There is a quote from a 2019 New York Times story that still haunts me today. The Time journalist was describing the negative economic impacts President Donald Trump’s government shutdown was having on rural towns in the Florida Panhandle. A woman who voted for Trump told the Time: “He [Trump]doesn’t hurt the people he needs to hurt.
I remembered those words while thinking about what the Florida Board of Medicine might do soon: severely restrict or ban gender-affirming care for young people. Today my son, a transgender boy, is among the ‘people he has to hurt’ – although now the ‘he’ is Governor Ron DeSantis, working through his political hack of a surgeon general, Joseph Ladapo .
On Oct. 28, Florida’s Boards of Medicine and Osteopathic Medicine plan to discuss, and likely uphold, guidelines Ladapo released in April banning gender-affirming treatments for minors, including social transitioning. Ladapo’s recommendations are part of a larger campaign against transgender care that has at times been driven by ignorance, bigotry and partisan politics of rank.
Ladapo’s guidelines, which run counter to current standards of care used by all major medical organizations, are based on hand-picked and distorted evidence as well as the testimony of a handful of carefully chosen anti-LGBTQ “experts.” . Ladapo’s recommendations have already had a chilling effect on Florida hospitals; some have stopped accepting new patients requiring care for gender dysphoria in anticipation of upcoming changes in state law.
The reason Ladapo is seeking to ban gender-affirming care for young people is the “lack of conclusive evidence” of its benefits. This is one of the oldest tricks of science deniers. Science, especially medical and mental health science, is rarely “conclusive” in the sense of absolute certainty that Ladapo uses. Science – again, especially medical and mental health science – is an ongoing process of dealing with uncertainty and trade-offs.
Research on gender-affirming care has many uncertainties, but the majority of up-to-date research suggests it is beneficial. As with any other medical treatment, there are potential side effects to puberty blockers – which have been used for decades without public outrage – or hormone treatments that can be assessed and monitored for each person. Based on the research we currently have, their benefits outweigh any possible side effects. And there is Nope negative medical side effects on social transition.
A a handful of vocal right-wing crooks have pushed the idea that gender-affirming care for young people is a kind of free for all, where anything goes and there are no guidelines or best practices and doctors are all awakened militants.
It’s not true. Let me tell you what gender-affirming care for young people looks like from my experience as a parent: it is a long, careful and individualized process that involves teams of therapists, psychologists, doctors, patients and families. The recent book A childhoodby Carolyn Hays, is a great primer on what navigating this process is like, as well as the fears and threats families of transgender youth often endure.
Regret rates for gender-affirming care are low. There are people who have detransitioned or want to, and they should get all the help they need. But the evidence suggests that there is much more the people who would benefit from the care that the Florida Board of Medicine could prohibit if it adheres to Ladapo’s request. The fact that some people stop or cancel treatments is not a reason to deny these treatments to a larger population.
Restricting gender-affirming care would take a broad look at a complex reality. He would ignore the differences between the patients. And it would also deprive families of autonomy. I work at the intersection of data and scientific culture, and I don’t want someone as politically motivated as Joseph Ladapo dictating the health care that my family – or any other family – can or cannot. to access. I prefer to rely on actual standards and let the families decide for themselves.
This is, after all, what ‘parental rights’ means.
JThe problem is that discussing science, freedom or autonomy is irrelevant. What’s happening in Florida has nothing to do with science; it is about fueling political polarization. Ron DeSantis is a man of theoconservative and authoritarian leanings, as his rhetoric and actions suggest, and he has presidential ambitions. He’s also a keen observer of what his most ardent supporters want, such as a desire to attack those whose existence they find offensive while claiming they’re doing it for our own good.
Those who support DeSantis’ crusade against families with trans children should beware. History teaches that when you choose leaders to hurt the people you hate, they end up hurting the people you love too.