Florida Agencies Manipulated Research To Ban Trans Care And Coverage

Florida has banned gender affirming care for trans youth as well as Medicaid coverage for trans adults. New information in court findings shows how they manipulated research to support this.

On August 11th, Florida’s Agency for Health Care Administration banned gender affirming care coverage from Medicaid. Meanwhile, the board of medicine proceeded to ban gender affirming care for transgender youth. To do this, they relied on a newly created “Standards of Care” for the treatment of gender dysphoria that was rife with errors and omissions. Now, new court filings show that the Florida Surgeon General’s Office and the Agency for Health Care Administration purposefully manipulated this research to justify banning gender affirming care, including a flow chart produced before the “research” was commissioned with the explicit end goal of “care effectively banned.” Worse, they utilized a consultant from a religious conversion therapy organization to do so.

The newly minted Florida “Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria” were released in June 2022, and within a month, Florida’s Agency for Health Care Administration banned gender affirming care coverage. Florida’s board of medicine relied on it heavily in their ban on gender affirming care for transgender youth as well. The document, which claims that “gender affirming care” is experimental and does not meet medical guidelines, was immediately slammed by scientific and medical organizations and experts.

A Yale Review scathingly criticized the report, stating, “We are alarmed that Florida’s health care agency has adopted a purportedly scientific report that so blatantly violates the basic tenets of scientific inquiry… So repeated and fundamental are the errors in the June 2 Report that it seems clear that the report is not a serious scientific analysis but, rather, a document crafted to serve a political agenda.”

Now, we have direct evidence that this was the case. In a lawsuit aiming to reverse Florida's Medicaid ban, the discovery process unearthed documents from the Florida Surgeon General’s Office. These papers reveal the unambiguous objective of the research: to arrive at an outcome where "care is effectively banned." See this flowchart obtained in discovery documents:

Flowchart of the research plan with “Care effectively banned” as an end result.

To make matters worse, the Surgeon General’s Office of Florida, which is supposed to make its decisions using rigorous scientific and medical standards, tapped leaders from the misleadingly named American College of Pediatricians (ACP), a conversion therapy organization designated as a hate group by the Southern Policy Law center, to consult on its production. Emails show that Jason Weida of Florida’s AHCA was put in touch with Dr. Andre Van Mol, a religious fundamentalist and conversion therapy supporter who chairs the adolescent sexuality committee of the American College of Pediatricians.

You can see this email, unearthed by anti-LGBTQ+ extremism researcher Zinnia Jones from discovery documents in Florida:

Dear Jason and Trey,

Due to two unforeseen family crises, I must decline serving as a consultant for the State of FL at this time. My well-credentialed and equally expert in GD colleague, Dr. Andre Van Mol, has agreed to take my place so I am introducing him to you in this email.

Dr. Van Mol is a practicing Family Medicine physician in CA. In addition to being published on matters of medical ethics and childhood GD, he is Chair of the Adolescent Sexuality Committee of the American College of Pediatricians and a spokesperson for the Christian Medical and Dental Associations. He will be an outstanding consultant for your team in terms of provision of and analysis of studies. He has catalogued the literature as long as I have.

Dr. Van Mol would go on to promote documents created by the ACP in order to get them enshrined into Florida’s medical literature. One such document was developed in January 2023 and was discovered due to a massive leak of documents by the organization. This document is quoted by Jones as being a “129-page file of references and sources for anti-trans arguments, attributed to Andre Van Mol and dated January 2, 2022” - you can find a full link to the first version of the document in Jones’ research. The slightly updated document was directly sent to the AHCA with a few additions in order to help develop their standards of care with the explicit goal to ban trans care and can be found in the court filings.

This document houses much of the now-known-to-be deliberately distorted research that Yale scientists denounced as flagrantly unscientific. For example, Yale researchers highlighted how the Florida Standards of Care recommend that trans youth should not receive any medical care, asserting that psychotherapy alone, termed "watchful waiting" by the Florida standards, is adequate for trans youth. To validate this, the standards lean heavily on a criticisms from a single doctor, Dr. James Cantor, while overlooking studies that demonstrate the effectiveness of gender-affirming care in reducing suicides. All justifications for this approach, including the dependence on Cantor, can be traced back to the documents from the American College of Pediatricians (ACP) that Dr. Van Mol utilized and passed on to the Florida Agency for Healthcare Administration (AHCA).

Dr. Van Mol himself is a noted proponent of “reparative therapy” and “sexual orientation change efforts.” He has published multiple articles in favor of conversion therapy, including an article that claims that “homosexuality can be changeable” and that there is “no evidence of harm” in sexual orientation conversion therapy, despite research showing that conversion therapy raises suicide rates by as much as 800%. In a recent video discussing conversion therapy, Dr. Van Mol advocates for conversion therapy and asks for pastors supporting LGBTQ+ people to repent.

The Florida Agency for Healthcare Administration and the Florida Surgeon General are now incontrovertibly implicated in distorting research to further their objective of banning gender-affirming care. The manipulated research was facilitated using materials generated by a Christian fundamentalist conversion therapy group, the American College of Pediatricians, and a consultant advocating for sexual conversion therapy, Dr. Van Mol, with the end goal of banning care explicitly spelled out.

The newly established "standards of care" in Florida have been lambasted for flawed interpretations of scientific papers, selective omission of critical facts, and the incorporation of unsubstantiated pseudoscience reviews by Yale researchers. Such practices, in an academic context, would warrant severe sanctions and spell the end of careers for those involved. It amounts to academic misconduct on a scale rarely seen, particularly given the subsequent use of this research to deny care to tens of thousands of Floridians.

The manipulated research has begun to infiltrate other scholarly arenas. A recent British Medical Journal article, "Gender dysphoria in young people is rising—and so is professional disagreement," cited the Florida study to question the appropriateness of gender-affirming care as the standard medical approach to gender dysphoria. Subsequently, an expert in the case of Dekker v Weida, which contests the ban on gender-affirming care, referenced the BMJ's article to back the ban. Ironically, that very article partly relies on Florida's manipulated research!

It reveals a striking lack of integrity for those involved in Florida to question the scientific validity of the care standards for transgender individuals, given that the state's research findings were deliberately tampered with to endorse banning such care. The court will assess these arguments when deciding whether to overturn the rule prohibiting Medicaid coverage of gender-affirming care in the months ahead. Documents uncovered during the discovery process will be instrumental in shaping the final judicial decision.