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Florida’s trans community in “chaos” after DeSantis took away gender-affirming care from many adults

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Florida’s laws predicated on banning gender-affirming healthcare for transgender young people under the age of 18 have resulted in transgender adults losing access to gender-affirming care as well.

In addition to banning access to treatments like puberty blockers, hormone replacement therapy (HRT), and gender-affirming surgeries for minors, Senate Bill 254, one of several anti-LGBTQ+ bills signed into law by Republican Gov. Ron DeSantis in May, also requires trans adults to receive care from a physician. Under the new law, patients can no longer receive care from a nurse practitioner or via telehealth services.

Lana Dunn, chief operating officer at SPEKTRUM Health Inc., an Orlando clinic that provides gender-affirming treatments, estimates that 80 percent of transgender adults in Florida get their healthcare from a nurse practitioner, leaving them scrambling to find an MD to provide care.

But another law signed by DeSantis last month allows healthcare providers or payers to deny service based on “a conscience-based objection,” including any ethical, moral, or religious beliefs. Advocates worry it will be used to deny LGBTQ+ people gender-affirming care, HIV-prevention medication, and other essential and life-saving care.

S.B. 254 also requires all trans adults to submit an informed consent form to the state’s Board of Medicine and Board of Osteopathic Medicine explaining that they understand the “risks” of trans-related healthcare. Journalist Erin Reed reports that the state’s medical board has not even produced the form yet, leaving the remaining 20 percent of trans adults in Florida who receive gender-affirming care from a doctor at risk of forced medical detransition as well.  

“Right now what we’re seeing in the community is just chaos,” Dunn told the Associated Press.

Dunn said that SPEKTRUM Health’s Orlando clinic has had to stop providing gender-affirming care altogether. “There are a lot of people looking for care that we’re no longer legally able to provide.”

Reed reports that Planned Parenthood, which relies on nurse practitioners to provide care, has also had to pause its gender-affirming care services for adults. She also spoke to one transgender woman in Florida who said that her local Publix pharmacy refused to refill her prescription while they evaluated the impact of the state’s new laws.

“Losing access or not being able to refill would be possibly the worst thing,” 38-year-old Mia told Reed. “The last nine months have been the best mental health-wise, even with all of the fear from the law changes. I’ll find refills through the gray market before being forcibly detransitioned.”

Lucas, a 26-year-old transgender man in Florida lost access to his HRT meds when SPEKTRUM stopped providing gender-affirming care. He told the AP he is likely to run out of medication this month. “It’s just going to be extremely difficult mentally to have your body changing in a way that doesn’t align with your brain,” he said.

Lucas and his partner Eli, who is also trans, are considering leaving Florida. “My entire life is here. All my friends, my family. I just got a promotion at my job, which I’m probably not to be able to keep,” Lucas said. “I’m losing everything except Eli and my pets moving out of here. So this was not a decision that I took lightly at all.”

But as transgender researcher Zinnia Jones told Reed, “Leaving the state is also not a realistic or scalable option: Florida has the second-largest adult trans population in the country after California. 94,900-100,000 adult trans people are affected by this ban.”

As the AP notes, at least 19 states have enacted laws banning gender-affirming care for minors. While bans on care for adults have been rare so far, Dunn said that Florida’s laws make the state “the proving ground” for what anti-trans lawmakers can get away with.

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