Florida AHCA’s anti-trans expert G. Kevin Donovan stated in deposition that he’s never been a member of the American College of Pediatricians hate group; the group’s financial records indicate he paid membership dues for several years

In 2022, Florida hired a Catholic bioethicist to argue against gender-affirming care

Dr. Gerard Kevin Donovan (G. Kevin Donovan), a pediatric gastroenterologist and Catholic bioethicist, contributed one of five anti-trans expert reports (Attachment G) to Florida AHCA’s June 2, 2022 determination revoking Medicaid coverage of gender-affirming treatment. In the ensuing lawsuit against the exclusion (Dekker v. Weida), he went on to provide expert declarations for Florida in support of the rule (ECF no. 49 attachment 9; February 15, 2023 expert declaration). The court ultimately declared the ban invalid and found that Florida adopted this rule “for political reasons” (ECF no. 246), and evidence introduced during the trial showed that AHCA’s reports only served to support a predetermined outcome of the rulemaking process: “Care Effectively Banned” (ECF no. 182-36).

Dr. Donovan trained under Catholic ethicist Edmund Pellegrino, the second chair of the President’s Council on Bioethics during the George W. Bush administration, and succeeded him as director of the Pellegrino Center for Clinical Bioethics at Georgetown University Medical School from 2012 to 2020; Donovan stated during deposition that both the Pellegrino Center and the university take an explicitly Catholic approach to ethics and healthcare (ECF no. 235-3 at 29-30):

Q The Georgetown University — I’m sorry, the Pellegrino Center at Georgetown University was established to “fill a unique need for bioethics that’s oriented towards clinical medicine and strongly rooted in the Catholic and Jesuit tradition.” Is that a fair description of its mission or purpose?

A Yes.

…

Q Is Georgetown University Medical Center a Catholic healthcare institution?

A Yes.

He also confirmed that his views as an ethicist are guided by the USCCB’s Ethical and Religious Directives, a religious policy document intended to prohibit any gender-affirming care from being provided in Catholic hospitals and clinics (pp. 33-34):

Q … Are ethical consultations and advisements at the Pellegrino Center for clinical bioethics guided by these ethical and religious directives?

A Yes, they are.

Q And are your views as an ethicist guided by this document?

A Yes.

Q Did you rely on this document during your active work as an ethical consultant at the Pellegrino Center?

A Yes.

Notably, Donovan stated that his Attachment G report for AHCA and his expert report in Dekker v. Weida reflected the course material he had been teaching at the Pellegrino Center for the past five years (pp. 64-65):

Q But what was being taught? What specifically — what was the subject that was being discussed?

A Well, we’d be talking about basically gender dysphoria and transgender individuals and gender-affirming care.

Q And what perspectives were being discussed or shared?

A Without recalling specific aspects of it, they would be very compatible with what I’ve already written in the reports you just referenced.

Q It would be consistent with the — when you say “reports,” we’re talking about the expert report you submitted in this matter that’s Plaintiffs’ Exhibit Number 1?

A And the — and the other one, which was –

Q The GAPMS memo report?

A Yes, ma’am.

Q And when were you teaching these courses?

A In the past five years.

Q While at the Pellegrino Center?

A Yes.

He later acknowledged that during his career as an ethicist, he had never participated in any ethical consultation regarding treatment of even one transgender patient (ECF no. 235-3 at 128-129).

Donovan provided an error-filled report to AHCA

Donovan was allocated $34,650 from AHCA for his “expert witness services” in support of the proposed exclusion, later enacted as Rule 59G-1.050(7). His Attachment G report and expert declarations in Dekker v. Weida contain a number of questionable assertions:

