The Death Spiral

Status
Not open for further replies.
Ohh and the Florida Bill...yeah it is not just impacting kids

Transgender adults in Florida `blindsided' that new law also limits their access to health care​


TALLAHASSEE, Fla. (AP) — Debate surrounding Florida’s new restrictions on gender-affirming care focused largely on transgender children. But a new law that Republican presidential candidate and Gov. Ron DeSantis signed last month also made it difficult – even impossible – for many transgender adults to get treatment.

Eli and Lucas, trans men who are a couple, followed the discussions in the Legislature, where Democrats warned that trans children would be more prone to suicide under a ban on gender-affirming care for minors and Republicans responded with misplaced tales of mutilated kids. Eli said he and his partner felt “blindsided” when they discovered the bill contained language that would also disrupt their lives.

“There was no communication. … Nobody was really talking about it in our circles,” said Eli, 29.

Like many transgender adults in Florida, he and Lucas are now facing tough choices, including whether to uproot their lives so that they can continue to access gender-confirming care. Clinics are also trying to figure out how to operate under regulations that have made Florida a test case for restrictions on adults.

Lucas, 26, lost his access to treatment when the Orlando clinic that prescribed him hormone replacement therapy stopped providing gender-affirming care altogether. The couple also worries about staying in a state that this year enacted several other bills targeting the LGBTQ+ community.

“My entire life is here. All my friends, my family. I just got a promotion at my job, which I’m probably not to be able to keep,” Lucas, who works in a financial aid office at a college, said. “I’m losing everything except Eli and my pets moving out of here. So this was not a decision that I took lightly at all.”

The Associated Press is not using Eli’s and Lucas’ last names because they fear reprisal. While their friends and families know they are trans, most people who meet them do not.

The new law that bans gender-affirming care for minors also mandates that adult patients seeking trans health care sign an informed consent form. It also requires a physician to oversee any health care related to transitioning, and for people to see that doctor in person. Those rules have proven particularly onerous because many people received care from nurse practitioners and used telehealth. The law also made it a crime to violate the new requirements.

Another new law that allows doctors and pharmacists to refuse to treat transgender people further limits their options.

“For trans adults, it’s devastating,” said Kate Steinle, chief clinical officer at FOLX Health, which provides gender-affirming care to trans adults through telemedicine. Her company decided to open in-person clinics and hire more physicians licensed in Florida in order to continue to provide care to patients who have already enrolled, even though that represents a major change to the company's business model.

Eli has been seeing a physician for years and therefore still has access to care. But SPEKTRUM Health Inc., the Orlando clinic that prescribed Lucas hormone replacement therapy, has stopped providing gender-affirming care.

“There are a lot of people looking for care that we’re no longer legally able to provide,” said Lana Dunn, SPEKTRUM Health’s chief operating officer.

Florida has the second-largest population of transgender adults in the U.S., at an estimated 94,900 people, according to the Williams Institute at the University of California, Los Angeles School of Law. It used state-level, population-based surveys to determine its estimates. Not all transgender people seek medical interventions.

At least 19 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors. But restrictions on adults haven't been part of the conversation in most places. Missouri’s attorney general tried to impose a rule in that state, but it was pulled back.

Florida is “the proving ground of what they can get away with,” Dunn said.

Her organization treats about 4,000 people — most in Florida and some out-of-state telehealth patients, she said. While SPEKTRUM has bolstered its mental health services since the law passed, it and other organizations heavily rely on nurse practitioners to provide care.

Dunn estimates that 80% of trans adults in the state were getting their health care from a nurse practitioner and now have lost access.

"Right now what we’re seeing in the community is just chaos,” Dunn said.

The law also contains language that she said could scare off doctors who would be otherwise willing to treat trans patients, such as a 20-year statute of limitations to sue over care they provide.

As a trans woman herself, Dunn is grappling with losing her own access to hormones while trying to provide support to terrified patients. That's taken “a significant emotional toll,” she said.

“Not only am I faced with this lack of care for myself but a lot of people within the community are also facing the same thing, and they’re reaching out to me for guidance,” Dunn said. “So I’m doing my best to help guide people and console them, but nobody’s really reaching out to me saying, ’How are you doing? Are you OK?'”

Lucas, who transitioned eight years ago when he was 18, anticipates running out of hormone treatments in June. In the best case scenario he can foresee now, he will be able to get a new prescription in August. He fears he might start to get his period again.

“It’s just going to be extremely difficult mentally to have your body changing in a way that doesn’t align with your brain,” Lucas said.

Eli and Lucas have switched to a month-to-month lease and tentatively plan to relocate to Minnesota in November. They said they would leave sooner if they can afford it and started an online fundraiser to help. Moving with their dog and two cats increases the expense and difficulty of finding a new place.

