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(单词翻译:双击或拖选)
Parents raise concerns as Florida bans gender1-affirming care for trans kids
When 13-year-old Liz Bostock thinks back, she remembers feeling in-between genders3 as early as preschool.
Assigned male at birth, she identified as nonbinary by fifth grade and decided4 to use they/them pronouns. Now a seventh-grader in Gainesville, Fla., with a passion for manga and anime video games, and a bedroom filled with stuffed animals, Liz identifies as female and transgender.
"I figured out that I actually felt like a girl," she says. "Not just in-between."
Liz's birth certificate now bears her new legal name and gender marker.
After months of counseling, and with a diagnosis5 of gender dysphoria, Liz started receiving puberty blockers last August. Every three months, she gets a shot of Lupron, a gonadotropin-releasing hormone6, or GnRH, that essentially7 presses the "pause" button on male puberty.
The goal is to keep her body from developing further in ways that don't align8 with her gender identity.
"It's been amazing," says her mother, Virginia Hamner, who says she's seen her daughter "light up" with gender-affirming care. "It's fun and exciting for her to be able to be exactly who she wants to be," she says.
But under new rules passed by Florida's medical boards, it's unclear whether Liz will be able to continue on to further treatment.
The future is uncertain for trans kids' medical care
Florida is one of a growing number of states to prohibit gender-affirming care for transgender minors9. It is the only state to do so not through legislative10 action, but through a vote of its medical boards.
With the encouragement of Florida Gov. Ron DeSantis, the state's Board of Medicine and Board of Osteopathic Medicine both passed rules that will ban gender-affirming care such as puberty blockers and cross-sex hormones11, as well as surgical12 procedures, for new patients under age 18.
As for existing patients such as Liz, who may want to proceed on to cross-sex hormones (estrogen in her case; testosterone for transgender males), the language of the new rules is vague.
"There is a lot of uncertainty13 about that," says Hamner, who worries that the rules might be tightened14 still further.
"It doesn't feel like it's over, which makes living in Florida really challenging right now," she says, "because you're basically being told that your child shouldn't be able to be who they are, and that it would be better if they didn't exist in the way that you, medical professionals, and the child who is thriving, feel is best for the child."
For Liz, the fear of what's to come could mean a future outside Florida.
"If it gets too bad, I'm also already thinking about for high school going to a boarding school that isn't in Florida," she says, "which would honestly make things a lot easier."
Gov. DeSantis has targeted LGBTQ rights, and has made "parental15 rights," especially in education, a running theme as he eyes a potential White House bid.
The irony16, says Hamner, is that her parental rights are being trampled17.
"It's a gut18 punch," she says. "It's so frustrating19 to hear the rhetoric20 of parental rights be used to say, 'Kids shouldn't have access to treatment because we need to let them be kids.' When it's like, you're right. And guess what? That's all I want for my kid."
Politicians disagree with the medical consensus21 on the safety of gender affirming care for minors
Dozens of leading U.S. medical groups, including the American Academy of Pediatrics, the American Medical Association and the Endocrine Society, endorse22 gender-affirming care as time-tested, effective, medically necessary, and potentially life-saving.
But Gov. DeSantis has called the treatment "an example of woke ideology23 infecting medical practice." The state's surgeon general, Dr. Joseph Ladapo, who was appointed by DeSantis, called the treatments "highly experimental," "risky24 and unproven." Board of Medicine member Dr. Hector Vila said that by banning gender-affirming care, the board was acting25 to protect children from "irreversible harm."
The Tampa Bay Times has reported that many of the members of the Board of Medicine who were appointed by Gov. DeSantis have contributed to his campaigns or political committee.
Pediatric endocrinologist Dr. Kristin Dayton, who runs the Youth Gender Program at the University of Florida in Gainesville, disputes claims that gender-affirming care is risky or experimental.
"There is tons of evidence to back my assertion that this is safe and healthy for children," she says. "It's pretty offensive to me, because I pride myself in being someone who always follows the evidence, does the right thing for my patients."
