Florida Medicaid may soon refuse to cover "puberty suppression, cross-sex hormones, and surgical procedures," stating that these "do not conform" to professional medical standards, which are a condition of coverage.
The report, obtained by The Federalist, states that "as a condition of coverage, sex reassignment treatment must be 'consistent with generally accepted professional medical standards (GAPMS) and not experimental or investigational,'" as determined by the deputy secretary for Medicaid.
The report emphasizes the dangers of such procedures on minors, but applies to Florida Medicaid patients as a whole.
"Available medical literature provides insufficient evidence that sex reassignment through medical intervention is a safe and effective treatment for gender dysphoria," the report states.
The document includes accompanying analyses by medical experts, which highlight concerns and dangers regarding genital surgeries and cross-sex hormones, especially in regards to children.
The report also states that "the available evidence demonstrates that these treatments cause irreversible physical changes and side effects that can affect long-term health."
It includes a list of potentially or permanently irreversible effects of cross-sex hormone usage, like the growth of body and facial hair, an enlarged clitoris, and a deeper voice for females taking male hormones, and infertility, sexual dysfunction, and breast growth for males taking female hormones.
"Treatments that pose irreversible effects should not be utilized to address what is still categorized as a mental health issue,” the authors wrote, noting that “until 2013, the APA considered having gender identity issues a mental disorder by itself,” citing studies that indicate “individuals with gender dysphoria have high rates of anxiety and depressive disorders with results ranging as high as 70 percent having a mental health diagnosis.”
In conclusion, Florida Medicaid found that the research behind sex reassignment treatments, whether surgical or hormonal, is "insufficient to demonstrate efficacy and safety."
"Considering the weak evidence supporting the use of puberty suppression, cross-sex hormones, and surgical procedures when compared to the stronger research demonstrating the permanent effects they cause, these treatments do not conform to GAPMS and are experimental and investigational," the report stated.
While a final decision regarding the coverage status was not publicized, the report indicated that Florida Medicare may refuse to cover such procedures.
If they refuse to do such, Florida would join Arkansas, Arizona, Ohio, Georgia, Tennessee, Texas, Nebraska, and Missouri in excluding puberty blockers, cross-sex hormones, and surgical procedures regarding Denver from their Medicaid coverage.
The report follows an April guidance issued by the Florida Department of Health regarding gender dysphoria care.
The guidance took aim at one released by the Department of Health and Human Services, which spoke in high regard on hormone usage and surgical intervention for gender dysphoria.
The Florida guidance states: "A paper published in the International Review of Psychiatry states that 80 percent of those seeking clinical care will lose their desire to identify with the nonbirth sex. One review concludes that 'hormonal treatments for transgender adolescents can achieve their intended physical effects, but evidence regarding their psychosocial and cognitive impact is generally lacking.'"
Citing the Merck Manual of Diagnosis and Therapy, the guidance states: "gender dysphoria is characterized by a strong, persistent crossgender identification associated with anxiety, depression, irritability, and often a wish to live as a gender different from the one associated with the sex assigned at birth."
Signing onto this guidance was Governor Ron DeSantis, as well as Florida Surgeon General Joseph Ladapo.
"The federal government's medical establishment releasing guidance failing at the most basic level of academic rigor shows that this was never about health care," said Ladapo in a statement, according to Fox 4.
"It was about injecting political ideology into the health of our children. Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18."
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