“I just never thought it could happen this way, this fast and to us,” Eli said.


mandates that adult patients seeking trans health care sign an informed consent form. It also requires a physician to oversee any health care related to transitioning, and for people to see that doctor in person.

Do you mean to tell me that they will now have to sign an informed consent form and see a doctor in person? That's obviously a bridge too far.
 
Do you mean to tell me that they will now have to sign an informed consent form and see a doctor in person? That's obviously a bridge too far.

Florida Medical board conducted emergency hearing last week to try to pass some new temp rules and then later this month focus on permanent changes

Florida medical board may pass a rule to reduce disruptions caused by trans care law​

Transgender patients say their doctors have been holding off on prescribing treatments as they wait for new consent forms. Medical boards are proposing to allow them to continue for now.


The Florida Board of Medicine is expected to pass an emergency rule on Friday that would allow patients receiving gender-affirming care to continue as officials craft new standards for treatment.
The goal is to address disruptions caused by a new law that restricts access to transgender care for minors and also makes it harder for adults to get care.
A group of board members discussed the proposal in concept with a committee from the Florida Board of Osteopathic Medicine on Thursday during a contentious public meeting in Tampa. The full board of medicine is scheduled to meet on Friday morning at the same location.
About 100 people attended Thursday’s meeting, held on the first day of Pride Month. Almost all were there to protest the new law, SB 254. It bars doctors from prescribing gender-affirming treatments to minors, but allows kids who were already receiving care, along with adults, to continue.

Patients say they're losing access to care


The meeting focused on a provision in the law that tasks medical boards with developing consent forms patients must sign in the presence of a doctor. Patients already have to sign consents to obtain medications like puberty blockers and hormones, but doctors moving forward must use the state-approved forms.
Those forms aren’t available yet, and board members noted during Thursday’s meeting that they probably won’t be until July. Since the law went into effect immediately after Gov. Ron DeSantis signed it on May 18, transgender patients and their health providers say it’s caused significant disruptions in care.


“It’s unconscionable to impose a law that says you cannot access this care without a consent form, and then it doesn’t exist,” said Alex Sierra. The Orlando resident has been taking hormones for more than 15 years to help his body align with his identity and has been worried about what will happen if his prescription runs out.
That fear was echoed by Luke Monaco of Winter Haven, who said he and his spouse both recently learned from their health care provider that they cannot be prescribed their testosterone medication until the new forms are ready.
“Because they're scared; they're afraid of repercussions, they're like, 'I don't know what’s going to happen to me, legally speaking,' ” Monaco said.

Who needs to consent?


Under the emergency rule, doctors would be allowed to refill existing prescriptions for patients as medical boards work on the forms. Once they’re ready, patients would have six months to get them signed in the presence of a doctor and would need a psychiatrist or psychologist to verify their gender dysphoria diagnosis.


While the Florida Board of Medicine is expected to vote on the emergency rule on Friday, the full Board of Osteopathic Medicine is not scheduled to meet again until August. That will likely change to meet the law’s requirements, which gave the boards 60 days to establish standards for youth.
Because of this, the committee members largely focused their discussion on children. Some stressed potential side effects from gender-affirming treatments and voiced skepticism about the mental health benefits, which audience members responded to with anger.
“It’s given me a new life,” said Tampa resident Felix Sutphin Garcia, 27, about how hormone therapy and emotional support have helped him. “Before I started having gender-affirming care I felt like I was living in a shell, and now I actually feel like I am living my true life, so it’s really scary that people are trying to take that away from other people, especially kids.”

What trans residents told the boards


Board members discussed the possibility of requiring both of a child’s parents or legal guardians to be present for the appointment to sign the consent as well. That drew concern from Bree Jackson of New Port Richey, who noted families may not easily be able to get both parents in the same room for a variety of reasons including military deployment, divorce or incarceration, among others.


The law doesn’t establish a clear timeframe for the boards to address standards for adults, which is why attendees like Monaco urged the committee to work as quickly as possible to avoid further disruption.
Board members thanked him and Jackson for their feedback during an often-heated public comment period during which they accused other attendees of veering off-topic and verbally attacking the committee.
At one point, committee chair Dr. Zachariah Zachariah called for a brief recess to restore order, inspiring attendees to break out into song. They sang “Leon On Me” by Bill Withers, which encourages people to support one another.

What's next in the process


Leviathan Lier, a 19-year-old from Orlando, also addressed the committee. Lier takes testosterone hormones as well, and had chest surgery scheduled for seven months before he learned late last month that it was canceled due to the consent form issue, leaving him “devastated.”