Dayton worries about her patients, many of whom haven't yet started on puberty blockers or hormones, and now won't be able to. "People are feeling incredibly panicked and sad and distressed26 and coming to our office saying, 'What are we going to do when this passes?' And frankly27, we don't have the answers."
Dayton's colleague, clinical psychologist Jennifer Evans, says she is "extremely concerned" about what the ban will mean for her patients' mental health. She cites research showing that medical transition has clear benefits. "Depression rates go down. Along with that, suicidal ideation and attempts go down," she says. "Anxiety goes down. Eating disorders28 rates start to go down. Substance abuse rates start to go down."
Doctors say medical care is being politicized and creating a climate of fear
The new rules haven't taken effect yet, but providers and advocates say they've already had a chilling impact. Several gender clinics in Florida have shut down.
Under the new rule, violators could lose their medical license29 and face steep fines.
Here's what a Tallahassee mom named Sandi heard from her transgender son's doctor, who explained that he will not prescribe anything beyond the son's current puberty blockers. "One thing he has said several times is 'I don't want to go to jail,'" she recounts.
As another family told NPR, the doctor said, "I don't look good in orange."
To be clear, jail time is not a penalty under Florida's new rules. But many fear that sanctions could be toughened.
That fear is shared by some families, which is why NPR agreed to use only Sandi's first name.
"We would love to be shouting at the top of our lungs all the time about all of these issues," she says. "But there's just fear of not knowing what's coming in the future and how transgender families will be retaliated30 against." Just look at Texas, she says, where the state investigated parents of trans kids for child abuse.
When NPR visited her at home, she was wearing a tee-shirt that says "Believe Trans Kids." "I probably have a shirt for every day of the week!" she says with a laugh. "It's a great conversation-starter."
Parents of trans children worry about "constant invalidation"
Sandi's son River (we're using his middle name, as he's not out yet to all of their extended family) started saying he was a boy, and presenting as a boy, when he was about 3 years old.
"It was like a light switch went off," Sandi recalls.
River is now 12, a 7th-grader who loves rock-climbing, math and fishing, and is a whiz with a Rubik's puzzle.
Sandi says she's seen her son flourish in the past year since he started on puberty blockers. "I have this glorious picture right after he got his first puberty blocker shot where he is literally31, like, ear to ear smiling," she says. "He's glowing. I felt like he could finally put his shoulders down, like, relax."
In the current climate, she worries about what she calls "the constant invalidation" of who River is. "Constantly seeing that who you are is a political debate, [or] an agenda item on anyone's list," she says, "makes you feel less than human."
Sandi says River "has always been this solid force within himself. And so the visualization32 I have is, whenever there's more of this anti-trans rhetoric, it's just chipping away at that solid block of who he is."
The relentless33 focus on trans kids is demoralizing for her, as well. "There are some days that you look at everything going on and you are just paralyzed by fear of what's coming at your kid next," she says. "But you can't show that to your beautiful, wonderful trans kid. And it's exhausting. You know, it's so exhausting."
Sandi is on regular calls with other families who have trans kids, many of whom are planning what she calls "escape routes." They're considering moving out of Florida to more trans-friendly states.
She and her husband think about it, too; they think about moving to Oregon, where they have family. But it's hard to imagine uprooting34 their entire support system.
"The fact that you have to consider re-homing your family to have access to health care in the United States in 2023 is ridiculous," she says. "I just want my kid to be happy and healthy. And I just don't think that's a lot to ask."
Transgender advocates vow35 to fight the new rules in court
Nikole Parker, director of transgender equality for the LGBTQ civil rights group Equality Florida, has talked with a number of families who are actively36 planning to leave the state.
"They're like, 'Listen. The health care for my kid is my number one priority. And there are states who will allow that to happen seamlessly. And I'm not going to sit here and just wait in limbo37 to see what happens.' "
"As a born and raised Floridian," Parker says, "I truly feel Florida is a place for everybody, and we need to make sure that we stand firm in that. And it just makes me sad to see where we are, because this isn't the Florida that I was born in."
