As critics made it painfully clear, Florida's law banning gender-affirming care for minors signed into law last month by GOP Gov. Ron DeSantis, also makes it effectively impossible to get for adults, and the state's trans community is finding out the hard way that this was the intent all along.
Eli and Lucas, trans men who are a couple, followed the discussions in the Legislature, where Democrats warned that trans children would be more prone to suicide under a ban on gender-affirming care for minors and Republicans responded with misplaced tales of mutilated kids. Eli said he and his partner felt “blindsided” when they discovered the bill contained language that would also disrupt their lives.
“There was no communication. … Nobody was really talking about it in our circles,” said Eli, 29.
Like many transgender adults in Florida, he and Lucas are now facing tough choices, including whether to uproot their lives so that they can continue to access gender-confirming care. Clinics are also trying to figure out how to operate under regulations that have made Florida a test case for restrictions on adults.
Lucas, 26, lost his access to treatment when the Orlando clinic that prescribed him hormone replacement therapy stopped providing gender-affirming care altogether. The couple also worries about staying in a state that this year enacted several other bills targeting the LGBTQ+ community.
“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, who works in a financial aid office at a college, 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.”
The Associated Press is not using Eli’s and Lucas’ last names because they fear reprisal. While their friends and families know they are trans, most people who meet them do not.
The new law that bans gender-affirming care for minors also mandates that adult patients seeking trans health care sign an informed consent form. It also requires a physician to oversee any health care related to transitioning, and for people to see that doctor in person. Those rules have proven particularly onerous because many people received care from nurse practitioners and used telehealth. The law also made it a crime to violate the new requirements.
Another new law that allows doctors and pharmacists to refuse to treat transgender people further limits their options.
“For trans adults, it’s devastating,” said Kate Steinle, chief clinical officer at FOLX Health, which provides gender-affirming care to trans adults through telemedicine. Her company decided to open in-person clinics and hire more physicians licensed in Florida in order to continue to provide care to patients who have already enrolled, even though that represents a major change to the company’s business model.
Eli has been seeing a physician for years and therefore still has access to care. But SPEKTRUM Health Inc., the Orlando clinic that prescribed Lucas hormone replacement therapy, has stopped providing gender-affirming care.
“There are a lot of people looking for care that we’re no longer legally able to provide,” said Lana Dunn, SPEKTRUM Health’s chief operating officer.
Florida has the second-largest population of transgender adults in the U.S., at an estimated 94,900 people, according to the Williams Institute at the University of California, Los Angeles School of Law. It used state-level, population-based surveys to determine its estimates. Not all transgender people seek medical interventions.
At least 19 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors. But restrictions on adults haven’t been part of the conversation in most places. Missouri’s attorney general tried to impose a rule in that state, but it was pulled back.
Florida is “the proving ground of what they can get away with,” Dunn said.
That last sentence there, marking trans folks for increasingly brutal and endless state-sponsored cruelty, is, as they say, the point. More is coming. Republicans will block any federal attempt to stop red states from eliminating trans folks, but the government-sponsored destruction of an entire class of people is the key to a fascist state. Once you can take the rights of a group, then everyone else's rights become secondary to the whims of state decreeing the next group slated for demolition, until nobody is left.
Regardless of DeSantis's ongoing failure as a GOP presidential primary candidate, his policies are going national across dozens of states, hurting hundreds of thousands of Americans.
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