“Just the fact that I waited so long and went through so much effort, saved so much money for my top surgery just to be told, ‘Nope, can't do it’ — it's insane,” he said.
Until the boards finalize consent forms, Lier's surgery will have to wait because it's considered a change in treatment. But he could continue his testosterone medication under the emergency rule if it passes.
The challenge, he and others noted, is that there are a lot less health care professionals left in the state who are allowed to provide this care. Advocates say nurse practitioners accounted for a majority of gender-affirming care providers in Florida before the law stripped them of their ability to prescribe hormones.
The demand for physician services could be overwhelming in the coming months. Some speakers cautioned that could make it difficult for patients to be seen in person to reestablish consent within that six-month timeframe.
The committee agreed to reconvene and discuss draft language for the consent forms on June 23.

 
Do you mean to tell me that they will now have to sign an informed consent form and see a doctor in person? That's obviously a bridge too far.
also the law says that adults have to sign a consent form with a Doctor present as a witness for seeing a Dr in Person...as well as sign a consent form to receive the medications.

And the law states that only State provided consent forms can be used for both of these and the State hasn't even made the consent forms yet...so they do not exist ....and the law says without the form then legal access to Meds AND Dr visits in person are illegal.
 
also the law says that adults have to sign a consent form with a Doctor present as a witness for seeing a Dr in Person...as well as sign a consent form to receive the medications.

And the law states that only State provided consent forms can be used for both of these and the State hasn't even made the consent forms yet...so they do not exist ....and the law says without the form then legal access to Meds AND Dr visits in person are illegal.
The horror!!🤯
 
The horror!!🤯
law also removed the ability of Nurse Practitioners from issuing prescriptions or refilling prescriptions for hormone therapy for adults.

Also for an Adult when they sign their medical consent to see a Dr and must do it in the presence of the Dr they are going to see must also provide proof from a psychiatrist or psychologist to verify their gender dysphoria diagnosis....which could easily be shared between the two Dr's office in this modern world

We can't pretend this law was aimed at protecting kids...it wasn't it was about limiting and restrictions of medical access and medical freedom to Trans Adults as well.

And the law does NOT define any timelines for when the state has to have the consent forms available....so as it sits now......Dr's can't see Trans Adult Patients legally and they can not perscribe any medications to Trans adults until the consent forms are made...and Florida has NO obligated time line to produce and provide the forms.....thus banning Adult Trans care, access and medicine.

You jest in saying it is a Horror.....it truly is horrible what they are doing to these American Adults in restricting and limiting their Freedoms
 
Last edited:

he Center for Investigative Reporting revealed in 2017 that the FDA had received more than 10,000 adverse event reports from women who were given Lupron off-label as children to help them grow taller. They reported thinning and brittle bones, teeth that shed enamel or cracked, degenerative spinal disks, painful joints, radical mood swings, seizures, migraines and suicidal thoughts. Some developed fibromyalgia. There were reports of fertility problems and cognitive issues.

Gender-affirming care for children is undoubtedly a flashpoint in America’s culture wars. It is also a human experiment on children and teens, the most vulnerable patients. Ignoring the long-term dangers posed by unrestricted off-label dispensing of powerful puberty blockers and cross-sex hormones, combined with the large overdiagnosis of minors as gender dysphoric, borders on child abuse.
 
I have only had open conversations with one person experiencing gender dysphoria, so I can't claim to know what's best on this topic from a medical standpoint or otherwise.

That said, what are the supporting reasons for allowing (or encouraging) kids to go through conversions, specifically making such a massive decision at such a young age? After all, we have more advanced ages for adulthood, voting, marriage, driving cars, or obtaining firearms. It just seems like an impossibly young age for such a decision, even if there are totally valid reasons for it.
 
I have only had open conversations with one person experiencing gender dysphoria, so I can't claim to know what's best on this topic from a medical standpoint or otherwise.

That said, what are the supporting reasons for allowing (or encouraging) kids to go through conversions, specifically making such a massive decision at such a young age? After all, we have more advanced ages for adulthood, voting, marriage, driving cars, or obtaining firearms. It just seems like an impossibly young age for such a decision, even if there are totally valid reasons for it.
The medical community supports it. And more importantly their doctor supports it as medically necessary.
 
I have only had open conversations with one person experiencing gender dysphoria, so I can't claim to know what's best on this topic from a medical standpoint or otherwise.

That said, what are the supporting reasons for allowing (or encouraging) kids to go through conversions, specifically making such a massive decision at such a young age? After all, we have more advanced ages for adulthood, voting, marriage, driving cars, or obtaining firearms. It just seems like an impossibly young age for such a decision, even if there are totally valid reasons for it.
It seems impossible because it is impossible and there are zero valid reasons for it.
 

he Center for Investigative Reporting revealed in 2017 that the FDA had received more than 10,000 adverse event reports from women who were given Lupron off-label as children to help them grow taller. They reported thinning and brittle bones, teeth that shed enamel or cracked, degenerative spinal disks, painful joints, radical mood swings, seizures, migraines and suicidal thoughts. Some developed fibromyalgia. There were reports of fertility problems and cognitive issues.

