In what at times appeared more like a tent revival than an agency rule hearing, state health officials on Friday received public input on a proposal that would deny Medicaid coverage for treatments such as puberty-blocking medication and hormone therapy for transgender people.
The state Agency for Health Care Administration rolled out the proposed rule in June, drawing harsh criticism from national and state legal and LGBTQ-advocacy groups.
Friday鈥檚 meeting drew more than 150 people, with supporters of the proposed rule --- many of them sporting 鈥淟et Kids Be Kids鈥� decals and making biblical references --- vastly outnumbering opponents.
Speakers supporting the proposal included a Baptist minister, members of the Florida Citizens Alliance, the head of the Christian Family Coalition, the founder of the Florida Prayer Network, a representative of the Florida Federation of Republican Women and a man carrying a giant American flag on a pole.
In contrast to typically staid rule hearings, the crowd at Friday鈥檚 session frequently broke out in applause and more than once attempted to shout down opponents of the proposal.
The proposed rule centers on treatment for gender dysphoria, which the federal government defines as clinically 鈥渟ignificant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.鈥�
Under the proposed rule, the Medicaid program would not cover puberty-blocking medication, hormones and hormone 鈥渁ntagonists,鈥� sex-reassignment surgeries and any 鈥渙ther procedures that alter primary or secondary sexual characteristics.鈥�
The proposal also would establish that such treatments don鈥檛 meet a definition of 鈥渕edical necessity.鈥� That is important because, by law, services provided in the Medicaid program must be deemed medically necessary.
The agency, which oversees the state鈥檚 Medicaid program, issued a report last month to back denying coverage of the treatments, which it said were 鈥渘ot consistent with generally accepted professional medical standards and are experimental and investigational.鈥�
Friday鈥檚 hearing opened with testimony from Chloe Cole, who said she is a 17-year-old 鈥渄e-transitioner鈥� from California who underwent treatments, including surgery to remove her breasts, between the ages of 13 and 16. Cole said she supports the proposed rule.
鈥淚 was unknowingly cutting off my true self from my body,鈥� she said, adding that she 鈥渨asn鈥檛 capable of understanding鈥� the decisions being made at the time.
Jeannette Cooper, a co-founder of Parents for Ethical Care, applauded the proposed rule, saying children are 鈥渂eing met with a medical treatment for a psychological condition.鈥�
Such treatments are 鈥渃ausing permanent psychological and physical harm by solidifying an idea that maybe you were born in the wrong body,鈥� Cooper argued.
鈥淲e are here to state the obvious. No child can or ever will be born in the wrong body. Everybody knows what a woman is, but some people are afraid to say it. We are not afraid,鈥� she said. 鈥淎ffirmation (gender affirming care) is a poison bandage that does not help to heal.鈥�
But Nathan Bruemmer, an attorney who works as LGBTQ advocate for state Agriculture Commissioner Nikki Fried, said that 鈥済ender-affirming care is the standard of care,鈥� noting that numerous medical associations support treatment for gender dysphoria.
鈥淚 am one of thousands, tens of thousands, of transgender Floridians here in our state who had the privilege to have access to gender-affirming health care 鈥� who are happy and successful and thriving,鈥� Bruemmer said. 鈥淲e are part of the fabric of this nation and this great state and we deserve the rights afforded to all.鈥�
Anthony Verdugo, founder and executive director of the Christian Family Coalition, called gender-affirming treatments 鈥渃rimes against humanity.鈥�
鈥淕roomers are using their authority as adults to pressure children and ruining their lives,鈥� he said. 鈥淟et kids be kids.鈥�
But critics of the proposal warned that it could have deadly effects on transgender Floridians and is based on politics rather than policy.
鈥淭he rule is simply discriminatory, undeniably targets the transgender community. You may not understand what it鈥檚 like to be transgender 鈥� but transgender friends are here in this audience, and they are telling you about how horrible this will be for the more than 9,000 transgender Floridians on Medicaid,鈥� said Jon Harris Maurer, public policy director for the LGBTQ-advocacy group Equality Florida, whose comments were drowned out by jeers.
Rule supporter Pam Olsen, founder of the Florida Prayer Network, said the state needs to 鈥渟top the nonsense, and let鈥檚 do what鈥檚 right.鈥�
鈥淭here are boys. There are girls. There are men. There are women,鈥� she said.
Ed Wilson was among numerous speakers who alleged that children are being indoctrinated into believing they are transgender.
鈥淭axpayer money should never be used to destroy lives,鈥� he said.
Lambda Legal attorney Carl Charles, however, said his organization is 鈥渄eeply disturbed鈥� by the proposed rule and disputed the state report backing it.
Treatments targeted in the proposal are 鈥渃linically effective, evidence-based and widely accepted and used by medical professionals across the country for treating gender dysphoria,鈥� Charles said.
The proposal 鈥渨ill cause serious, immediate and irreparable harm to transgender Medicaid participants in Florida who have already experienced 鈥� well-documented and pervasive stigma and discrimination in their day-to-day lives, including significant challenges, if not all-out barriers, to accessing competent home-care services,鈥� he argued.
The proposed rule comes as the DeSantis administration and Republican leaders target transgender issues in advance of the 2022 elections.
The Florida Department of Health in April released guidelines that said treatment such as puberty-blocking medication and hormone therapy should not be used for transgender youths. Federal officials have blasted the state鈥檚 stance.
Also, Gov. Ron DeSantis in March signed a controversial law that restricts instruction about gender identity and sexual orientation in public schools, disparagingly dubbed by critics as the 鈥渄on鈥檛 say gay鈥� bill.
At the close of Friday鈥檚 two-hour meeting, Jason Weida, assistant deputy secretary of Medicaid policy and quality for the Agency for Health Care Administration, said the proposal does not apply to private insurers or people who pay for treatment on their own.
鈥淲e鈥檙e not talking about a ban for treatment of gender dysphoria. We鈥檙e talking about not covering through reimbursement in the Florida Medicaid program for the services that are inherently enumerated in the rule itself,鈥� Weida said.