Florida’s anti-trans expert Dr. Quentin L. Van Meter was discredited on trans youth care in court, believes trans people are “delusional”, and promotes anti-gay conversion therapy

Summary and key points

Dr. Quentin L. Van Meter, a pediatric endocrinologist practicing in Atlanta, Georgia, has served in leadership roles at the anti-LGBT American College of Pediatricians (ACPeds) hate group since 2008.

  • During his time at ACPeds, the group has published a number of position statements and legal filings against acceptance of LGBT youth, against same-sex parenting and adoption, and in support of anti-gay conversion therapy.
  • Van Meter has a history of providing expert reports and declarations in a variety of court cases, almost universally in opposition to transgender rights and healthcare. His testimony includes claims that gay students are harmed by being affirmed as valid, trans students are harmful to those around them and cause “social contagion”, and no trans youth or adults should ever medically transition.
  • He has stated during depositions that he is specifically hired to testify against gender-affirming care, and that his use of the term “child abuse” to describe transition is actually for the purpose of “emphasis” and “attention”.
  • Van Meter was selected by Florida AHCA/Medicaid in May 2022 to provide an expert report (Attachment E) against gender-affirming medical care, which was then incorporated into the June 2, 2022 “Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria” Medicaid report describing transition care as “experimental and investigational” and “not proven safe or effective”.

Dr. Van Meter’s report was submitted to the Florida Board of Medicine in July 2022 for a Board of Medicine hearing this Friday, August 5. The Florida Department of Health’s petition for rulemaking (pp. 870-877, 1112-1113) includes a proposal to:

  • Ban all trans youth under 18 from accessing puberty blockers, HRT or surgery for gender-affirming care.
  • Impose a 24-hour waiting period before any gender-affirming medical care for adults.
  • Require the use of Department of Health-issued informed consent forms which direct patients to the Florida AHCA website, containing inaccurate information by Van Meter and other anti-trans “experts”.

The following is an aggregation of Dr. Quentin L. Van Meter’s anti-LGBT statements, activities, and affiliations leading up to his involvement with Florida Medicaid.

Timeline

2007: Van Meter joins the American College of Pediatricians anti-LGBT hate group, later joining the board of directors in 2008, becoming vice president/president-elect in 2015 and president in 2018 (Defendant’s exhibit 4 in Eknes-Tucker v. Ivey filed May 2, 2022; exhibit 2 in Carcaño v. Cooper, August 12, 2016).

August 2008: ACPeds publishes the letter “On the Promotion of Homosexuality in the Schools”, claiming that being gay is “changeable” and the “homosexual lifestyle carries grave health risks”:

The etiology of homosexual attraction is determined by a combination of familial, environmental, and social influences. For some individuals the inheritance of predisposing personality traits may also play a role.

While homosexual attraction may not be a conscious choice, it is changeable for many individuals.

Declaring and validating a student’s same-sex attraction during the adolescent years is premature and may be harmful.

Many youth with homosexual attractions have experienced a troubled upbringing, including sexual abuse, and are in need of therapy.

The homosexual lifestyle carries grave health risks.

Sexual reorientation therapy can be effective. Students and parents should be aware of all therapeutic options.

Van Meter was questioned about this letter in his March 18, 2019 deposition in the Grimm v. Gloucester County School Board bathroom case (transcript), and he confirmed he believes it could be “harmful” to affirm or validate gay and trans students:

Q: And so homosexuality is also not normal, right?

CORRIGAN: Object to form.

A: The statement is that promoting it as an immutable biologically based norm is not — is not based on valid science.

BY MR. BLOCK: Q: If we go to the second checkmark on the right-hand column, just as affirming a transgender student’s identity can be harmful, this checkmark says: Declaring and validating a student’s same-sex attraction during the adolescent years is premature and may be harmful. Is that right?

CORRIGAN: Object to form. Go ahead.

A: This is based on the handbook of the APA, which says that there is an incredible amount of fluidity in and out of same-sex attraction, and that validation is premature.

BY MR. BLOCK: Q: And can be harmful?

A: If it’s — if it’s premature and ends up causing ill health, it’s harmful.

Q: And the next checkmark says that — you testified that many — that all transgender people have a dysfunctional — dysfunction in their background. This checkmark says: Many youths with homosexual attractions have experienced a troubled upbringing, including sexual abuse, and are in need of therapy.

Is that right?

CORRIGAN: Object to form of the question, object to mischaracterization of prior testimony. Go ahead.

A: The answer to that is yes, it’s proven based on published science.

BY MR. BLOCK: Q: So you agree — and you agree with that. You agree with what that checkmark says, right?

CORRIGAN: Object to form. Go ahead.

A: Yes, I do.

March 2009: ACPeds files an amicus brief in support of Florida’s 2003 law banning gay parents from adopting. This brief was brought up in the March 18, 2019 deposition of Quentin Van Meter in the Grimm v. Gloucester County School Board restroom case (transcript), eliciting an objection from Van Meter’s attorney:

Q: Isn’t it true that the American College of Pediatricians filed a legal brief supporting Florida’s law prohibiting same-sex couples from adopting?

