Florida House bill threatens gender-affirming care for minors, adults alike
The bill would not only prevent minors from starting treatments for gender transitions and stop treatments for those who have already begun the process. It would also ban public expenditures of all gender-affirming care for those over 18, outside of Medicaid.
At 11 years old, Tyler Audino’s Google search history was often filled with questions like “Why do I look like a girl but feel like a boy?”
Access to the internet at such an early age, he said, was a big component in helping him realize he was transgender. Before he was even close to adulthood, he knew he wanted access to gender-affirming healthcare to pursue a medical transition.
“I was lucky to start my medical transition at 16, and that was life-saving for me,” he said.
Audino, now 19, has undergone hormone replacement therapy and top surgery — a voluntary procedure for removing breast or chest tissue.
But the introduction of House Bill 1421, a companion bill to Senate Bill 254 that passed Tuesday, bans gender-affirming health care — including hormone replacement therapies and puberty-blocking medication — for Florida residents under the age of 18.
In August, the Florida Agency for Healthcare Administration ruled that Medicaid would no longer cover gender-affirming health care. In November, the Florida Board of Medicine and Board of Osteopathic Medicine voted to ban gender-affirming health care for minors but allowed those who had already begun the transition process prior to March 16 to continue receiving medical treatment.
House Bill 1421 is sponsored by Rep. Randy Fine and Rep. Ralph Massullo, both Republicans from Lecanto. The bill would not only continue to prevent minors from starting these treatments for gender transitions but stop treatments for those who have already begun the process. It would also ban public expenditures of all gender-affirming health care for those over 18, outside of Medicaid.
“It’s all disheartening,” Audino said. “It’s crazy to me how there are issues in our world like poverty or homelessness, and legislators just want to focus on marginalized communities.”
As a child, Audino said he struggled to grasp that being transgender was considered a taboo thing, and he couldn’t understand why he didn’t have much of a support system that understood why he felt the way he did.
“This was something I was thinking about every moment of my life, basically,” he said. “So not having full support was definitely hard.”
He said he is worried about the legislation slowly taking away the option to medically transition, and he fears the effect it could have on children.
According to the American Civil Liberties Union, more than 430 anti-LGBTQ bills have either been proposed or passed in the United States — 10 of which have been filed in Florida.
These bills deal with a range of matters from civil rights and nondiscriminatory practices to providing equitable access to healthcare.
Gov. Ron DeSantis argued that it is best to wait to undergo gender-affirming medical care instead of causing what could be “irreversible harm.”
“Most of it resolves itself by the time they become adults, but the way to deal with that is to provide whatever counseling is needed, not to hack off their body parts,” DeSantis said at a news conference in Bradenton in February.
But the process of detransitioning — when a person who has sought gender-affirming medical care decides to stop or reverse its effects — is statistically unlikely, according to GenderGP.
Only about 3% of transgender people who transition experience some form of regret — primarily because of social stigma and outside pressures, not dissatisfaction with the care. Ninety-seven percent of those who transition are reportedly happy with the result of the overall decision.
Simone Chriss, an attorney and the director of the Transgender Rights Initiative at Southern Legal Counsel, said the recent bill goes directly against national legislation protected by the U.S. Constitution. She said it violates the equal protection rights and due process rights under the 14th Amendment.
“I think that it’s really easy to get people excited and energized and frantic and angry and motivated around something that they do not really understand but that they’re afraid of,” Chriss said. “Using trans children and pretending that these awful bills and laws are actually protecting them from some sort of harm, that this care is experimental or harmful, that’s not true.”
The newest anti-trans bills also violate section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of sex and gender identity, she said.
“These things have been demonstrated across the country in other federal courts to be unconstitutional, and Florida knows that, and they’re doing it anyway,” Chriss said.
She said she is overwhelmed with trying to legally address the anti-LGBTQ rhetoric exchanged throughout Congress, but she is fighting to help the people these laws are hurting to the best of her abilities.
“It’s hard to really put into words the impact that I know this will have on the communities that I serve,” she said. “There will be blood on the hands of the legislators who are pushing these things forward and allowing these things to happen.”
Lindsey Ice, an 18-year-old studying hospitality management at the University of Florida, is nonbinary — meaning they are neither exclusively man nor woman.
“Being able to look at yourself in the mirror and see who you feel you are on the inside reflected back to you is such an important part of being true to who you are and feeling comfortable in your own body,” Ice said.
Coming from a conservative family, Ice said it was difficult to come out as nonbinary. It was not until they left for college and primarily surrounded themself with other LGBTQ people that they really started to feel comfortable in their own skin.
“So many LGBTQ children already struggle so much with mental health and suicidal thoughts and things like that and being completely denied validity as to who you are … it’s not going to limit the amount of people who are trans or gay,” they said.
Regina Livingston, a trans woman from Gainesville, noticed a lack of support in Alachua County, leading her to found the Unspoken Treasure Society in 2018 to provide a support network for transgender people in the community. With the new legislation coming forward, she said she felt outraged at what a disservice it would do to young adults and children.
“We’re going through this, and we will get through this,” she said. “We’ve been here forever, and we’ve had to fight before. It’s very unfortunate that we have to be in this place and time.”
Livingston said the Unspoken Treasure Society is raising funds to help people who may not have the money to continue receiving gender-affirming health care if this bill were to pass. She said they would do whatever is necessary to continue financing medical treatment without insurance for those who need it.
“Children not being able to be who they are leads to suicide, it leads to depression,” she said. “There’s a lot of things that happen when you try to keep a child from living in their absolute truth and being who they are … we’re going to fight, most definitely.”
Macy McClaren, 20, said she thinks these bills suppress the way people express themselves. Even as a cisgender person, she made the decision to cut her hair to solidify her gender identity. She said she likes the freedom of choice to be either masculine or feminine based on how she feels.
It’s all about how you want to express yourself, and gender identity is a big component of doing that, she said. She fears what this could mean for her friends who are trans.
“They express themselves in their own way, and it’s beautiful and amazing,” she said. “I think that taking [gender-affirming care] away would definitely affect that and hurt them.”
Audino said it makes him angry that legislators keep passing bills targeting the LGBTQ community.
“It makes me so disheartened for the future of Florida, especially,” Audino said. “I grew up here. I’ve lived here for 15 years. This is my home, and I hate that I feel like the state doesn’t want me.”