Trans advocates have vowed38 to fight Florida's new rules in court. Simone Chriss, director of the transgender rights initiative with the nonprofit public interest law firm Southern Legal Counsel in Gainesville, is among the lawyers who will lead that fight.
She's keeping a close eye on states that want to ban gender-affirming care not just for minors, but for adults, too. "I don't think that this is gonna slow down," she says. "I think that more and more states are going to ban, likely first for minors and then, you know, try to move on to adults. Which is why I think it's so critical that we stop them here in Florida."
It can feel "overwhelming and soul-crushing," Chriss admits, when she considers the cascade39 of states that want to ban gender-affirming care.
"It's hard not to feel like we're losing on a daily basis, which can be very demoralizing. It really does take a toll," she says. "All we can do is keep fighting."
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gender
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| n.（生理上的）性，（名词、代词等的）性 | |
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transcript
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| n.抄本，誊本，副本，肄业证书 | |
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genders
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| n.性某些语言的（阳性、阴性和中性，不同的性有不同的词尾等）( gender的名词复数 )；性别；某些语言的（名词、代词和形容词）性的区分 | |
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decided
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| adj.决定了的，坚决的；明显的，明确的 | |
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diagnosis
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| n.诊断，诊断结果，调查分析，判断 | |
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hormone
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| n.荷尔蒙，激素，内分泌 | |
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essentially
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| adv.本质上，实质上，基本上 | |
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align
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| vt.使成一线，结盟，调节；vi.成一线，结盟 | |
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minors
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| n.未成年人( minor的名词复数 )；副修科目；小公司；[逻辑学]小前提v.[主美国英语]副修，选修，兼修( minor的第三人称单数 ) | |
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legislative
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| n.立法机构，立法权；adj.立法的，有立法权的 | |
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hormones
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| n. 荷尔蒙，激素 名词hormone的复数形式 | |
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surgical
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| adj.外科的，外科医生的，手术上的 | |
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uncertainty
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| n.易变，靠不住，不确知，不确定的事物 | |
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tightened
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| 收紧( tighten的过去式和过去分词 )； （使）变紧； （使）绷紧； 加紧 | |
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parental
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| adj.父母的；父的；母的 | |
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irony
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| n.反语，冷嘲；具有讽刺意味的事，嘲弄 | |
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trampled
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| 踩( trample的过去式和过去分词 )； 践踏； 无视； 侵犯 | |
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gut
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| n.[pl.]胆量；内脏；adj.本能的；vt.取出内脏 | |
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frustrating
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| adj.产生挫折的，使人沮丧的，令人泄气的v.使不成功( frustrate的现在分词 )；挫败；使受挫折；令人沮丧 | |
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rhetoric
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| n.修辞学，浮夸之言语 | |
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consensus
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| n.(意见等的)一致，一致同意，共识 | |
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endorse
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| vt.(支票、汇票等)背书，背署；批注；同意 | |
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ideology
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| n.意识形态，(政治或社会的)思想意识 | |
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risky
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| adj.有风险的，冒险的 | |
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acting
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| n.演戏，行为，假装；adj.代理的，临时的，演出用的 | |
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distressed
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| 痛苦的 | |
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frankly
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| adv.坦白地，直率地；坦率地说 | |
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disorders
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| n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调 | |
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license
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| n.执照，许可证，特许；v.许可，特许 | |
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retaliated
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| v.报复，反击( retaliate的过去式和过去分词 ) | |
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literally
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| adv.照字面意义，逐字地；确实 | |
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visualization
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| n.想像，设想 | |
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relentless
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| adj.残酷的，不留情的，无怜悯心的 | |
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uprooting
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| n.倒根，挖除伐根v.把（某物）连根拔起( uproot的现在分词 )；根除；赶走；把…赶出家园 | |
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vow
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| n.誓(言)，誓约；v.起誓，立誓 | |
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actively
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| adv.积极地，勤奋地 | |
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limbo
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| n.地狱的边缘；监狱 | |
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vowed
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| 起誓，发誓（vow的过去式与过去分词形式） | |
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cascade
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| n.小瀑布，喷流；层叠；vi.成瀑布落下 | |
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