A: The problem is that there is subsequent research that has been out that’s — that shows that there are detrimental effects of that, and that if there is a detrimental effect it should be explained and not accepted as a — an unharmful beneficial thing when there is actual harm that happens. So if there is a circumstance where there is no other place for a child to go and circumstances are that — are as such that a same-sex couple can adopt a child, but do not advertise it as equal to or better than a heterosexual couple.

Q: Did the American College of Pediatricians take a position defending a Florida law that prohibited same-sex couples from adopting under any circumstance?

CORRIGAN: Let me interject here. Why are we talking about this? How does this have anything whatsoever to do with our case?

BLOCK: He’s the president of this organization.

CORRIGAN: But what does that have to do with anything? I don’t see how — we’re here talking about transgender individuals, and we’re talking about restroom use, and that’s what our case is about, and this talking about whether or not the organization that he’s the president of filed a brief in a case dealing with whether same-sex couples can adopt children has nothing to do with that. I think — I think we’re wasting time, I don’t think there’s anything related to the case, it has nothing to do with anything in his report, there’s just no basis for it, Josh. And if you have some basis for it, then please tell me.

March 31, 2010: ACPeds sends a letter to all school superintendents in the United States warning them against accepting or affirming gay and trans students. The letter describes gay youth as likely to desist before age 25, and cites Ken Zucker and Susan Bradley to claim that accepting trans youth means “the confusion is reinforced” and schools “reinforce the disorder”:

Adolescence is a time of upheaval and impermanence. Adolescents experience confusion about many things, including sexual orientation and gender identity, and they are particularly vulnerable to environmental influences

Rigorous studies demonstrate that most adolescents who initially experience same-sex attraction, or are sexually confused, no longer experience such attractions by age 25. In one study, as many as 26% of 12-year-olds reported being uncertain of their sexual orientation, yet only 2-3% of adults actually identify themselves as homosexual. Therefore, the majority of sexually-questioning youth ultimately adopt a heterosexual identity.

Even children with Gender Identity Disorder (when a child desires to be the opposite sex) will typically lose this desire by puberty, if the behavior is not reinforced. Researchers, Zucker and Bradley, also maintain that when parents or others allow or encourage a child to behave and be treated as the opposite sex, the confusion is reinforced and the child is conditioned for a life of unnecessary pain and suffering. Even when motivated by noble intentions, schools can ironically play a detrimental role if they reinforce this disorder.

In dealing with adolescents experiencing same-sex attraction, it is essential to understand there is no scientific evidence that an individual is born “gay” or “transgender.” Instead, the best available research points to multiple factors – primarily social and familial – that predispose children and adolescents to homosexual attraction and/or gender confusion. It is also critical to understand that these conditions can respond well to therapy.

November 19, 2010/March 14, 2011: Van Meter authors “Gender Identity Issues in Children and Adolescents” for ACPeds, and in contrast to his later positions, states that puberty blockers could be considered in some cases as a possible treatment to relieve distress in trans youth:

For those patients who persist into adolescence with disordered gender identity, no medical treatment should be instituted before the patient reaches at least Tanner stage II of true puberty. For patients experiencing significant psychological morbidity or unbearable social pressure, it may be reasonable at that point to temporarily arrest further pubertal development with the use of gonadotropin super-agonist therapy since all effects of such an intervention are reversible when it is discontinued (including accretion of bone mineral density). This course of action should only be undertaken in the absence of psychopathology in both the patient and family.

Institution of cross-gender sex steroid therapy should be discouraged and certainly not be instituted until the age of consent, 18 years, since such therapy can cause irreparable changes and can be harmful, if certain parameters are not monitored (i.e. Prolactin levels in male-to female patients who receive estrogen therapy, and lipid levels in female-to-male patients on androgen therapy). Similarly, surgical changes should also be discouraged and not considered until the age of consent. Given the established evidence of significant morbidity in those patients who do undergo hormonal transformation and eventual surgery, psychotherapy should be continued throughout adult life.

April 17, 2015: At a meeting in Atlanta, Georgia, the ACPeds board of directors including Van Meter host a presentation from ACPeds member David Pickup, who describes “gay identity” as “a manufactured construct to meet the needs of happiness” and proposes using anti-gay reparative therapy with a therapist serving as a substitute father figure:

David Pickup, LMFT: David Pickup is an Associate member of the College and a Board of Director for Alliance for Therapeutic Choice

David spoke to those in attendance about the efforts to ban sexual orientation change efforts (SOCE) for minors. He had a very helpful Powerpoint presentation, “Homosexuality in Children and Adults,” that is available from the College upon request.

Take away points from the presentation are as follows:

Everyone needs the three a’s: affirmation, affection and approval. In many cases, people who embrace a homosexual identity are lacking in the three a’s. Most male patients he sees tend to be of a sensitive nature. That in his opinion is the main predisposition. The male person most likely heard – due to his sensitive predisposition – statements from others such as, “You’re such a girl,” “you run like a girl,” You’re a sissy,” etc. If a male rejects his father between the ages of 1.5- 4 y.o. because the father is not affirming, affectionate or approving, the male will attach to his mother.

