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Tuesday, May 21, 2024

UF Health complies with state audit, reports increase in gender-affirming care patients

UF declined to speculate on motivation for state’s audit

<p>Nine members of the UF wildlife ecology and conservation department’s Inclusion, Diversity, Equity and Access Committee wrote a letter criticizing the guidelines and called upon the UF community to advocate for transgender healthcare access for children.</p>

Nine members of the UF wildlife ecology and conservation department’s Inclusion, Diversity, Equity and Access Committee wrote a letter criticizing the guidelines and called upon the UF community to advocate for transgender healthcare access for children.

UF reported a steady increase of patients diagnosed with gender dysphoria or who received gender-affirming care at UF Health since 2018, according to an audit requested by the governor’s office and obtained by The Alligator.

Gov. Ron DeSantis’ Jan. 18 memo, issued by Chris Spencer, director of the Office of Policy and Budget, mandated Florida public universities compile a report on the number of patients receiving numerous types of gender-affirming care through UF Health facilities starting from Jan. 1, 2018. The information was due Feb. 10.

DeSantis’ press secretary Bryan Griffin responded Monday afternoon to The Alligator’s request for comment, saying the administration plans to reassess the public funding of certain initiatives through state-funded institutions.

“Like [diversity, equity and inclusion] and [critical race theory], radical gender ideology has supplanted academics at many institutions of higher education,” Griffin said. “We are committed to fully understanding the amount of public funding that is going toward such non-academic pursuits to best assess how to get our colleges and universities refocused on education and truth.”

UF followed all applicable state and federal laws when complying with the request, UF spokesperson Cynthia Roldan said. The UF Office of the General Counsel reviewed the responsive documents and ensured protected health information was removed before the audit’s production.

The university will not speculate on the state’s intended use of the report, Roldan added.

The audit details the number of patients diagnosed with gender identity disorders and the different forms of treatment they received, including puberty blockers, hormone therapy, surgical procedures and behavioral health services. It was composed of data from UF Health’s Gainesville and Jacksonville facilities. The data was broken down into two age categories: minors and adults. 

UF Health’s Gainesville entity reported 164 interactions between patients and doctors for gender-affirming care in 2018 and 410 in 2022 — a 150% increase. However, the numbers fluctuated throughout the four years. Roughly 30% of the 410 encounters were patients’ first times seeking gender-affirming care. 

UF Health in Gainesville reported 192 patients diagnosed with gender identity disorders — either before, during or after treatment with UF Health — in 2018 and 465 patients diagnosed in 2022, a 142.2% increase. The number of minors diagnosed with gender identity disorders increased from 82 in 2018 to 148 in 2022.

UF Health’s Jacksonville facility reported lower numbers for treatment encounters, with 16 in 2018 and 10 in 2022. 

At UF Health in Jacksonville, the institution reported 36 patients diagnosed with gender identity disorders in 2018 and 77 diagnosed in 2022. Only nine of the 77 patients diagnosed in 2022 were minors. 

No minors have undergone gender-affirming care surgical procedures at UF Health’s Gainesville or Jacksonville facilities within the four years. Gender-affirming care surgical procedures performed include surgeries that cater to the areas of the body above and below the waist, including facial feminization surgeries and breast augmentation. 

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In comparison, Doernbecher Children's Hospital gender clinic at Oregon Health & Science University in Portland treated 248 patients in 2017 and 724 in 2021, according to a Reuters investigation

Diagnosis for gender dysphoria, which UF Health defines as the anxiety individuals may experience when their biological sex doesn’t match their gender identity, has continuously risen among youth in the U.S. 

Youth gender dysphoria diagnoses among minors aged 6 to 17 increased from 15,172 in 2017 to 42,167 in 2021, according to reporting by Reuters

The number of initiations for hormone therapy and puberty blockers prescriptions has also had stable growth for minors in the U.S., according to the report. 

An increased social acceptance surrounding exploring one's gender identity contributes to the rise in the number of young people identifying as transgender, Dr. Angela Goepferd, medical director of the Gender Health Program at Children’s Minnesota hospital told The New York Times.  

The broadening of the idea of what being transgender looks like, as not every transgender or nonbinary person medically transitions, has also been attributed to the increase, Goepferd said. 

Florida Sen. Keith Perry, R-Gainesville, who will review the audit when he goes to Tallahassee March 6 for the start of the legislative session, said questioning gender-affirming care concerning children is crucial. He supports Florida’s ban on the treatment for minors, he said.

“I think that gender-affirming care [for minors] should be outlawed — probably at almost every level,” he said. 

Florida is one of at least eight states to ban gender-affirming care for minors. The treatment was prohibited through a vote of the state’s medical board, not legislation.

Additionally, Perry said he would like to see patients have a cause of action to sue providers for supplying minors with gender-affirming care, so the court system can decide whether the treatment was appropriate. 

As a member of the senate committee on post-secondary education, Perry said he’ll do what he can to ensure Florida isn’t funding gender-affirming care at institutions like UF Health.

“It is our duty to make sure that your money is being spent in what is the best interest of the public,” Perry said. “There's a lot of things the state should pay for in health care, and there's a lot of things that the state shouldn't.”

A Florida medical provider who works in gender-affirming care and requested anonymity for fear of retaliation, hadn’t seen the audit as of March 5. They worry the state legislature and the DeSantis administration will misrepresent the audit’s data to further propel its political agenda of restricting access to gender-affirming care, they said. 

“My guess is that they'll use that to say people are just getting put on hormones left and right without thoughtful and meaningful evaluations,” they said. “But that's not true.”

They emphasized how the audit discloses that more often than not, patients at both facilities did not receive behavioral health services before their first treatment. Although, the audit only includes data for behavioral health services provided by UF, not providers unaffiliated with the university.

The doctor is also concerned about legislation aiming to restrict gender-affirming care, such as SB 254, a bill introduced by Florida Sen. Clay Yarborough, R-Jacksonville. 

The bill seeks to criminalize parents and medical providers who provide gender-affirming care to minors and allow the government to claim jurisdiction over children if their parents allow them to receive the treatment. The legislation also proposes prohibiting the use of public funds to finance gender-affirming care through state-funded entities. 

“It's pretty egregious,” the medical provider said. “It's just another example of hypocritical governing rather than the free state of Florida like our governor likes to state regularly.”

The bill has seen no action in the Florida Senate since its introduction.

The medical provider said they have been receiving numerous phone calls from panicked parents amid the pending ban on gender-affirming care for minors. 

“It's very scary times for these families,” they said. “We're literally going to create medical refugees who have to try to go elsewhere to get care if all these things are passed.”

The ban will go into effect March 16, the medical provider said, prohibiting gender-affirming care for minors seeking first-time care, not those already receiving treatment. However, they said, they have little doubt that further restrictions will be implemented in the future.

While these restrictions are going into effect now, the medical provider said they predict much of Florida's anti-gender-affirming care legislation will be overturned by the state legal system. Until then, they said, many trans youth and their families will suffer.

"People have been seeking care for all kinds of things for thousands of years, and a physician's job is to treat them the best that we can," they said. "The state deciding to specifically restrict access to this care is particularly barbaric."

Contact Amanda Follow her on Twitter @amandasfriedman.

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Amanda Friedman

Amanda Friedman is a senior journalism major and the Enterprise Editor at The Alligator. She previously wrote for the Avenue, Metro and University desks. When she isn't reporting, she loves watching coming-of-age films and listening to Ariana Grande. 

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