• Donovan claimed, without citing any supporting evidence, that “upwards of 80% of minors who identify as transgender will reverse this identity by the time they reach their mid-20’s if left untreated” (Attachment G, p. 3); persistence of childhood gender dysphoria into adolescence is typically determined by ages 10-13, not “mid-20s” (Steensma et al., 2011).
• Donovan referred to “a diagnosis of transgenderism” (ECF no. 49 attachment 9, ¶16); “transgenderism” is not a diagnosis.
• He stated that “transgender adults treated in early adolescence with puberty blockers may never experience orgasm” (Attachment G, p. 4); in a sample largely comprised of trans women with genital underdevelopment due to use of puberty blockers, 100% reported having sexual arousal following vaginoplasty, and 84% said orgasm was possible after surgery (Bouman et al., 2016).
• He claimed that in Virginia “a sexual assault by a self-described trans- female (with a penis) was repeated in another school after the perpetrator was transferred” (Attachment G, p. 5); the perpetrator in this case was not transgender, and the victim’s father explained “I think he’s just a sexual deviant”.
• He speculated that social transition for trans youth “may be altering the natural course of the phenomenon”, suggesting that even social gender affirmation (a change of pronouns, attire, or hairstyle) can cause gender dysphoria to persist when it otherwise would not. This is contradicted by Rae et al. (2019): trans children who would later go on to socially transition initially showed just as strong of a cross-gender identification as those who had already socially transitioned, suggesting that this strength of identity precedes transition rather than being caused by it.
• He asserted that “we must rely on the ancient principal [sic] of medical ethics ‘In the first place, do no harm’” (Attachment G, p. 7); the traditional oath to “do no harm” has never positioned avoidance of harm as a first priority, but rather as one value to be considered among many, including the need to help patients. Elsewhere, Donovan has recognized that “the focus must be on the good of the patient in all we do” and that “This is the oldest and most sacred duty of physicians, preceding even the principle ‘In the first place, do no harm’” (Donovan, 2015).
• Donovan variously compared trans women to people who think they are chickens (“Our first response would not be to immediately clothe him in a dress, any more than we would attempt to clothe him in feathers if he believed he were a chicken”, ECF no. 49 attachment 9 ¶16), called gender-affirming care “almost cult like” and compared it to an epidemic of opioid abuse (¶24), called trans people “disturbed patients”, and described gender-affirming counseling as “love bombing” (Attachment G, p. 5). Outside of this particular issue, Donovan shows little taste for applying empirical rigor to metaphysical beliefs and ‘cult-like’ claims: he asserts elsewhere that “[a] functioning brainstem maintaining respiration, blood pressure, and some reflexes indicates that the soul has not left the body but is still present”; that Catholics should display “‘ready and respectful submission of will and intellect’” to bishops as an “internal act prompted by faith”; that conscience consists of “discovering God’s will and following it”; that “suffering itself may have salvific importance”; and that Catholics can find comfort in experiencing “sacramental death” (Donovan, 1997). He acknowledges that this is predicated on belief in “a better life after death”.

“If one does not share the conviction of a better life after death, then one will not only fail to see the value of one’s own suffering, but will see no good possible in the suffering of others.” –Dr. G. Kevin Donovan (1997)

“Exit strategy”

Most noxiously, Donovan argued in his expert declaration that the only problem with forced detransition due to trans care bans is that gender-affirming care providers haven’t come up with a treatment other than transitioning (ECF no. 49 attachment 9 ¶24):

My discussion of the ethics of providing transgender care has been criticized by Dr. Dan Karasic. He views Florida’s actions in terminating Medicaid coverage of gender affirming care as problematic for those who were previously approved for that same coverage. He states “Florida’s actions amount to forced detransition” and goes on to admit “there has been little research on those forced to detransition”. He fails to see that those pathways upon which he has set patients for “gender affirming care” should have included protocols for “detransitioning” that patients are already voluntarily seeking in increasing numbers. To place patients on such a one-way conveyor belt of treatment is to fail to account for all their needs, an ethical as well as a medical failure on their part. It would be analogous in the present opioid epidemic to treating a patient’s pain with opioids but not knowing how to wean them off successfully. Were such an exit strategy in place, it could be used for all who needed it. This would include not just patients who lose their insurance coverage, but could also extend to patients who develop neurologic injury significant enough to cause a loss of “gender identity”. Would a patient in an ICU or a nursing home situation continue to receive these treatments? To begin treatment of such patients without knowing how to successfully discontinue such treatment, and not to warn patients of this issue in advance, again reflects unfavorably on the issue of informed consent for the treatment of patients identifying as transgender.