The theory of healing or reparative therapy is all about compassion. You have to be able to break through the shame so that the person can have compassion for themselves. They grow up thinking that they are “not really a boy,” “I’m inferior,” “I am wrong.” They ‘disown’ their body parts since there is no pride in being male and thus may choose to live as the opposite sex. He now gets his ‘maleness’ from another man in sexual behavior – and this relationship may include affirmation, affection and approval. Therapist now intercedes when help is requested by the male person. The therapist may be perceived over time as a ‘father’ figure.

Progress begins when the client admits to grief and anger. Once he experiences grief he can begin to forgive himself for what he has always blamed on himself because he could not face placing blame on a parent or accepting the fact that perhaps that parent did not love him. When a client enters the grief stage, which may be repeated over and over, doing so with the therapist, then the same-sex attraction declines or disappears (sometimes rapidly and sometimes slowly over weeks and weeks). With the decreased shame, comes decreased anxiety and decreased depression as well.

Authentic reparative therapy is all about the rising of the true self. It meets the needs of the patient with the three a’s that they did not find in childhood. The gay identity is a manufactured construct to meet the needs of happiness.

November 23, 2018: Van Meter coauthors a letter to the editor (Laidlaw et al., 2018) in response to the Endocrine Society’s 2017 transgender clinical practice guidelines. Their brief response substantially misrepresents trajectories of adolescent and adult gender identity development, asserts that the hoax “rapid onset gender dysphoria” condition is real, and calls for “psychological therapy” as “an obvious and preferred therapy”. This reflects a similar strategy by the anti-trans group SEGM, whose affiliate Romina Brignardello-Petersen also contributed a report to Florida Medicaid’s standards determination. As noted in an April 28, 2022 Yale Law School report, SEGM and its related groups like Genspect operate as a small number of core individuals working under many group names, and they prefer to place letters to the editor in the “peer-reviewed literature” over publishing studies or original research:

A contextual examination reveals that SEGM is an ideological organization without apparent ties to mainstream scientific or professional organizations. Its 14 core members are a small group of repeat players in anti-trans activities – a fact that the SEGM website does not disclose. These 14 often write letters to the editor of mainstream scientific publications; these letters appear in the list of publications on the website (even though letters to the editor typically are not peer-reviewed or fact-checked). (Our review shows that the group of 14 has a total of 39 relevant publications and that 75% of these are letters to the editor.)

The core members of SEGM frequently serve together on the boards of other organizations that oppose gender-affirming treatment and, like SEGM, feature biased and unscientific content. These include Genspect, Gender Identity Challenge (GENID), Gender Health Query, Rethink Identity Medicine Ethics, Sex Matters, Gender Exploratory Therapy Team, Gender Dysphoria Working Group, and the Institute for Comprehensive Gender Dysphoria Research.

February 26, 2019: A letter from Van Meter is included in the Grimm v. Gloucester case in which he claims that affirming a trans student’s gender is harmful to them and to other students:

Allowing a biologic female to use a male-designated bathroom facility is one of several “gender affirming” care options, but it is creating harm to at least two parties. The harm to the gender incongruent person is that it promotes a pathway to inevitable long-term medical and psychological morbidity. The premise of gender affirming care can be managed through other methods without requiring school systems to permit transgender students to use the restroom associated with their new gender identity. The second party harmed is the student without gender incongruence who must suffer emotionally while being told they must tolerate the presence of an opposite sex individual in a sexually segregated space and embrace the regulation which gives the gender incongruent person special privileges as if they were based on a civil right founded on immutable biology.

When questioned about this statement during his deposition in this case, Van Meter’s attorney offered an assurance that Van Meter would not say this during the trial:

Q: Let’s look at the paragraph 41 again. Near to the bottom it says: The second party harmed is the student without gender incongruence who must suffer emotionally while being told they must tolerate the presence of an opposite sex individual in a sexually segregated space and embrace the regulation which gives the gender incongruent person special privileges as if it were based on civil rights founded on immutable biology. Did I read that right?

A: Yes.

CORRIGAN: Let me — can I interrupt for a second?

BLOCK: Yeah.

CORRIGAN: He’s not going to offer that opinion. I can tell you that in this case he’s not going to offer that opinion. I know it’s in his thing, and you can ask him about it, but he’s not going to offer that opinion at trial.

BLOCK: Okay.

March 18, 2019: During his deposition in Grimm v. Gloucester, Van Meter is asked if he considers the providers of gender-affirming care to trans youth to be committing child abuse. At first, he will only describe this treatment as “causing harm” and “inappropriate”:

Q: And do you think someone providing hormone therapy to those patients is engaging in child abuse?

A: If they are treating a child, I would say that that is essentially treating the patient and causing harm. Whether I specifically use the term “child abuse,” it is known to have inappropriate long-term effects, it is not evaluating — it’s not paying attention to the core issue, it is preventing that child from being able to make it through natural puberty with their natal hormones to allow them to resolve these issues through counseling and personal experience of living in the biologic body unaltered by opposite hormone therapy. So it is — I would say it is inappropriate to do that.

