Legal Restrictions on Gender-Affirming Medical Care: Impacts on Practice among Mental Health Professionals

<i>In 2023, the state of Florida enacted legislation that imposed significant restrictions on access to gender-affirming medical care for transgender and gender-diverse individuals. These restrictions included a comprehensive ban on gender-affirming medical care for minors, with some exceptions for minors already receiving treatment. For adults, access was restricted by prohibiting nurse practitioners, pharmacists, and physician’s assistants from prescribing or administering hormone therapies. Further restrictions were effected by prohibiting Medicaid from funding gender-affirming medical care and by requiring in-person consent, thereby excluding telehealth options for consent. This study investigated the impacts of these restrictions by inviting licensed mental health professionals to share their experiences of how their practices with transgender and gender-diverse clients had changed since implementation of this law. Upon analyzing the interviews with these mental health professionals, six themes emerged: (1) Some participants stopped or reduced their services for transgender and gender diverse clients; (2) Some participants changed their practice to ensure safe and affirming spaces for their clients; (3) Some participants became more involved in advocacy and adaptating their services to help transgender and gender-diverse address the new challenges posed by SB-254; (4) Some participants experienced confusion, fear, and anxiety as a result of SB-254; (5) Some participants focused more on education and legal understanding; and (6) Although most participants indicated substantial changes in their practice, two participants suggested that SB-254 had no substantial impact on their practice with TGD clients.</i>