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Your support makes all the difference.In a crowded public meeting room in Florida on 10 February, standing before the assembled members of two state medical licencing boards, Lindsey Spero opened his jacket, lifted up his shirt, and injected himself with 0.5 ml of testosterone.
This was an entirely routine procedure for Spero, a 25-year-old transgender youth worker in St Petersburg, Florida, who has been taking testosterone to masculinise their body since June 2019.
But it was almost certainly a first for Florida's Board of Medicine and Board of Osteopathic Medicine, which are in the process of pushing through a controversial statewide ban on prescribing such treatments to trans people under 18.
"There was a lot of silence, and about three or four of them looked away," Spero told The Independent the day after the protest, which was broadcast live online and quickly captured the imagination of trans people across the country.
Spero, who is non-binary and uses both masculine and gender-neutral pronouns, said they wanted to help normalise the treatment in the eyes of cisgender (or non-trans) people and inspire others to take action against what he described as a "targeted attack" on trans people in the Sunshine State.
"I wanted the Board to see and be forced to bear witness, because I could tell they are the kind of people that would be uncomfortable with something like that, because people are often fearful and uncomfortable with something they don't understand," Spero said.
"But even more, I did want it to be something that would encourage our trans siblings... an injection can be a really intimidating routine thing to have to participate in, and it's even more intimidating to know how important it is and still have people essentially gaslighting you over the necessity of your medication, despite you overcoming all the barriers to be able to get it.
"This was one big old 'f*** you’ to all of that, and a declaration of the necessity and the sacredness of this medication for myself and my body."
'We need to take action, even when it's scary'
The medical boards' rule changes are part of a sustained campaign by Florida Governor Ron DeSantis to restrict trans teenagers' access to transition healthcare.
The state's Department of Health asked the Board of Medicine last year to ban doctors from prescribing puberty blockers, hormone replacement therapy (HRT), or surgery to new trans patients under-18.
The policy allows trans minors already undergoing a given treatment to continue getting it, and does not apply to cis minors prescribed the same treatments for conditions such as precocious puberty.
Yet although these treatments are broadly endorsed for trans teenagers by national and international medical organisations, the Board of Medicine – whose members are directly appointed by the governor for four-year terms – approved the proposal.
Mr DeSantis and his supporters argue that under-18s cannot truly consent to such procedures, pointing to the relative paucity of long-term research into their outcomes and touting testimony from a minority of people who regret the treatments. The governor has repeatedly referred to sex reassignment surgery, which is rare for under-18s, as “genital mutilation”.
"Today’s vote will protect our children from irreversible surgeries and highly experimental treatments," said Florida's surgeon general Joseph Ladapo last November. "Children deserve to learn how to navigate this world without harmful pressure, and Florida will continue to fight for kids to be kids."
Spero did not expect any change to come from Friday's meeting, which was held to hear public comments and allow the Board of Osteopathic Medicine to bring their own policy into line with the Board of Health's. Even so, he drove four hours to the state capital of Tallahassee to make their statement.
"I came to the conclusion that I could give them all the logic and reason in the world," Spero tells The Independent. "I could offer that Board of Medicine every sympathetic story, every tear-jerking response, I can put my heart on full display, I can call them out for their lack of understanding.
"None of these tactics seem to have been effective or changed their perspectives in any way... it just seemed like a powerful way to show them that we would be willing to do more than just stand at that podium and talk... we are going to have to take action, even when it's hard and even when it's scary."
Indeed, the Board appeared unmoved by another speaker, trans 12-year-old Lola Smith, who said: “The most embarrassing moment of my life is happening right now as I stand in front of a panel of strangers and publicly beg for my right to exist. Nothing is more humiliating and dehumanising than pleading for one’s own existence."
Leading up to their protest, Spero was "pretty nervous" and prepared to potentially be kicked out of the room or even arrested and charged with a crime. But once they stood up, they say they felt "overcome" with calmness drawn from the “courage” of the other trans people with them and ”trancestors” long past.
“To be able to share that space with them, and know that all their courage and the courage of our ancestors was behind me, really just kind of filled me. It felt like something else came over me entirely, to be honest.”
Draped in a trans pride flag, Spero told the officials that he had attempted suicide in the past because he could not access transition healthcare, and accused them of "sneering" and not listening while trans speakers "put their hearts on full display".
"My medication is life-saving. I will use HRT for the rest of my life," Spero said. "Your denial of my need for this medication doesn't make my existence as a trans person any less real."
The Board of Medicine was not swayed, and the Board of Osteopathic Medicine voted unanimously to remove an exemption for trans minors enrolled in research programmes at state universities, bringing the two bodies’ policies into line.
“I’m sorry it’s uncomfortable. We’re in an uncomfortable situation,” said Board of Medicine member Dr Hector Vila, according to the South Florida Sun-Sentinel. “I feel like there’s a lot of the public thinks I dislike them. Not at all. We can’t even make a sincere comment, and it’s hurtful to us.”
After the vote, Spero says board members they left the room, causing the audience – who mostly opposed the new rule – to stand up and begin chanting trans rights slogans.
The video was then posted on Twitter by civil rights lawyer Alejandra Caraballo, activist Erin Reed, and others, spreading widely among trans people on the social network.
Trans teens ‘already being cut off from treatment’
Beyond seeking to ban transition care for minors, Mr DeSantis has sought to stop schools teaching children about trans issues, targeted all-ages drag shows and parents who bring children to them, and requested data from state universities on how many people they had provided trans healthcare to.
Meanwhile, Republicans in numerous states have proposed similar healthcare bans, as well as bans on trans people competing in school sports as their chosen genders. In some places, such as Texas, they have sought to define trans healthcare for minors as child abuse.
Because Spero works with young trans people in Florida, they are acutely aware of what effect the Board's rule changes – and a general climate of growing "vitriol" – are already having.
"Unfortunately I'm seeing this impact every single day," they say. "I had three different youths who lost access to gender-affirming care because local organisations have been fearing fallout as a result of the medical board creating this language, and so they prematurely decided to remove access for anyone under the age of 18."
He says the distress caused by having medical care cut off – forcing patients to live with intense feelings of despair and discomfort with their body as they undergo the wrong puberty – is likely to lead to "an uptick in suicide", making this a "life and death" situation that he has “no choice” but to oppose.
Spero knows about that first-hand because, they say, they are a survivor of conversion therapy. They grew up in an "incredibly conservative evangelical environment" and were sent to several programmes and facilities designed to suppress their sexuality and gender identity, which they describe as "a form of torture".
Eventually, HRT relieved their suicidal feelings and intense gender dysphoria. “Testosterone and hormones have no only given me comfort within my body but authority and control over my body that I never felt before,” they say, describing “a peace within that has calmed the voices in my head that were always telling me my body was not a place of safety”.
Despite his past troubles with religion, Spero still considers being trans a "holy" experience. In his speech he referred to his testosterone shot as "a sacred and weekly ritual", and he tells The Independent he is "still a pastor's kid".
"Being trans is holy because we exist to heal the broken parts of society," they say. "The divides that exist, the binaries that have been built, the structures all around us that divide us as human beings...
"My shot has never just been my shot; it’s not just by me and for me. It is being done with the hands of my trancestors and for the trans youth who need access and who are going to need access in the future."
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