Q: So my question isn’t about people who have not yet come through puberty. My question is about people whose dysphoria persist through puberty. So, for example, someone who is 16 years old and falls within that small category of people we referred to earlier about for whom Dr. Zucker thinks treatment might be appropriate, do you think it is child abuse to provide that group of teenagers with gender-affirming hormone therapy?

A: So adolescence goes actually up through age 21, technically. It happens that age of majority sort of falls in the last stages of adolescence in this country. I would think that it’s inappropriate for a patient to be treated while they are still going through puberty.

When asked again about whether he considers the providers at youth gender clinics to be committing child abuse, Van Meter responds that “child abuse” is a “flashy term” to “catch attention”. Van Meter will not call these providers unqualified, and considers to be them conscientious and acting in the best interest of their patients, but simply “misinformed”:

Q: So the people that you know personally who run these clinics, do you think they are practitioners of child abuse?

A: I think they are misguided in terms of recommending hormone therapy. The term “child abuse” is a flashy term in my worldview to catch attention. I would say that my concern for these individuals is that there are going to be adverse outcomes in their patient population because of what they recommend and what they — how they are treating, and I don’t think that they are necessarily paying attention to the broader literature, which says that that treatment is harmful more than it is beneficial. They are very much drawn to the Endocrine Society guidelines because they are convenient, and they themselves have no personal experience.

Q: Do you consider them just in their — as practitioners to be unqualified as — in general as pediatric endocrinologists?

A: Not at all.

Q: You consider them to be conscientious practitioners?

A: I do.

Q: And you think that they are acting in what they believe is the best interest of their patients?

A: I think that they are practicing in what they do believe is the best interest, but I also believe they are not informed.

Later in the deposition, Van Meter is asked about the March 2016/September 2017 ACPeds document, “Gender Ideology Harms Children”, which he cosigned and which describes trans acceptance and affirmation as “child abuse”. Van Meter explains he uses the term “primarily for emphasis”:

Q: Turn the page to paragraph 8. It says: Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and helpful is child abuse.

Did I read that right?

A: You did.

Q: So when I referenced the term “child abuse” before you said it was a flashy term. Am I accurately characterizing your testimony?

A: Yes.

Q: So why do you use that term here in this paragraph?

A: Primarily for emphasis.

Citing the “Gender Ideology Harms Children” document, Van Meter claims that schools “should discourage” students from transitioning, and that respecting a trans student’s name and pronouns is harmful to them:

Q: So at the very beginning of the document it says: The American College of Pediatricians urges healthcare professionals, educators, and legislators to reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex. Did I read that right?

A: Yes, you did.

Q: So according to this document, schools shouldn’t be sending a message that gender transition is normal, right?

A: That is correct.

Q: And schools should be discouraging students from transitioning genders, correct?

A: To their– to their detriment to affirm.

Q: So the schools should discourage it?

A: It should not — yeah, they should discourage it.

Q: Do you think that a school is acting in the best interest of a child by calling the child by pronouns that are different than the sex assigned to them at first?

A: We don’t feel that that is appropriate or beneficial to the child.

Q: So you think it’s harmful to the child?

A: Yes.

Q: And by agreeing to use the child’s — changing a child’s new name as consistent with their gender identity, you think that’s harmful to the child also, right?

A: Yes.

He claims that a school’s acceptance of a transgender student could cause a “social contagion” that would make other students believe they’re trans:

Q. So if the school affirms the gender identity of the transgender student, that transgender student could spark a social contagion that causes other students to say they’re transgender too?

A. Absolutely. It has happened, and it’s documented.

Q. So by not allowing the transgender student to use the same restrooms as cisgendered students with their gender identity, the school is stopping the spread of a social contagion; is that right?

MR. CORRIGAN: Object to the form of the question. The witness is not being called in this case to discuss these very issues; he’s not speaking on behalf of the school board. Go ahead.

A. I have no proof to say that not allowing use in a bathroom would make that difference. Again, there is no study I’m aware of that says using the gender-identified non-biologic sex bathroom has any benefit or any detriment to the long-term outcome of a patient. Those studies have not been done.

BY MR. BLOCK: Q. So my question is that you believe that if a transgender student is affirmed and allowed to use the bathroom consistent with their identity, then that is more likely to cause other students to think they might be transgender too?

MR. CORRIGAN: Object to form of the question. Go ahead.

A. It is theoretically quite possible.

Van Meter also asserted that affirming the gender of trans adults is harmful to them:

Q: So you think — in terms of adults you think that affirming an adult transgender person’s gender identity is harmful to their health?

A: I do.

He states that he would never recommend cross-sex hormone therapy for any adult:

Q: So but you disagree with his view that hormone therapy should be considered for transgender youth whose dysphoria persists until late adolescence; is that right?

A: Yes, I do. I’m not — he is not an endocrinologist. I am. I’m aware of the endocrine side effects and the long-term morbidity that’s caused by cross-hormone therapy, and I could not recommend it for any adult. But I do not practice adult medicine. I’m a pediatrician. I go up through my age range up through age 21 or 22, and in no circumstance would I recommend cross-hormone therapy personally as an endocrinologist.

