Academics attack Florida plan to limit transgender treatment

A plan by Florida health officials that likely would restrict Medicaid insurance coverage for gender dysphoria treatments for transgender people lacks sound medical justification and may be politically motivated, according to a group of academics from Yale University and other schools.

The Florida Agency for Health Care Administration said puberty blockers, cross-sex hormones and sex reassignment surgery have not been proven safe or effective in treating gender dysphoria. Tom Wallace, the state's deputy director of Medicaid, signed off on the report last month.

But a group of seven scientists and a law professor from Yale and other schools said in a report last week that the Florida's agency's conclusions are "incorrect and scientifically unfounded." The Florida conclusions are so flawed "that it seems clear that the report is not a serious scientific analysis but, rather, a document crafted to serve a political agenda," according to the academics.

"Medical treatment for gender dysphoria does meet generally accepted professional medical standards and is not experimental or investigational," the academics' report said.

A spokesman for the Florida health agency dismissed the academics' report as "another example of the left-wing academia propaganda machine."

"The Yale 'review' is a hodgepodge of baseless claims using 'expert opinions' that lack any sort of real authority or scientific credibility," Brock Juarez, AHCA communications director, said in an email to news organizations.

Transgender for children and teens is increasingly under attack in many states where it has been labeled a form of child abuse or subject to various bans. Critics point to the irreversible nature of many elements of gender transition treatment.

Many doctors and mental health specialists argue that medical treatment for transgender children is safe and beneficial and can improve their well-being, although rigorous long-term research on benefits and risks is lacking. Federal guidelines say gender-affirming care is crucial to the health and well-being of transgender and nonbinary children.

Last year, the American Medical Association issued a letter urging governors to block any legislation prohibiting the treatment, calling such action "a dangerous intrusion into the practice of medicine."

Among criticisms in Florida's ACHA report on treatment, seen as a precursor to limiting Medicaid coverage in Florida of the procedures, are that studies on the benefits of the procedures are of "low quality." That typically means they involve and not randomized controlled trials, which are considered the gold standard of medical research.

The review by the Yale-based academics says randomized trials can't be conducted for all potential treatments or conditions, in part for ethical reasons, and that many medical recommendations have been based on observational studies. It cites as an example prescriptions for lowering with statins, medicines that are given to millions of older Americans every year and are covered by Medicaid.


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