Transgender Care: GOP Leaders Battle with Medical Groups



Republican attorneys general from multiple states are seeking to sway a federal appeals court considering Florida’s restrictions on treatments for transgender people, such as puberty blockers and hormone therapy. They have argued against a previous ruling that blocked Medicaid coverage for these treatments and rules preventing minors from receiving them, claiming that medical organizations are increasingly performative and that there’s a replication crisis in scientific literature. On the opposing side, 23 medical organizations argue that denying these treatments to adolescents who meet the necessary medical criteria puts them at risk of significant harm and emphasize that gender-affirming care is widely accepted as the appropriate treatment for gender dysphoria.

Republican AGs and Medical Organizations Debate Florida’s Transgender Treatment Restrictions

Republican attorneys general and prominent medical organizations are attempting to influence a federal appeals court on Florida’s limits on transgender treatments. The 11th U.S. Circuit Court of Appeals received briefs on Friday presenting differing views on treatments such as puberty blockers and hormone therapy for patients with gender dysphoria.

After U.S. District Judge Robert Hinkle opposed a ban on Medicaid coverage for such treatments and halted rules preventing minors from receiving them, Florida turned to the Atlanta-based appeals court. Eighteen Republican attorneys general submitted a friend-of-the-court brief, arguing that the Florida Agency for Health Care Administration’s decision to refuse Medicaid coverage for the treatments should be respected and challenging many medical organizations’ support for puberty blockers and hormone therapy.

They argued that American medical organizations have become increasingly ‘performative,’ and their leaders are using them as platforms to advance current popular causes. The attorneys general also raised concerns about the safety and efficacy of gender-transition procedures on children.

Meanwhile, 23 medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society, filed a brief arguing that denying medically necessary treatments to adolescents poses significant risks.

With Governor Ron DeSantis prioritizing the matter, Florida regulators and lawmakers have approved restrictions on treatments for gender dysphoria throughout 2022 and this year. This follows a broader national trend of politically-charged debates about transgender issues, with GOP-controlled states passing similar restrictions.

“The widely accepted view of the professional medical community is that gender-affirming care is the appropriate treatment for gender dysphoria and that, for some adolescents, gender-affirming medical interventions are necessary. This care greatly reduces the negative physical and mental health consequences that result when gender dysphoria is untreated.”

– Brief filed by 23 medical organizations on Friday

At the center of the issue are treatments for gender dysphoria, defined by the federal government as the distress a person may feel when their gender identity doesn’t align with the sex assigned at birth. The Florida Agency for Health Care Administration ruled against Medicaid reimbursements for treatments like puberty blockers and hormone therapy last year, considering them “experimental” and “not medically necessary.”

Judge Hinkle ruled against the restrictions in June, arguing that they were driven more by politics than medicine. The state and the Republican attorneys general, however, dispute the major medical organizations’ claims that the treatments are proven and necessary. They were supported by the American College of Pediatricians, who are opposed to transgender interventions on minors.

The attorneys general brief included legal officers from Alabama, Arkansas, Tennessee, Georgia, Montana, Idaho, Nebraska, Indiana, South Carolina, Iowa, Texas, Kansas, Utah, Kentucky, Virginia, Mississippi, West Virginia, and Missouri.

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