Notably, Van Meter offers his opinion that being transgender is not a matter of immutable biology, but that even though religion is not immutable or biological, religion is a matter of protected personal expressive rights:

Q: You say special privileges, as if they were based on a civil right founded on immutable biology. Do you think that civil rights should be based only on immutable biology?

CORRIGAN: Object to form, legal conclusion. Go ahead.

A: So I think in terms of things like religious faith, that is something that is not immutable biology, and I think that intolerance of religious faith becomes an issue of the right of expression and — personal right of expression. I don’t feel that something that is furthering a detrimental mental health issue is a civil right, especially when it is advertised as if it is immutable biology and it’s based on that that we can treat that person as if that were a biologic race or a biologic sex, which it is not.

BY MR. BLOCK: Q: Do you have a medical basis for an opinion on what traits should be protected by civil rights laws and which ones shouldn’t?

CORRIGAN: Object to the form. That’s why he’s not giving the opinion. Go ahead.

A: Yeah, I mean, my personal opinion here in this deposition is I would think that race and gender — and biologic sex are immutable and should be considered to allow people to have specific rights or not be denied rights.

September 27, 2019: Van Meter is deposed in Ray et al. v. Himes et al., a case involving changes to gender markers on Ohio birth certificates (transcript). He states that he is typically hired by those seeking testimony that gender-affirming care is harmful and not beneficial:

Q. Okay. Okay. Okay. In the cases where you say you simply provided background on trans issues, what party hired you?

A. It was either the family of the patient — most often it was representing the family of the patient. I can’t recall specifically other entities which, you know, compensated me for my time. It was usually the attorneys for the person who was involved. Or if they were being sued, the families and the entities asked me for expert opinion.

Q. What were the parties’ position? Why did they need you?

A. Because they needed somebody to give an opinion that essentially stated that the possibility of social affirmation, medical affirmation and surgical affirmation was more harmful than beneficial.

Q. Okay. So just to be clear, they needed somebody to testify that affirmative care treatment for trans folks to affirm the trans identity of somebody was not the correct, in your opinion —

A. That’s correct.

Van Meter describes giving a presentation at the anti-LGBT “Teens 4 Truth” conference in Fort Worth, and claims not to know it had any religious affiliation:

Q. Okay. So what again was the name of the conference? I’m sorry.

A. Teens — No. 4 — Truth.

Q. Oh, okay. Perhaps if I remind you, you may recall. That’s a Baptist anti-LGBT conference. Does that characterize it accurately?

A. No.

MR. BLAKE: Objection.

BY MS. INGELHART: Q. Okay. But is it a Baptist affiliated organization?

MR. BLAKE: Objection.

THE WITNESS: I was unaware that it had any religious affiliation to it.

BY MS. INGELHART: Q. Okay. Were the topics — you said, primarily, though, they were about sexual orientation and gender identity, correct?

MR. BLAKE: Objection.

THE WITNESS: Primarily about depression and anxiety and how it manifests as someone’s developing their sexuality.

BY MS. INGELHART: Q. Okay. And do you use the term developing their sexuality to include the terms like sexual orientation and gender identity or specifically —

A. All of it. It’s all inclusive.

The event, “Teens 4 Truth Conference”, listed the following description of Bible-based homophobia/transphobia and conversion therapy, along with the claim that “LGBT activists are influencing your children”:

What does the Bible REALLY say about LGBT issues?…

How to counter LGBT issues in your schools…

How to support bathroom & gender privacy…

Emotional change in gender & sexuality issues CAN and DO occur…

How LGBT activists are influencing your children…and

How churches can help.

During the deposition, Van Meter endorses a form of anti-trans “counseling” that he acknowledges most people would recognize as conversion therapy, although he does not like to call it that:

Q. Okay. And so in that case, where you discussed the benefits and the science of affirmation versus counseling, did you have professional conclusions about which was the better course of treatment?

A. Yes.

Q. And what was that?

A. Is that the counseling, which is referred to as watch and wait, which there’s nothing just watching and waiting. It’s very intense and consistent. It is that there is clear benefit there that those patients that go through that — this was a minor, okay, at the time — have a very high likelihood of resolving their gender incongruence with the benefit of counseling, appropriate counseling, in-depth counseling. And that if that is the case, affirmation with hormones and social circumstances and then, if chosen, surgery, provide far more complications for that patient’s life, and their quality of life that is diminished significantly compared to those who went through counseling alone.

Q. Okay. And just so I’m clear, is the counseling course of treatment ever colloquially referred to as conversion therapy?

A. It is often mislabeled as conversion therapy. It is, in truth, affirming one’s sex, if possible. Most often it’s focused on the issues of depression and anxiety and the childhood adverse events that created the background for which set this patient up to have a world view that they were born into the wrong body.