Gender-affirming care for children is undoubtedly a flashpoint in America’s culture wars. It is also a human experiment on children and teens, the most vulnerable patients. Ignoring the long-term dangers posed by unrestricted off-label dispensing of powerful puberty blockers and cross-sex hormones, combined with the large overdiagnosis of minors as gender dysphoric, borders on child abuse.
Late to the conversation. But are you medical personnel or just guessing or surmising what doctors are prescribing for each and every case? Are growth hormones regularly prescribed for transgendered people? I can’t pretend to know, enlighten me. Do you believe law makers or physicians should make medical decisions ? Should high hurdles be placed to influence medical decisions ? Who can live so perfectly to believe that EVERYONE should be forced to live and be judged according to their ideals?
 
The medical community supports it. And more importantly their doctor supports it as medically necessary.
What medical community supports it? The drugs have not been approved by the FDA for this use.

The Food and Drug Administration has approved those medications to treat prostate cancer, endometriosis, certain types of infertility and a rare childhood disease caused by a genetic mutation. But it has never approved them for gender dysphoria, the clinical term for the belief that one’s body is the wrong sex.


Thus the drugs, led by AbbVie’s Lupron, are prescribed to minors “off label.” (They are also used off-label for chemical castration of repeat sex offenders.) Off-label dispensing is legal; some half of all prescriptions in the U.S. are for off-label uses. But off-label use circumvents the FDA’s authority to examine drug safety and efficacy, especially when the patients are children. Some U.S. states have eliminated the need for parental consent for teens as young as 15 to start puberty blockers.
 
Late to the conversation. But are you medical personnel or just guessing or surmising what doctors are prescribing for each and every case? Are growth hormones regularly prescribed for transgendered people? I can’t pretend to know, enlighten me. Do you believe law makers or physicians should make medical decisions ? Should high hurdles be placed to influence medical decisions ? Who can live so perfectly to believe that EVERYONE should be forced to live and be judged according to their ideals?
I'm not in the medical profession. I'm also not guessing, please read the WSJ article that I linked. I think medical decisions should be based on science and, in this case, the drugs given to these very young children aren't even FDA approved for this use. We know there are horrible side effects. They are basically experimenting with children. It's ridiculous and I can't believe that there are people on here that are cool with it. Sorry man, you lost me on the last part.
 
"I'm not in the medical profession."

*Proceeds to express medical opinions requiring actual medical knowledge and expertise*

Face Palm GIF
 
I'm not in the medical profession. I'm also not guessing, please read the WSJ article that I linked. I think medical decisions should be based on science and, in this case, the drugs given to these very young children aren't even FDA approved for this use. We know there are horrible side effects. They are basically experimenting with children. It's ridiculous and I can't believe that there are people on here that are cool with it. Sorry man, you lost me on the last part.
I like where you linked a WSJ article and then told people to go read it to get science based facts. Then you linked an Opinion column

1686256806346.png
 
So people are only allowed to have opinions related to the professions they are in? Interesting stance. What's your profession?
Your "allowed" to have whatever opinion regarding any and everything you want to have an opinion on.

Feel free to tell your doctor he's taking out your appendix incorrectly or unnecessarily.

No skin off my nose.
 
Your "allowed" to have whatever opinion regarding any and everything you want to have an opinion on.

Feel free to tell your doctor he's taking out your appendix incorrectly or unnecessarily.

No skin of my nose.
I'm just trying to figure out how you're such an expert in so many topics that you feel qualified to judge and/or ridicule others' opinions. You must be in a LOT of professions according to......yourself.... Sounds to me like you're just a professional BS'er.

For the record, my post which you Zzz'd above was asking a legit question, because I don't know. I'm not a medical professional, and I was asking if anyone in this thread could provide some insight into the life-altering decisions that people are making at such young ages, because that seems like a super tough thing to experience. I'm asking, because I have at least one friend that expressed their experience to me, and I have kids that I'd like to know how others may have navigated it, etc....
 
Your "allowed" to have whatever opinion regarding any and everything you want to have an opinion on.

Feel free to tell your doctor he's taking out your appendix incorrectly or unnecessarily.

No skin off my nose.
So according to you (as expressed in post #193), it is always problematic for a person to express an opinion about a topic unless they are professionals, yet you see no problems expressing your own opinions about myriad topics on this board? The only logical conclusions are as follows,
1. You hold many, many professions
2. You strategically employ cognitive dissonance as it suits your needs

You can choose (1) of the above.

Totally prepared for your auto-response of Zzz or laughing emoji. Bring it.
 
Status
Not open for further replies.
Back
Top