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Florida medical board may pass a rule to reduce disruptions caused by trans care law

Daylina Miller
WUSF Public Media
Transgender residents say the new law is causing confusion and fear in the community and disrupting some people's access to treatment. Medical boards will continue updating standards of care in the coming months.

Transgender patients say their doctors have been holding off on prescribing treatments as they wait for new consent forms. Medical boards are proposing to allow them to continue for now.

For support, contact the National Transgender Lifeline at 1-877-565-8860 (additional resources below.)

The Florida Board of Medicine is expected to pass an emergency rule on Friday that would allow patients receiving gender-affirming care to continue as officials craft new standards for treatment.

The goal is to address disruptions caused by a new law that restricts access to transgender care for minors and also makes it harder for adults to get care.

A group of board members discussed the proposal in concept with a committee from the Florida Board of Osteopathic Medicine on Thursday during a contentious public meeting in Tampa. The full board of medicine is scheduled to meet on Friday morning at the same location.

About 100 people attended Thursday’s meeting, held on the first day of Pride Month. Almost all were there to protest the new law, SB 254. It bars doctors from prescribing gender-affirming treatments to minors, but allows kids who were already receiving care, along with adults, to continue.

Patients say they're losing access to care

The meeting focused on a provision in the law that tasks medical boards with developing consent forms patients must sign in the presence of a doctor. Patients already have to sign consents to obtain medications like puberty blockers and hormones, but doctors moving forward must use the state-approved forms.

Those forms aren’t available yet, and board members noted during Thursday’s meeting that they probably won’t be until July. Since the law went into effect immediately after Gov. Ron DeSantis signed it on May 18, transgender patients and their health providers say it’s caused significant disruptions in care.

Daylina Miller
WUSF Public Media
Alex Sierra recently launched a website where transgender people can find doctors willing to prescribe hormone therapy and other resources.

“It’s unconscionable to impose a law that says you cannot access this care without a consent form, and then it doesn’t exist,” said Alex Sierra. The Orlando resident has been taking hormones for more than 15 years to help his body align with his identity and has been worried about what will happen if his prescription runs out.

That fear was echoed by Luke Monaco of Winter Haven, who said he and his spouse both recently learned from their health care provider that they cannot be prescribed their testosterone medication until the new forms are ready.

“Because they're scared; they're afraid of repercussions, they're like, 'I don't know what’s going to happen to me, legally speaking,' ” Monaco said.

Who needs to consent?

Under the emergency rule, doctors would be allowed to refill existing prescriptions for patients as medical boards work on the forms. Once they’re ready, patients would have six months to get them signed in the presence of a doctor and would need a psychiatrist or psychologist to verify their gender dysphoria diagnosis.

Daylina Miller
WUSF Public Media

While the Florida Board of Medicine is expected to vote on the emergency rule on Friday, the full Board of Osteopathic Medicine is not scheduled to meet again until August. That will likely change to meet the law’s requirements, which gave the boards 60 days to establish standards for youth.

Because of this, the committee members largely focused their discussion on children. Some stressed potential side effects from gender-affirming treatments and voiced skepticism about the mental health benefits, which audience members responded to with anger.

“It’s given me a new life,” said Tampa resident Felix Sutphin Garcia, 27, about how hormone therapy and emotional support have helped him. “Before I started having gender-affirming care I felt like I was living in a shell, and now I actually feel like I am living my true life, so it’s really scary that people are trying to take that away from other people, especially kids.”

What trans residents told the boards

Board members discussed the possibility of requiring both of a child’s parents or legal guardians to be present for the appointment to sign the consent as well. That drew concern from Bree Jackson of New Port Richey, who noted families may not easily be able to get both parents in the same room for a variety of reasons including military deployment, divorce or incarceration, among others.

 Luke Monaco of Winter Haven has been struggling to find someone who will prescribe his hormones since the new law went into effect last month.
Stephanie Colombini
WUSF Public Media
Luke Monaco of Winter Haven has been struggling to find someone who will prescribe his hormones since the new law went into effect last month.

The law doesn’t establish a clear timeframe for the boards to address standards for adults, which is why attendees like Monaco urged the committee to work as quickly as possible to avoid further disruption.

Board members thanked him and Jackson for their feedback during an often-heated public comment period during which they accused other attendees of veering off-topic and verbally attacking the committee.

At one point, committee chair Dr. Zachariah Zachariah called for a brief recess to restore order, inspiring attendees to break out into song. They sang “Leon On Me” by Bill Withers, which encourages people to support one another.

What's next in the process

Leviathan Lier, a 19-year-old from Orlando, also addressed the committee. Lier takes testosterone hormones as well, and had chest surgery scheduled for seven months before he learned late last month that it was canceled due to the consent form issue, leaving him “devastated.”

Daylina Miller
WUSF Public Media
Leviathan Lier, 19, recently had chest surgery canceled because of the new law.

“Just the fact that I waited so long and went through so much effort, saved so much money for my top surgery just to be told, ‘Nope, can't do it’ — it's insane,” he said.

Until the boards finalize consent forms, Lier's surgery will have to wait because it's considered a change in treatment. But he could continue his testosterone medication under the emergency rule if it passes.

The challenge, he and others noted, is that there are a lot less health care professionals left in the state who are allowed to provide this care. Advocates say nurse practitioners accounted for a majority of gender-affirming care providers in Florida before the law stripped them of their ability to prescribe hormones.

The demand for physician services could be overwhelming in the coming months. Some speakers cautioned that could make it difficult for patients to be seen in person to reestablish consent within that six-month timeframe.

The committee agreed to reconvene and discuss draft language for the consent forms on June 23.

How to get help

Equality Florida's transgender resource guide is a statewide directory of quality, transgender-friendly service providers from across the state.

The Umbrella Guide is an Orlando-based effort that's compiling a list of providers willing to provide hormone therapy.

You can reach the National Transgender Lifeline (staffed by trans individuals} at 1-877-565-8860.

The Trevor Project also operates a 24-hour lifeline at 1-866-488-7386

Copyright 2023 WUSF 89.7

Stephanie Colombini joined WUSF Public Media in December 2016 as Producer of Florida Matters, WUSF’s public affairs show. She’s also a reporter for WUSF’s Health News Florida project.