Post AVyy9HaDS5vnXkYCDw by zinnia@kolektiva.social
(DIR) More posts by zinnia@kolektiva.social
(DIR) Post #AVyy9FdggDWHVw9wMC by zinnia@kolektiva.social
2023-05-23T14:34:04Z
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Yes - this is what is happening in Florida due to SB 254, which was signed into law on Tuesday 5/17/2023, taking immediate effect. This immediately cut off 80%+ of adult trans people in Florida from having their HRT refilled, because SB 254 uniquely prohibits only nurse practitioners from prescribing only gender-affirming medications.This has already been in effect for 7 days now. Trans adults in Florida have already been cut off from their HRT refills for a week now, including those of us who have been stable on these medications for years or decades. https://kolektiva.social/@broccoliccoli@tech.lgbt/110416336809690401
(DIR) Post #AVyy9GgYn1Pal8VkTQ by zinnia@kolektiva.social
2023-05-23T14:41:06Z
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This is VERY different from the general situation of trans youth care bans in 19 states, many still working their way through the courts.This has *already* happened, to *all* of us: all trans adults in the third most populous state in the US.The number of trans adults on HRT massively exceeds the sliver of the population that are under 18 and are prescribed puberty blockers or hormone therapy.These laws, advanced under the pretext of 'protecting children', are now directly impacting a far larger group of people who are not children and are not subject to those pretextual concerns.Other arguments about withholding public Medicaid funding for transition treatment also do not apply here: SB 254 does not even allow receiving this care through private insurance or paying cash out of pocket. The care isn't simply not covered - the care itself cannot be provided regardless.What is happening in Florida requires special attention above the situation of trans youth care bans nationally. This is having a vastly larger impact quantifiably.It will have worse impacts qualitatively as well: adults are responsible for taking care of and protecting trans kids and making sure they do not hurt themselves.Whereas as a trans adult, we have no one standing guard at the brink but our own self and the void to which we are accountable.
(DIR) Post #AVyy9HaDS5vnXkYCDw by zinnia@kolektiva.social
2023-05-23T14:46:42Z
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These are the facts as they stand right now. These are the facts as they have stood for a WEEK and NO ONE nationally is putting any attention on this because there are 19 trans youth care bans all across the country going on, along with everything else targeting trans people and the LGBT community broadly.This is a specific harm that is happening now and has been happening for 168 hours. It is not a hypothetical issue to raise awareness of, as if it were at the stage of some proposal that needs to be fought back. This has already happened and is happening right now. Active harm is happening until this law is rolled back.
(DIR) Post #AVyy9IN8WD3xzTRGTY by zinnia@kolektiva.social
2023-05-23T14:55:45Z
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For all of Florida's history since the inception of the applicable regulatory and licensing bodies, nurse practitioners have been allowed to prescribe hormone therapy, testosterone blockers and other relevant gender-affirming medications.That has been the case since I moved here in 2011. There was no reason why this wouldn't be the case. It's also the case in every other state.This new law is a carveout of prescriptions when used for one purpose, gender-affirming care, from nurse practitioners specifically, in a way that has never been done before. It affects all ages.It has immediately obstructed access to HRT prescription refills for more than 80% of TRANS ADULTS in Florida.It has also prohibited first appointments for HRT via telehealth with in-state or out-of-state MDs or DOs - first appointments must be in person. This will require expensive and time-consuming travel that is beyond most trans people's means: driving to Georgia from Florida can take 8 hours.This was an intentional targeting of almost all trans adults in Florida, and the means by which we have received our generic, FDA-approved medications for years. And it included closing every possible door that would let us find another way to keep taking the medications we have taken for...Well, for me it was 3,891 days when the clock stopped
(DIR) Post #AVyy9JGnBHaAm5TiE4 by zinnia@kolektiva.social
2023-05-23T15:01:27Z
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I don't want to talk about what that means for us. I was already talking about it for nine years before this happened. I know.https://genderanalysis.net/depersonalization/https://genderanalysis.net/2017/06/depersonalization-in-gender-dysphoria-widespread-and-widely-unrecognized/https://genderanalysis.net/2017/12/i-tried-detransition-and-didnt-like-it/https://genderanalysis.net/depersonalization/psychosocial-impact-of-depersonalization-depression-anxiety-and-suicidality/https://genderanalysis.net/2018/12/did-california-state-prisons-perform-unethical-medical-experiments-on-transgender-women-in-1987/
(DIR) Post #AVyy9KM98rSY8yzVD6 by zinnia@kolektiva.social
2023-05-23T19:59:05Z
