Florida’s surgeon general is no stranger to controversy and clashes. A second term is imminent

Florida Surgeon General Dr. Joseph Ladapo is on his way to a second term as the state’s top public health official.

In his first term — Gov. Ron DeSantis appointed him in September 2021, and the Florida Senate confirmed him in February 2022 — Ladapo clashed with federal health officials on the state’s COVID-19 response, and his colleagues at the University of Florida medical school sharply criticized him for his research behind his recommendation that men between 18 and 39 shouldn’t get COVID-19 vaccines.

The state Senate Ethics and Elections Committee voted 6-3 along party lines Monday, April 24, to confirm him to a second term as the chief of the Florida Department of Health. His confirmation is now headed to the state Senate floor.

Here’s a look at some of Ladapo’s positions during his first term:

Gender-affirming care

New rules: Florida’s ban on gender-affirming care for minors began in March, with Florida doctors prohibited from prescribing puberty blockers, hormone therapy and surgeries to treat new patients younger than 18 for gender dysphoria. The ban also applies to clinical trials, although it does not apply to children and teens who have been undergoing treatment.

The rules, which the state’s Board of Medicine and Board of Osteopathic Medicine passed in November and went into effect in March, may soon become law under a bill making its way through the Florida Legislature. The legislation, if passed and signed into law by DeSantis, would make it a third-degree felony for doctors who violate the law.

The Senate passed the bill, SB 254, in early April and it has gone to the House, which amended HB 1421 to stipulate that children currently getting treatments for gender dysphoria cease treatments after this year. The Senate will need to vote on it again before the bill goes to the governor.

Lawsuits: Parents of four transgender children filed a federal lawsuit in March against Ladapo and Florida’s two medical boards, seeking to invalidate the ban. They allege the rules violate the state’s equal protection clause of the Constitution by blocking transgender minors from getting medical care.

Another group has sued Florida’s Agency for Health Care Administration, part of the state health department that Ladapo oversees, over its new rule prohibiting Medicaid from funding gender-affirming care.

READ MORE: Florida House passes bills affecting LGBTQ community. Vocal protesters toss underwear

Medical experts: Florida’s stance is at odds with what the federal government and major medical organizations say, including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry and the Endocrine Society.

The American Academy of Pediatrics, in its 2018 policy statement urging care of transgender children and adolescents, said those who receive support from their families and doctors are more likely to have better physical and mental health, noting transgender and gender-diverse youth have high rates of depression, anxiety, eating disorders, substance abuse, self harm and suicide.

READ NEXT: State employee says Florida ignored procedure in putting out transgender Medicaid study

Letters to and from CDC/FDA

Questioning COVID vaccines: In February, Ladapo sent a letter questioning the safety and effectiveness of mRNA COVID-19 vaccines to Dr. Robert Califf, the U.S. Food & Drug Administration commissioner, and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

In his letter, Ladapo raised concerns over an increase of adverse reactions, including life-threatening conditions, recorded after COVID vaccinations in Florida and elsewhere in the country were administered. He said this likely reflected “increased risk” from the COVID-19 vaccines, citing data from the national Vaccine Adverse Event Reporting System (VAERS).

READ NEXT: Florida surgeon general slammed for ‘fueling vaccine hesitancy.’ It’s not the first time

CDC/FDA response: In their March 10 letter to Ladapo, the FDA and CDC heads sharply criticized him, saying his claim is ... “incorrect, misleading and could be harmful to the American public.”

Anyone can submit a report of an adverse reaction to the VAERS system, they noted, but it doesn’t mean the adverse reaction was caused by the vaccine. The agencies said there is no evidence of increased risk of death following COVID-19 vaccines and that vaccination actually saves lives.

“It is the job of public health officials around the country to protect the lives of the populations they serve, particularly the vulnerable. Fueling vaccine hesitancy undermines this effort,” they wrote.

COVID vaccines for young men

COVID study: In October 2022, Ladapo advised men between 18 and 39 not to get COVID vaccines after he and the Florida Department of Health released an analysis that found men in this age group had a “modestly increased” risk of cardiac-related deaths within a month of getting an mRNA COVID vaccine.

Reaction to study: The analysis, which was not peer-reviewed, was sharply criticized by federal health officials and medical experts at the UF College of Medicine, where Ladapo is a faculty member. They contend the study failed to weigh the benefits of vaccination against the potential risks and that it relied on cherry-picked data to support an anti-vaccine hypothesis.

Draft versions of the analysis, recently obtained by Tampa Bay Times, show that Ladapo made the recommendation despite the state having data indicating that COVID infections raised the risk of cardiac-related deaths by at least five times more than the vaccine.

Four UF epidemiologists and professors wrote a column in the Tampa Bay Times last fall, when Ladapo’s analysis came out, decrying his research methodology.

Ladapo told the Tampa Bay Times he stands by his study.

COVID vaccines for children

COVID vaccines not recommended for healthy kids: In March 2022, Ladapo announced that Florida would be the first state to no longer recommend COVID vaccines for healthy children, a move that shifted the state away from the recommendations of the CDC and the American Academy of Pediatrics.

Reaction: Dr. Lisa Gwynn, a pediatrician with the University of Miami Health System, criticized the state last June for not pre-ordering COVID-19 shots for children ages 6 months to 5 years old. (The state did go on to order the vaccines.)

She had been president of the Florida chapter of the American Academy of Pediatrics when Florida Chief Financial Officer Jimmy Patronis, a member of DeSantis’ cabinet, removed her last year from the Florida Healthy Kids board of directors, citing her “political statements.”

The CDC continues recommending COVID vaccination for everyone 6 months and older. The COVID-19 vaccine is also now part of the CDC’s list of recommended routine childhood vaccines.

School COVID mask, quarantine rules

Mask, quarantine changes at schools: In September 2021, shortly after DeSantis named him surgeon general, Ladapo signed a rule that gave parents the power to decide whether their child should wear a mask at school. The rule also left quarantine decisions up to the parents, regardless if their child was vaccinated. (COVID-19 vaccines are optional at Florida schools)

The ruling came after Florida saw a summer surge of COVID cases, fueled by the delta variant, with daily new case counts in the state topping 20,000.

Reaction: The high COVID case counts led a handful of school districts across the state, including Miami-Dade and Broward, to impose mask mandates at the start of the school year in August 2021, defying the governor’s July 2021 executive order to make masks optional..

Under the new rule, a parent could choose to send their child to school, even if they were exposed to COVID, as long as the student remained asymptomatic. While masking, quarantine and COVID-19 testing policies have changed throughout the pandemic at schools, the health department’s decision at the time went against the CDC recommendation.