Van Meter also states that he advises the parents of his trans and gender-questioning patients to avoid providers who specialize in transgender care, because “It has to be somebody you know doesn’t have an agenda up front”:

Q. Okay. So you have an intake appointment?

A. Yes.

Q. Okay. And then after that?

A. The intake is staged, so that initially the first appointment is a thorough physical exam and a total review of medical history, and then it is sort of focusing on their specific complaint about transgender issues. I interview the child and the family all together. I find out what kind of mental health support they’re using and who that person is. If they haven’t had any, then I suggest like through their primary care a general behavioral health person, because that’s a very difficult choice. It has to be a good fit. It has to be somebody personality wise. It has to be somebody you know doesn’t have an agenda up front, that’s not a transgender specialist. There is no such reality of somebody who is not an activist, who just does transgender health only, in terms of mental health. If they advertise that as colleagues I interviewed and talked to, say I’ve been doing this for 37 years in treating transgender health in Atlanta, I sort of question them and say, okay, what else do you do? And they often do nothing but transgender health issues. Transgender is a psychological issue at its core, and you don’t have to be trained in transgender only issues.

He also states that he refers his gender-dysphoric patients to mental health providers who will only address their depression and anxiety:

Q. Okay. You referred your patients, these 15 patients, out to outside mental health professionals who provide the counseling. Are they in the watch and wait program, the counseling that you were talking about? Is that the kind of treatment they’re receiving?

A. No. It’s just general mental health care.

Q. Okay. But as it regards to treating their gender dysphoria symptoms?

A. The symptoms of dysphoria are the depression and the anxiety.

Q. Okay.

A. It’s whether or not it’s the undercurrent or the reaction or a combination of that, that’s what’s being addressed is depression and anxiety.

Van Meter adds that he believes more trans and gender-questioning youth are seeking gender-affirming care because of “social contagion”, online “recruiting”, and “encouragement”:

Q. And so people’s awareness makes — how does that awareness affect the rate of incidence?

A. The study that was published by Lisa Littman showed there was sort of a social contagion among adolescent females particularly. The ratio of incidence from twice as many males as females in the background for any number of years, from published studies back in the 1970s, ’80s, and ’90s and even in the early 2000s, to the point where it is now twice as many females as males, and the age of onset in these females is mid adolescence.

Q. Okay. So what I heard you say was that there’s a social contagion. What is the social contagion?

MR. BLAKE: Objection.

THE WITNESS: The presence on the internet of YouTube videos, suggestions of what to say to your physician, helpful guidelines — hopefully helpful — to guide patients who have issues toward the idea that they are transgender.

BY MS. INGELHART: Q. Okay. How is that a contagion? I don’t think I understand your use of that term.

MR. BLAKE: Objection.

THE WITNESS: It is the increase cannot be explained by purely social acceptance. Okay? The sociologists who have reviewed this in the UK, particularly in the Scandinavian, can’t explain a hundred fold increase in the incidence of transgenderism since 2010.

Continuing, Van Meter recognizes that he is describing “personal stories” and that many people may not use the term “recruitment” for this, and alleges WPATH is the “transgender movement” doing the recruiting:

Q. Okay. And so for the cause and effect, if the effect is that there’s a higher rate now, what are you saying is the cause then?

MR. BLAKE: Objection. Answer if you know.

THE WITNESS: It’s sort of a recruiting of patients online.

BY MS. INGELHART: Q. Okay. And who’s recruiting?

MR. BLAKE: Objection. Answer if you know.

THE WITNESS: The nature of what is online when you Google transgender is explaining that transgenderism is a biologic entity, that if you are concerned and upset about any issues at all, consider this as a option and come see us, and go to this website, and tell your doctor this, and it’s — those kinds of websites exist.

BY MS. INGELHART: Q. Okay. Okay. So I apologize. Could you just explain to me your understanding of the word recruitment?

MR. BLAKE: Objection.

THE WITNESS: It’s sort of an enticement, if you will, to consider transgenderism as the answer to what they’re feeling about their lives.

BY MS. INGELHART: Q. Okay. Doesn’t recruitment kind of, again — active — activity or an active choice or an action?

MR. BLAKE: Objection.

THE WITNESS: If someone publishes something on the internet that says, this is the answer, read this list, come here, call these people, go to this clinic, I would call that recruitment. That’s an active — somebody has to go to that site, somebody has to be interested in it to read it, but if you will, they’re not — no, they’re not doing telephone robo calls and saying. I guess if you’re using the word recruitment that way, no, it’s not happening. But if you have access to the internet and you type in a word and you get to a website that it encourages you to consider that as an option, perhaps recruitment isn’t the right — but encouragement. Let’s call it encouragement then.

BY MS. INGELHART: Q. Okay. And those websites are being created by entities. Is that what you meant by the transgender movement? Are they creating these platforms?

A. I don’t know who creates them. Some of them are created individually, and they’re personal things. Personal stories, if you will.

Q. Okay. But previously you talked about the transgender movement and recruitment. So is that —

A. The transgender movement, I’m referring to W-Path as an entity, because it is an organization that is a social advocacy organization.

He later states that transgender people on the internet are an “indoctrinating society” and a “cult”:

Q. Can you explain to me what you mean by cult?

A. It’s a term that again is about the recruitment online. This is a — it is almost a religious faith, if you will, without scientific basis. It draws people in with a promise of something that is not based on reality. It separates kids from families. So it’s an indoctrination, if you will, and that’s what I mean by cult.

