Florida Medicaid moves against transgender therapies coverage, calls it 'experimental'

FIRST ON FOX – Florida's Agency for Health Care Administration appears to have taken a preliminary step against Medicaid coverage for transgender therapies after reviewing the medical literature on the benefits and the possible severe consequences of available treatments, Fox News Digital has learned. 

Florida Medicaid does not currently have a specific policy on covering transgender treatments. In general, its Medicaid coverage is determined based on Generally Accepted Professional Medical Standards (GAPMS). To determine GAPMS, the agency considered a review of research, consulted with experts, and entered into a final review by the Deputy Secretary for Medicaid. Secretary Tom Wallace signed the report indicating that he concurs with its findings. 

The report said, "Florida Medicaid has determined that the research supporting sex reassignment treatment 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 [generally accepted medical standards] and are experimental and investigational."

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Early treatment for youth experiencing gender dysphoria includes injections of puberty blockers, or gonadotropin hormone (GnRH) analogs, which provide time to figure out the possible future steps without the interference of some changes in puberty, such as the development of breasts in females and facial hair in males. However, puberty blockers can have adverse side effects that affect growth, future fertility and bone density, according to the Mayo Clinic.

The next part of the transition process includes cross-sex hormones. In females, masculinizing hormones can cause permanent changes such as facial and body hair growth, male-pattern baldness, deepening of the voice, and the development of an enlarged clitoris, the report said. In males, the feminizing hormones can cause irreversible effects such as breast growth. Sexual dysfunction is possibly irreversible in males, and a decrease in sperm production and infertility is likely irreversible. 

The Food and Drug Administration has not explicitly cleared hormone therapies for gender dysphoria treatment. As such, prescribers use it for "off-label" care, meaning the therapies are used to treat a medical condition it is not officially approved to treat. 

"Cross-sex hormones pose significant long-term health risks to transitioning individuals. Currently, little information is available given that researchers have not had adequate time to study the effects in this population," the report said. "The overall scientific consensus concludes that individuals who take cross-sex hormones will reduce the primary sexual function of his or her natal sex organs."

"Prescribers of cross-sex hormones focus so heavily on behavioral health outcomes that they de-emphasize that these drugs cause permanent physical changes and side effects that can lead to premature death."

It continued, "Use of hormones for other conditions has yielded data on how these drugs can affect the body and the cardiovascular system in particular. Because of the high dosages required to achieve physical change and the need to continuously take the drugs, cross-sex hormones can potentially harm quality of life and reduce life expectancy for transitioning individuals."

The report, which was released following a request from Agency for Health Care Administration Secretary Simone Marstiller, followed a series of laws and maneuvers in Florida regarding transgender youth. 

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An April 20 guidance was released by the Florida Department of Health which recommended against hormone therapies, gender-reassignment surgery and social transitioning. 

"Encouraging mastectomy, ovariectomy, uterine extirpation, penile disablement, tracheal shave, the prescription of hormones which are out of line with the genetic make-up of the child, or puberty blockers, are all clinical practices which run an unacceptably high risk of doing harm," the guidance said. 

Additionally, Republican Gov. Ron DeSantis signed laws that curbed education on "gender identity" in younger grades and another that blocked transgender athletes from competing in women's sports in public schools.