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UPDATE: There was a Joint Rules Committee teleconference meeting of the Board of Medicine, Board of Osteopathic Medicine and Board of Pharmacy this afternoon at 12:30 PM Eastern. https://floridasosteopathicmedicine.gov/meeting-information/, https://ww10.doh.state.fl.us/pub/hcpr/Pharmacy/2023/May/05.23.2023%20Joint%20Rules%20Committee/Agenda%2005.23.2023%20Joint%20Rules%20Commitee%20Meeting.pdfThat means some of the members of the Florida Boards of Medicine - the same ones responsible for passing the trans youth care ban, at the behest of the ACPeds-ghostwritten AHCA report - were in attendance. More on the AHCA report behind the Boards' trans youth care bans: https://genderanalysis.net/2023/05/andres-opinion-florida-medicaid-agency-paid-thousands-to-a-hate-group-leader-to-help-ghostwrite-their-anti-trans-policy-he-copied-nearly-all-of-his-sources-from-the-hate-g/, https://genderanalysis.net/2023/05/the-far-right-law-firm-alliance-defending-freedom-offered-a-florida-anti-trans-hate-group-15000-to-refute-the-wpath-standards-of-care-for-use-in-litigation/These members included: Hector Vila, who incorrectly asserted in November that about five traveling detransition campaigners had experienced the worst medical harm to happen in Florida over the last quarter of a century: https://genderanalysis.net/2022/12/closing-arguments-submit-public-comments-before-december-5-on-the-florida-board-of-medicines-youth-transition-treatment-ban/ (section 10)As well as Monica Mortensen of pediatric endocrinology at Nemours Jacksonville. She submitted a letter of support for the Board of Medicine's trans youth care bans in which she favorably referenced a case report of a trans teenager held in a psychiatric hospital for two years as conversion therapy. Then Ron DeSantis appointed her to the Board of Osteopathic Medicine: https://genderanalysis.net/2023/01/floridas-newest-boards-of-medicine-appointees-wrote-an-anti-trans-letter-calling-for-gender-exploratory-therapy-citing-a-report-of-a-trans-teenager-being-involuntarily-hosp/During the meeting in a period of audience comment, I asked this brief and on-topic question relating to the issue at hand of pharmacists serving as prescribers in concert with physicians, specialists, case management and others:"We’ve heard a lot about how important it is to find ways pharmacists can facilitate safe access to management of complex chronic conditions. And again, as it’s been said by Dr. Mesaros, sometimes that can be a matter of ‘bodies in the streets’ as he put it. And I appreciate that. My question is for the Boards of Medicine on prescribing practices and mental health, in this case a concern about the current implementation of practice standards. I am a consumer advocate with Gender Analysis for the transgender community. We’ve previously had correspondence with the Boards of Medicine on related rule proposals last year. Trans people receiving specialist care for substance use are a part of the community of people in recovery. Last week’s passage of SB 254 immediately kept almost all trans people from refilling their hormone therapy when it was prescribed by nurse practitioners. We know patients being forced to physician-hop is a problem, but they cannot hop to anywhere now. Even MDs and DOs are not prescribing because they do not have the emergency rule consent forms from the Boards of Medicine yet.Being taken off their stable medications abruptly for no reason can put people into a state of crisis, including people who are struggling with substance use. Our focus centers for the treatment of gender dysphoria with hormone therapy mostly can no longer provide that medication, and patients are already being harmed by this. This was not a medical decision in the treatment of their cases, this was an external decision that kept their providers, with ongoing relationships with them, from continuing to offer them that care. That was a long-running status quo that suddenly changed last week. And that entire therapeutic frame has been completely de-delegated from the providers and the patients.We would like to ask the Boards of Medicine when MDs and DOs should expect the emergency rule consent forms for hormone therapy for adults. And in the interim while we wait for those rules, what best practices should our providers currently follow for prescribing this? Thank you for your time."There were approximately 10 seconds of silence that seemed to stretch on and on. The chair said "Thank you for your comments" and waited about 20 more seconds for any others to respond. Only silence. Then they moved on to another subject, never bringing up anything about this question or related issues again, but talking at quite some length about how pharmacists can get paid and make money from participating in community collaboration programs.The meeting audio will be available later.
(DIR) Post #AVyy9LL7UAETC5WCFU by zinnia@kolektiva.social
2023-05-24T02:38:42Z
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Shareable guide to current Florida law as of last week (SB 254) effectively banning HRT prescriptions for trans adults immediately.
(DIR) Post #AVzoDglgx4H4QcLAvI by KrissyKat@hoosier.social
2023-05-24T13:21:43Z
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@zinnia Does Florida ban mail order scripts / telehealth?
(DIR) Post #AVzoDhzuNhEyF002im by riley@toot.cat
2023-05-24T14:32:04Z
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@KrissyKat: AFAIU, Florida explicitly banned teleheath for gender healthcare prescription extensions just recently.@zinnia
(DIR) Post #AVzoDvj3LA4momDmOO by riley@toot.cat
2023-05-24T14:33:16Z
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@KrissyKat: Under the way USA does federalism, though, mail order scripts from another state should fall under explicit federal jurisdiction, outside Florida's banning power.There may be some nasty long-standing Reagan rule against mailing androgens, though.@zinnia