Q. So you think the online presence or the transgender community is a cult?

A. It’s an indoctrinating society. Cult. Yeah. That’s what I mean.

Van Meter states that “talk therapy” refers to conversion therapy:

Q. Okay. So is talk therapy conversion therapy? I’m confused.

A. Talk therapy is called conversion therapy, yeah. Talk therapy is essentially conversion therapy. That’s what they’re referring to.

He then claims that talk therapy is the “proven most effective” way to “relieve” gender dysphoria by making someone stop being trans:

Q. Okay. Okay. So do you believe that talk therapy is the appropriate course of treatment to get someone’s gender identity to realign with their birth assigned sex?

MR. BLAKE: Objection.

THE WITNESS: It is the most effective, proven most effective means to relieve gender dysphoria.

Van Meter also states the belief that trans youth have a “delusional thought process” and trans adults have a “delusional disorder”:

A. It’s all wording. I mean it’s the same entity. It’s just his described — and I can’t remember word for word what was in DSM-III. DSM-IV I haven’t referred to recently, because DSM-5 is sort of the new entity that we have to — like it or not, it’s what’s in there. And so I have read, you know, the DSM-5 criteria and more familiar with them than I am the prior ones. But the idea is that it’s — you know, it describes the same thing. It’s just named differently, so that it wasn’t pathologic. So that it was not a delusional disorder. Zucker believed and stated that gender identity and gender incongruence is a delusional state. Period.

Q. Do you agree with that?

A. Yes, I do.

Q. Okay.

A. But it is not a delusional disorder, and I didn’t understand the difference between the two of those things, but he explained that sort of indirectly through a third party that a delusional disorder is a very specific psychiatric term and to say that all kids with gender identity disorder are delusional is incorrect. The only people that are delusional are the adults who persist in their delusion, and that becomes a delusional disorder. So all people who go through all the counseling and therapy who do not lose that delusional thought process then have a delusional disorder.

He explains that talk therapy “works” via a “common thread” both to turn gay people straight, and turn trans people cis:

Q. Okay. Thanks. That’s all on that one. And then I’m going to switch forward to this one. While we’re looking for that, do you believe that talk therapy can have similar effects for people who have same sex attraction as people who are gender dysphoric?

MR. BLAKE: Objection. Relevance.

THE WITNESS: The talk therapy is all aimed at the undercurrent anxiety, depression, related to ACEC, adverse childhood events. And so there’s a common thread that when that is the core issue that talk therapy works in both instances.

Van Meter believes trans people should never transition at any age:

Q. Okay. And can you clarify for me what gender incongruence is? I think I understand but…

A. It is when there’s a mismatch between the gender and the sex.

Q. Okay. Thank you. Do you believe it’s ever appropriate for a transgender person to undertake gender transition?

A. Yeah. I don’t think there’s any appropriate time or age.

February 27, 2020: A judge in a Texas divorce case finds Van Meter to be “discredited as an expert” to testify on harms of gender affirmation in trans youth:

After hearing evidence and argument of Counsel, THE COURT FINDS that Dr. Quentin L. Van Meter, M.D., is discredited as an expert to give testimony in this cause on his opinions regarding the legal question of whether an adolescent transgender child should be administered puberty blockers and whether affirmation of an incongruent gender in a child is harmful or not.

IT IS THEREFORE ORDERED that Dr. Quentin L. Van Meter, M.D. shall not be allowed to give any testimony in this cause as an expert and Dr. Quentin L. Van Meter, M.D. is hereby struck as an expert witness in this cause.

The Pennsylvania Capital-Star reports on September 15, 2020:

The first two Pennsylvania-based experts argued that gender-affirming care, including puberty-blocking drugs, were a safe way to help a young person grappling with their identity.

Then, lawmakers heard from Van Meter, who has previously called such treatment “medical experimentation based on wishful social theory,” but in a February 2020 court ruling, was “discredited as an expert” on hormone treatment.

The ruling came in a Texas divorce case overseen by Judge Germaine Tanner of Harris County.

She found that Van Meter could not offer expert testimony on “the legal question of whether an adolescent transgender child should be administered puberty blockers and whether affirmation of an incongruent gender in a child is harmful or not,” according to a court document acquired by the Capital-Star. …

York said that Van Meter’s testimony was thrown out because he did not offer a fact-driven opinion on the impact of puberty blocking drugs.

“He says all transgender youth are delusional and need psychiatric help, and the court took that and said wait a minute, his opinion tended to be more agenda driven than scientific driven,” York told the Capital-Star earlier this year.