This is an illogical response because gender dysphoria is a chronic condition requiring ongoing treatment: no amount of foresight on the part of providers would have made it stop being a chronic condition; it is not their responsibility to innovate an alternative treatment when an effective treatment already exists; and there is no reason to assume alternative treatments are possible merely because Donovan believes it should be so. Donovan clearly believes many things with no connection to the state of reality, and this is no different from arguing that anyone with any chronic condition should just find a way to stop taking their medications.

This suggestion is feckless, insulting, and shows a lack of serious engagement by this clinician-ethicist with the medical and ethical issues he was allocated $34,650 to address. The trans community of Florida values truth, not suffering, and we will not be treated like this man’s plucked chickens. We have evidence that Donovan may have lied under oath in Dekker v. Weida.

Donovan appears repeatedly in the records of the American College of Pediatricians hate group

During his deposition in Dekker v. Weida, G. Kevin Donovan was asked if he has ever been a member of the anti-LGBTQ American College of Pediatricians (ACPEDS) hate group, which he denied (ECF no. 235-3 at 59):

Q Are you a member of the American College of Pediatricians?

A No.

Q Have you ever been a member of the American College of Pediatricians?

A No, I don’t believe so.

This group has stated their absolute commitment against gender-affirming care: Quentin Van Meter, then-president of ACPEDS, declared on November 9, 2021 in American College of Pediatricians v. Becerra (ECF no. 15-1) that ACPEDS members “object on medical and ethical grounds” to “[s]aying in their professional opinions that these gender intervention procedures are the standard of care, are safe, are beneficial, are not experimental, or should otherwise be recommended” (at 41(m)). This section is substantially identical to the absolute objections in sections 69-70 of an earlier declaration on behalf of the Catholic Medical Association (CMA) (ECF no. 15-2), a far-right group that endorses anti-gay conversion practices.

So long as this commitment holds, members of these groups lack the impartiality required of their role in evaluating evidence for gender-affirming care. If this treatment is indeed safe and beneficial as a standard of care, ACPEDS and CMA members would not be able to recognize this – they would not be conducting any meaningful assessment of the evidence. Nevertheless, Quentin Van Meter and other ACPEDS members, including Michelle Cretella and Andre Van Mol, assisted the state of Florida in the sham anti-trans rulemaking process and did not recuse themselves or disclose this conflict of interest. At least two of the five expert reports attached to the June 2 GAPMS determination were provided by members of ACPEDS (Attachment E by Quentin Van Meter) or CMA (Attachment F by Deacon Patrick Lappert).

Although G. Kevin Donovan denied ever being a member of ACPEDS, a large trove of the organization’s internal files was leaked in May 2023, including details of Donovan’s long-running involvement with ACPEDS. These files, available via DDoSecrets and authenticated by the Washington Post, indicate Donovan was present at ACPEDS’ October 19, 2002 inaugural meeting with founder Joseph Zanga (see Annex A, 2002 board minutes), who has also served as a state expert in Dekker v. Weida (ECF no. 49-5 attachment 10):

The inaugural meeting of the American College of pediatricians was held in Boston Massachusetts on October 19th, 2022. Joseph Zanga M.D. served as the facilitator.

Attendees were: Reed Bell M.D., Christopher Benton, Tom Benton M.D., Gerry Boccarossa D.O., Fred de Miranda M.D., Kevin Donovan M.D., Phil Kaleida M.D., Don Lewis M.D., Robert Mann M.D., Rick Payne M.D., Dubose Ravenal M.D., Howard Rogers M.D., Leah Willson M.D., Jean Wright M.D., and Joseph Zanga M.D.

