Gender Analysis

The FLDOH guide to parenting: Ignore a child’s issues, and just hope it all goes away

Previously: FLDOH anti-trans guidance attacks “low-quality evidence” for gender-affirming care, citing low-quality evidence for conversion therapy

The Florida Department of Health states in their 2022 guidance:

Based on the currently available evidence, “encouraging mastectomy, ovariectomy, uterine extirpation, penile disablement, tracheal shave, the prescription of hormones which are out of line with the genetic make-up of the child, or puberty blockers, are all clinical practices which run an unacceptably high risk of doing harm.”

In this bullet point, FLDOH cites a brief article by psychoanalytic psychologist David Schwartz (2021) outlining his personal history in clinical practice and his opinions on gender-affirming care. Like Hruz (2019), this is not any kind of systematic review of evidence. Large swathes of Schwartz’s assessment of the “currently available evidence” are merely his own assertions without any supporting references, or the most cursory sprinkling of tangentially relevant sources, and none of it constitutes an adequate summary of that evidence. Continue reading →

FLDOH anti-trans guidance attacks “low-quality evidence” for gender-affirming care, citing low-quality evidence for conversion therapy

Previously: FLDOH guidance against social transition, puberty blockers, or HRT for minors is not supported by cited documents from CMS, Sweden, Finland, England, or France

In their 2022 document “Treatment of Gender Dysphoria for Children and Adolescents”, the Florida Department of Health writes:

Systematic reviews on hormonal treatment for young people show a trend of low-quality evidence, small sample sizes, and medium to high risk of bias.

Hruz (2019) is not a systematic review

The linked “systematic reviews” is actually one four-page article by Paul W. Hruz (2019) in the Catholic Medical Association’s journal The Linacre Quarterly, and it is not a systematic review. It broadly encompasses the spectrum of gender-affirming care across all ages and does not specifically focus on “hormonal treatment for young people”. The journal has published it as a “research article”, and it is an unorganized continuous wall of text:

It does not possess any of the expected features of a systematic review, such as a specific research question or discussion of search criteria for inclusion of studies (Robertson-Malt, 2014). The FLDOH has erred in labeling this a “systematic review”. Continue reading →

FLDOH guidance against social transition, puberty blockers, or HRT for minors is not supported by cited documents from CMS, Sweden, Finland, England, or France

On April 20, 2022, the Florida Department of Health published three nonbinding documents containing sweeping and inaccurate claims about transgender youth and gender-affirming care: the press release “Florida Department of Health Releases Guidance on Treatment of Gender Dysphoria for Children and Adolescents”; the PDF “Treatment of Gender Dysphoria for Children and Adolescents”; and the PDF “Treatment of Gender Dysphoria for Children and Adolescents – Fact Check”. These documents are sloppily written, typically citing either low-quality opinion sources or selectively quoting from sources that clearly contradict the position FLDOH is attempting to support, and at times referring to documents that are not about even about children and adolescents.

The FLDOH misrepresents brief opinion pieces from individual authors in Catholic and psychoanalytic journals as constituting reliable literature reviews of existing knowledge on transgender healthcare and development. FLDOH makes invalid assumptions about desistance of childhood gender dysphoria at adolescence, misrepresents its clinical relevance, and then offers advice far beyond what this evidence supports. And the FLDOH simply lies about numerous national health authorities in the United States and abroad agreeing with the department’s entirely unsupported anti-trans guidance.

These documents represent another disgraceful failure of the FLDOH under the DeSantis administration to fulfill its basic mission of providing reliable, high-quality health information to all citizens of Florida. The fact is that everyone in the state, cis or trans, whether they care about transgender issues or not at all, is now being subjected to another insulting disservice from a department that is already bleeding credibility in the COVID-19 crisis, particularly under the leadership of state surgeon general Joseph A. Ladapo. What they’ve passed off as guidance here is nothing but an embarrassment, and its fatal flaws will be visible to anyone who bothers to follow its sources. Those sources are examined here. Continue reading →