August 26, 2020: The Fourth Circuit Court of Appeals’ ruling in Grimm v. Gloucester greatly diminishes the significance of Van Meter’s expert testimony, finding that he contradicted other experts and professional medical organizations, and that the court may rely on “overwhelming evidence regarding the accepted standards of care” rather than “his assertions”:

That did not prevent the Board from finding an expert, Dr. Quentin Van Meter, who disagrees with the WPATH Standards of Care, and who treats transgender youth by encouraging them to live in accordance with their sex assigned at birth. It goes without saying that one can always find a doctor who disagrees with mainstream medical professional organizations on a particular issue. Aspects of Dr. Van Meter’s report blatantly contradict the views of Grimm’s expert, as well as the American Academy of Pediatrics and our other medical amici. On appeal, however, the Board relies on Dr. Van Meter’s testimony only for its assertion that Grimm remained biologically female. See Opening Br. 12, 27, 46. The Board does not assert that Dr. Van Meter’s report creates any genuine factual questions that would impact our legal analysis below. Therefore, we need not consider the remainder of his assertions, and may rely on the overwhelming evidence regarding the accepted standards of care.

May 17, 2022: Van Meter’s expert report, “Concerns about Affirmation of an Incongruent Gender in a Child or Adolescent” (Attachment E), is published by Florida AHCA/Medicaid.

July 8, 2022: A Yale Law School team reports that Van Meter’s Attachment E appears to be copied from his previous August 2016 expert statement in Carcaño v. Cooper and from Dr. Michelle Cretella’s August 2016 ACPeds report “Gender Dysphoria in Children”:

The author of the document provided as Attachment E is Quentin van Meter, whose history indicates bias and lack of expertise. Although the AHCA presents van Meter as an expert in medical treatment for gender dysphoria, at least one court barred him from providing expert testimony on the issue. Van Meter is the president of the American College of Pediatricians (the “ACP”), which presents itself as a scientific group (and might be confused, by a non-expert, with the authoritative American Academy of Pediatrics). The ACP is, in fact, a political group that opposes same-sex marriage, supports mental health providers practicing conversion therapy, and describes gender dysphoria as “confusion.” Troublingly, the van Meter attachment, proffered by the AHCA as a scientific report, contains several passages of uncredited, verbatim language that appears in a “position statement” published by the ACP. The van Meter attachment appears to be a re-use of paid testimony rather than an original product.

July 28, 2022: The Florida Board of Medicine publishes the public agenda for the Friday, August 5 Board of Medicine hearing in Fort Lauderdale, with the submitted materials including Van Meter’s Medicaid report along with two blog posts by SEGM. The proposed rule includes a ban on any use of puberty blockers, HRT, or surgery for gender affirmation in trans youth under 18, and mandates that providers of gender-affirming care use “informed consent” forms drafted by the Florida Department of Health. The forms mandate a 24-hour waiting period before any treatment and refer patients to the Florida AHCA website, which prominently features Van Meter’s report.

State-level anti-trans policy capture: A total system attack

Dr. Quentin Van Meter’s role in Florida’s healthcare agencies is not an anomaly, but part of a sweeping multi-pronged effort to compromise access to gender-affirming care via the exercise of executive power and administrative regulatory authority. Van Meter and his fellow anti-trans “experts” did not obtain these influential roles on the merits of their knowledge, experience, or ethical integrity. What they needed was a state government, like the DeSantis administration, that was willing to allow any bad science on trans people to pass unchallenged so long as it could be used to strip away our rights.

Along with Florida AHCA’s selection of SEGM’s Brignardello-Petersen to contribute an inadequate “literature review” of transition care which included the SEGM website itself, Ron DeSantis appointed University of Central Florida’s Dr. Patrick K. Hunter to the Florida Board of Medicine on June 17, the day AHCA’s trans care exclusion was officially proposed. In a December 2021 letter to the editor in JAMA Pediatrics (Hunter, 2021), he defended political interference in trans healthcare as potentially necessary based on an anonymous online survey of detransitioners; his previous publications were limited to a child polydactyly condition and the use of infant pulse oximeters in military hospitals (Eknes-Tucker v. Ivey, Defendant’s exhibit 6, May 2, 2022).

In March 2022, Hunter joined SEGM director Dr. Julia W. Mason in anonymously cosigning the anti-trans “Resolution #27” to the American Academy of Pediatrics. That letter, promoted by the SEGM-overlapping group Genspect, was retweeted by Hunter with no disclosure that he had signed it.

Seeing little wrong with concealing Hunter’s involvement, SEGM director Mason began complaining that revealing her cosigners’ names and email addresses was “rude” and a “reportable offense”.

SEGM-Genspect acolyte Hunter is now in a position to approve an SEGM-crafted rule that would prohibit all access to transition treatment for those under 18, along with forcing doctors to provide state-sponsored misinformation to trans adults as part of receiving our care. This has been a deliberately opaque process compromised by special interests and done badly on purpose in the name of government overreach. It will harm vulnerable youth by cutting them off from medically necessary care, impose targeted regulatory burdens, and create a chilling effect of legal uncertainty around providing gender-affirming care at all.

This was achieved in a matter of months with the assistance of a complicit Republican government, and this regulatory capture could be accomplished similarly in any other state that allows it to happen. We have to stop it here. All Floridians must now gather to take action at the Marriott Fort Lauderdale Airport in Dania Beach on Friday, August 5 and call on the Florida Board of Medicine to reject the proposed rule!

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About Zinnia Jones

My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.
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