The minutes of a board of directors meeting on March 28, 2009 note that Donovan was a nominee for the board in that year (Annex A, 2009 board minutes):

Dr. Hagler spoke about the some of the nominees we had this year: Bill Shaw, Jim Pearson, Frank Maffei, Kevin Donovan, Mark Grubb. He said they came with high recommendations, but circumstances prevented them from serving on the board in 2009. He suggests we follow up with these same individuals in August or September.

ACTION ITEM: Lisa will remind Dr. Hagler to follow up with these members (Shaw, Pearson, Maffei, Donovan, Grubb, Fondy, J. Anderson – possibly Weisberg) in August.

A spreadsheet updated October 3, 2018 lists him as serving on the “Medicine & Morality” committee with Michelle Cretella (Annex A, 2018 committee list):

ACPEDS’ WordPress database backups contain entries under Donovan’s name dated to 2012, with several listing him as a “fellow” and one describing him as “retired” (see Annex A, 2020 WordPress export and 2023 SQL dump); members of ACPEDS often refer to themselves by the title “Fellow of the American College of Pediatricians”. The office address and phone number in these entries matches the information in Donovan’s curriculum vitae attached to his expert declarations in Dekker v. Weida (ECF no. 49 attachment 9, App. 645).

Additionally, the hate group’s QuickBooks records report the following “Membership Dues” from a “G. Kevin Donovan” in 2003, 2005 through 2011, and 2015 (Annex A, 2021 QuickBooks backup):

• A 2003-04-11 deposit of $150 from “Acpeds/Dues/  DR  Donovan,Oakl U” for “Dues (Membership Dues)”. Donovan obtained his M.D. from the University of Oklahoma and later taught at the College of Medicine as a professor of pediatrics.
• A 2005-04-18 deposit of $150 from “Donovan,G” for “Dues (Membership Dues)”.
• A 2006-01-26 deposit of $150 from “Donovan, G. Kevin” for “Membership Dues”.
• A 2007-05-14 deposit of $225 from “Donovan, G. Kevin” for “Membership Dues”.
• A 2007-12-16 deposit of $225 from “Donovan, G. Kevin” for “Membership Dues”.
• A 2008-11-18 invoice of $225 labeled “Donovan, G. Kevin” and “Membership Dues:Fellow”.
• A 2008-12-17 payment of $225 from “Donovan, G. Kevin” for “2009 dues ck rec’d from Univ of OK”.
• A 2010-04-28 sales receipt for $225 labeled “Donovan, G. Kevin” and “Membership Dues:Fellow”.
• A 2011-03-07 sales receipt for $225 labeled “Donovan, G. Kevin” and “Membership Dues:Fellow”.
• A 2015-12-31 deposit of $225 from “Donovan, G. Kevin” for “Membership Dues:Fellow”.

Donovan was informed at the outset of his deposition in Dekker v. Weida that his oath required him to provide full and complete answers (ECF no. 235-3 at 9):

Q The oath you’ve taken that the court reporter provided is the same oath that you would take in a court of law. So do you understand that you are testifying today under penalty of perjury?

A Yes.

Q And your oath is to answer, not just truthfully, but also the whole truth. So do you understand that you’re expected to give full and complete answers today?

A Yes.

Although we at Gender Analysis are not legal professionals, we are concerned about the truthfulness of G. Kevin Donovan’s testimony. Donovan apparently was present at the inaugural meeting of ACPEDS, served on a committee, was under consideration for the board of directors, and paid membership dues for several years; at the same time, he represented under oath that he has never been a member of ACPEDS. In light of this contradiction, how can his other statements be considered credible or trustworthy?

Worryingly, other anti-trans experts may have sought to conceal their past or present affiliation with ACPEDS. In a September 2018 email, then-president Michelle Cretella mentioned that Paul Hruz keeps his ACPEDS membership secret, while Michael Laidlaw “dropped his membership with us as an associate for political reasons” (see Annex B, 2018 Cretella SPLC email). Both Hruz (ECF no. 120-13) and Laidlaw (ECF no. 49-5 attachment 11) went on to provide expert reports on behalf of the state of Florida in Dekker v. Weida.

