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On April 20, 2022, the Florida Department of Health issued guidance[ application/pdf ] related to the treatment of gender dysphoria in children and adolescents. In accordance with Chapter 59G-1035, Florida Administrative Code, the Secretary of the Agency for Health Care Administration requested [ pdf 167.3 kB ] that Florida Medicaid program review whether treatments are consistent with widely accepted professional medical standards. This report was completed on June 2, 2022, [ pdf 128.6 kB ] and found that several services for the treatment of gender dysphoria – i.e., sex reassignment surgery, cross-sex hormones, and puberty blockers – are not consistent with widely accepted professional medical standards and are experimental and investigational with the potential for harmful long term affects.

What You Should Know

The Agency’s report summarizes the scientific research about the effectiveness of treatment for gender dysphoria for children. Research found:

  • Scientific studies supporting hormone replacement therapy, puberty blockers, and sex reassignment surgery for treating gender dysphoria are weak to very weak.
  • The evidence showing benefits from hormone replacement therapies for gender dysphoria is very weak.
  • Scientific studies do not show that the use of puberty blockers improves mental health.
  • There is a lack of long term, follow-up studies after sex reassignment surgery.
  • There are no randomized control trials on the effectiveness of “gender affirming" treatment.

In clinical research, randomized controlled trials are the gold standard for demonstrating the effectiveness and safety of a new treatment. Read more about randomized control trials at the National Institutes of Health.

Read the Report
Florida Medicaid Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria [ pdf 2.5 MB ]

Attachment A:
Transmittal Letter [ pdf 167.3 kB ]

Attachment B:
Rule Chapter 59G-1.035, Florida Administrative Code [ pdf 118.5 kB ]

Attachment C:
Romina Brignardello-Petersen, DDS, MSc, PhD and Wojtek Wiercioch, MSc, PhD: Effects of Gender Affirming Therapies in People with Gender Dysphoria: Evaluation of the Best Available Evidence. 16 May 2022 [ pdf 2.7 MB ]

Attachment D:
James Cantor, PhD: Science of Gender Dysphoria and Transsexualism. 17 May 2022 [ pdf 655.1 kB ]

Attachment E:
Quentin Van Meter, MD: Concerns about Affirmation of an Incongruent Gender in a Child or Adolescent. 17 May 2022 [ pdf 125.6 kB ]

Attachment F:
Patrick Lappert, MD: Surgical Procedures and Gender Dysphoria. 17 May 2022 [ pdf 215.9 kB ]

Attachment G:
G. Kevin Donovan, MD: Medical Experimentation without Informed Consent: An Ethicist’s View of Transgender Treatment for Children. 16 May 2022 [ pdf 232.1 kB ]


Working Together to Protect Our Children