’s uneasiness stems from fears of sexualization, self-esteem issues and online influence. She said her daughter has now stopped wanting to switch.
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“I have spoken to many parents in Florida and they are not informed of all treatment options when they seek help for their child, often they are persuaded by medical professionals that affirmations and medicalization are their only option to avoid the impending suicide of theirs.” child,” she said.
Littlejohn said suicide is presented as a consequence of being denied gender-affirming care rather than a risk, pushing parents and children to make decisions they may later regret.
For Davis and her daughter, gender-affirming care was the only option, and even before the new rules, it was hard to come by.
“Gainesville is the only place in the state of Florida that offers health care to these kids, so we drive two hours anyway to get her health care… it’s kinda limited,” she said.
Davis said she will find alternatives to help her daughter when that care is no longer available, whether she leaves the state or finds medical providers online.
“All I know is that I will not allow my child to be hurt by these ignorant people,” Davis said.