If Donovan is in fact a member of ACPEDS, this would indicate that a majority of the five GAPMS attached reports were written by individuals – Donovan and Van Meter of ACPEDS, and Lappert of CMA – who may have already held an absolute commitment against trans healthcare. No matter how positive the evidence, they would never say that gender-affirming care is safe or beneficial under any circumstance. In deposition, Donovan revealed who reached out to him for these services: the DeSantis administration’s Department of Health.

Q Okay. Who contacted you to provide your report in support of the AHCA GAPMS memo?

A Someone from — I believe it was the health department in Florida.

Q Do you remember the name of that individual?

A No, I’m sorry, I don’t.

From the outset, this was a fixed result – there was never any opportunity for gender-affirming care to prevail on its merits. Instead, a gastroenterologist who believes the soul is stuck to the brainstem told us that being forcibly detransitioned by this gang of “experts” is our own fault for transitioning in the first place. If suffering is supposed to be good for you, then I truly wish them the best. ■

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Documents on G. Kevin Donovan related to AHCA and Dekker v. Weida

• May 10, 2022 email from G. Kevin Donovan to AHCA’s Jason Weida (ECF no. 117-9)
• May 12, 2022 report of G. Kevin Donovan for Florida AHCA determination against gender-affirming care (Attachment G of June 2 GAPMS report)
  • See also: Response to Donovan in expert declaration by Dr. Dan H. Karasic (ECF no. 11-3 at 84-85, September 10, 2022)
  • Response to Donovan in expert declaration by Dr. Armand H. Antommaria (ECF no. 11-5, September 11, 2022)
• October 2, 2022 expert declaration of G. Kevin Donovan in Dekker v. Weida (ECF no. 49 attachment 9)
  • See also: Response to Donovan in supplemental expert declaration by Dr. Dan H. Karasic (ECF no. 58-3 at 26, October 6, 2022)
• February 15, 2023 expert declaration of G. Kevin Donovan in Dekker v. Weida
  • See also: Response to Donovan in expert declaration by Dr. Armand H. Antommaria (ECF no. 120-24 at 32-37 and 43-47, February 16, 2023)
  • Response to Donovan in expert rebuttal report by Dr. Dan H. Karasic (ECF no. 175-11 at 57-59, March 9, 2023)
• March 22, 2023 deposition of G. Kevin Donovan in Dekker v. Weida (ECF no. 235-3)
• Plaintiffs’ trial exhibit 145, “Strangers in a Strange Land: How Our Founding Principles and a Bitter Pill Undo the Assimilation of US Catholics” by G. Kevin Donovan and Claudia Sotomayor (2020), published in the Catholic Medical Association journal The Linacre Quarterly (ECF no. 178-25)
• Purchase order BB0A89 dated May 13, 2022, allocating $34,650 to vendor Gerard Kevin Donovan from the Agency for Health Care Administration (“6840 -Gerard Kevin Donovan – Medical Expert Witness – State (Donovan)”)

Other publications and statements by G. Kevin Donovan

• “The Right to Best Care for Children Does Not Include the Right to Medical Transition” by former American College of Pediatricians member Michael K. Laidlaw, former ACPEDS president Michelle Cretella, and G. Kevin Donovan (2019)
  • See also: Reply by Florence Ashley (2019), “Watchful Waiting Doesn’t Mean No Puberty Blockers, and Moving Beyond Watchful Waiting”

Annex A. Files from the American College of Pediatricians mentioning G. Kevin Donovan

2002 board minutes (“Minutes Board Oct 19_ 2002.pdf”)

• Filepath: “Board of Directors\Archive\2002-2019 Minutes-Board Meetings_\Minutes Board Oct 19_ 2002.pdf” in DDoSecrets ACPeds.tar.zst

2009 board minutes (“Minutes Board Mar 27-28_2009.pdf”)

• Filepath: “Board of Directors\Archive\2002-2019 Minutes-Board Meetings_\Minutes Board Mar 27-28_2009.pdf” in DDoSecrets ACPeds.tar.zst

2018 committee list (“Committee List_revised_11.2.17.xlsx”)

• Filepath: “Staff\Staff Duties-Job Descriptions\Executive Administrator\Archive\Admin Laptop Documents\Conferences\Board\Archive\October 2018\Attachments\Committee List_revised_11.2.17.xlsx” in DDoSecrets ACPeds.tar.zst
• Date: October 3, 2018

Spreadsheet “Sheet1” at row 18:

• Committee: Medicine & Morality
• Committee Chairperson: Michelle Cretella
• Current Members: David Perry, Chris Ferrara, Mike Powell, Kevin Donovan

2020 WordPress export (“5.7.20 WP database export.xlsx”)

• Filepath: “Committees\Website Committee\5.7.20 WP database export.xlsx” in DDoSecrets ACPeds.tar.zst

Spreadsheet “membership-2020-05-07” at row 1146 (some fields are omitted):

• Select level of membership: fellow
• Name (First): G. Kevin
• Name (Last): Donovan**
• Name (Suffix): MD
• Email: donovanGK@georgetown.edu
• Date of Birth: 5/23/1948
• Office Address (Street Address): Center for Clinical Bioethics, 4000 Reservoir Rd. NW, Suite #D236A
• Office Address (City): Washington
• Office Address (State / Province): District of Columbia
• Office Address (Zip / Postal Code): 20007
• Office Address (Country): United States
• Office Phone: 202-687-1122
• Entry Date: 11/13/2012 19:14
• Source Url: http://www.acpeds.octoberblue.com/join

2021 QuickBooks backup (“QB 3.5.2021.QBB”)

• Filepath: “Staff\Staff Duties-Job Descriptions\Finance Administrator Position\Financial Administrator\Quickbook backup\QB 3.5.2021.QBB” in DDoSecrets ACPeds.tar.zst

2023 SQL dump (“acpeds_prod.sql”)

• Filepath: acpeds_prod.sql.zst in in DDoSecrets ACPeds-Supplement.tar
• Date: April 21, 2023

Tables:

• “wp_bpwpgd_rg_lead_detail_orig” and “wp_bpwpgd_rg_lead_detail_RON” contain entries listing Donovan as a “fellow” with information matching the 2020 WordPress export.
• “wp_bpwpgd_rg_lead_detail” contains an entry with the same information, but listing Donovan as “retired”.

Annex B. Other supporting materials from ACPEDS files

2018 Cretella SPLC email (“American College of Pediatricians Mail – Survey and AmazonSmile 9 28 18.pdf”)

• Filepath: “Staff\Staff Duties-Job Descriptions\Executive Administrator\Archive\Admin Laptop Documents\SPLC\American College of Pediatricians Mail – Survey and AmazonSmile 9 28 18.pdf” in DDoSecrets ACPeds.tar.zst

Excerpt:

drmcretella@gmail.com <drmcretella@gmail.com>
Fri, Sep 28, 2018 at 7:48 AM
To: Lisa Hawkins <acpedsfl@gmail.com>
Cc: Ronni Ann Lutovsky <admin@acpeds.org>, “Dr. Quentin Van Meter” <kidendo@comcast.net>

Quentin,

Matt Staver sent us the survey to fill out as the first step to pursuing legal action. In addition to the Amazon smile, I think we should also submit accounts of our members who have suffered including those who keep their membership secret. Paul Hruz for example comes to mine. Michael Laidlaw actually dropped his membership with us as an associate for political reasons. In addition I think the audio digest debacle is also evidence of harm against us. Ronni Ann, please keep this email on file so that I don’t forget to include all these things as evidence of defamation and concrete harm from SPLC.

Sent from my iPhone