This ‘Sneaky’ DeSantis Power Grab Might Be His Cruelest Yet

For months now, Florida Gov. Ron DeSantis has been aggressively using his executive power to deny transgender medical care for two of society’s most vulnerable groups—children and the poor. In that, he has been far from alone, as Republicans across the country lean into an ugly backlash against the trans community and the science that supports it.

Along the way, DeSantis has been employing a power grab some fear will be adopted by other Republican governors—with disastrous results.

As part of DeSantis’ ongoing MAGA crusade against progressives, his administration is simultaneously using different state agencies to cut off what is referred to as “gender-affirming” care that helps trans people realize their identities. When a far-right state legislator failed to pass an anti-trans bill earlier this year, the governor resorted to backroom bureaucracy to get the same result.

It’s the latest instance of DeSantis implementing increasingly cruel policies as he builds a national reputation in the run-up to a possible 2024 run for the White House.

But it also illustrates what political commentators say distinguishes DeSantis from his presumptive primary foe, former President Donald Trump. DeSantis knows how to operate the machinery of government effectively—as a weapon against the marginalized.

And time is running out for anyone to stop him.

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“We’re worried that DeSantis is creating a playbook for political ideology. Legislatures are failing to pass these laws because they are against science—and against what constituents in states want to be done with tax dollars. Governors are going to see this and think this is something they can do to sidestep the democratic process,” said Carl Charles, a civil rights lawyer with the advocacy group Lambda Legal, which is fighting to block one of those policies.

The governor’s attack is something of a pincer movement. His administration targeted the poor by eliminating state Medicaid coverage for transgender care in August, and it is currently preparing to bar doctors from providing related services to minors.

“They’re trying to destroy us. They think we’re less than everybody. They think people don’t empathize with us. And unfortunately, he’s targeting the youngest people,” said Andrea Montanez, a trans woman who began her medical transition when she was a TSA supervisor at Orlando’s international airport and now works as a human rights activist.

Montanez is worried that the state’s refusal to cover some people in the transgender community could embolden insurance companies to do the same.

“It’s scary,” she told The Daily Beast. “If the state starts with this, private companies will follow their example.”

The DeSantis administration did not reply to a request for comment for this story.

Florida is now using its health care regulators to gaslight the state’s transgender population—and doctors who specialize in the field—by casting doubt on the global scientific community’s emerging understanding of gender dysphoria. That condition is described in the psychiatric manual of mental disorders as the state of being when one feels a deep chasm between the gender they experience and the one they’re assigned at birth. Official government reports from the DeSantis administration cite disproven or outdated scientific studies, but the fact that this is playing out entirely through the executive branch means that the governor retains power he wouldn’t have in the legislature.

“The tactic makes sense to me. He would have full control,” said Tatiana Williams, a Black trans woman who founded the South Florida advocacy nonprofit Transinclusive Group.

“Most of those people, he put in place,” she said, referring to the agency officials setting DeSantis’ plans into motion. “They get to move the needle where he wants the needle to go. He would get pushback if he used legislation. People would have their own ideas and do their own research.”

“It saddens me that the mental health of our youth and our trans siblings is being impacted by his own political endeavors,” she added.

Given the increasingly fervent nature of DeSantis’ ultra-conservative streak, it’s easy to forget that he initially professed libertarian leanings—and seemed reluctant to waste taxpayer resources on culture battles.

"Getting into bathroom wars, I don’t think that’s a good use of our time," then-candidate DeSantis said in May 2018 while debating a fellow Republican at a forum hosted by the anti-gay marriage Florida Family Policy Council.

But the cracks started showing early on.

During his very first days at the governor’s mansion in Tallahassee in 2019, advocacy groups were quick to point out that newly-elected DeSantis left out sexuality and gender identity from an anti-discrimination executive order committing to government diversity.

Then, as Republicans nationwide declared war against transgender communities in 2021, DeSantis joined the fray by signing a law prohibiting transgender girls from playing on sports teams.

The most stark measure yet came in the form of a bill sponsored by far-right Florida State Rep. Anthony Sabatini, once hailed by the Orlando Sentinel as “the worst person in the legislature.” HB 211 sought to actually jail doctors by criminalizing transgender medical care for minors—with some exceptions for those “born with a medically verifiable genetic disorder of sex development.”

However, the freshman legislator made the boneheaded decision to give a speech vilifying the Republican House Speaker and even DeSantis himself. His proposed bill died in March of this year.

Yet behind the scenes, the governor’s office picked up the torch and kept advancing that agenda. The crackdown would continue, but through bureaucratic means.

In April, the Florida Department of Health—an agency with credibility already severely damaged under DeSantis for recommending against COVID-19 vaccines for kids—entered the fray. It got the ball rolling by issuing an official advisory saying that “social gender transition should not be a treatment option for children or adolescents.”

The state’s anti-COVID-vaccine surgeon general, Dr. Joseph Ladapo, followed that up in June by officially asking the state’s Board of Medicine to “establish a standard of care for these complex and irreversible procedures.”

At the same time, Florida’s medical industry regulator, the Agency for Health Care Administration, suddenly floated a new rule that would prevent the state’s Medicaid program from covering gender dysphoria treatments across the board. The state would no longer subsidize procedures for anyone of any age—including puberty blockers for minors, hormone therapy, and sex reassignment surgeries.

To support its position, AHCA released a report on the very same day as Ladapo’s letter, one that claimed to assert “generally accepted professional medical standards” about gender dysphoria. It’s also one that “relies on misrepresentation and discredited information,” warned two professors at the University of Miami’s medical school, Drs. Sara Danker and Lydia Fein, a plastic surgeon and obstetrician, respectively.

Bracing for the impending crackdown, two of Florida’s elected regional prosecutors signed a national joint statement pledging to use their law enforcement discretion and “not promote the criminalization of gender-affirming health care or transgender people.” One of them, Andrew Warren, got unceremoniously escorted out of his office in Tampa—for refusing to enforce the state’s new abortion law. But the other, State Attorney Monique H. Worrell, remains at her post in Orlando because she technically never refused to enforce an existing law. The crackdown on transgender health care isn’t a criminal matter, because the legislation failed.

Instead, it continues to proceed as a set of DeSantis administrative measures—quickly enacted, confusing, and highly technical.

“Because he’ll run for president, he wants as many wins as possible,” said State Rep. Anna Eskamani (D-Orlando). “He’s a faux populist. This is part of his track record of weaponizing state agencies to get his way.”

The new Medicaid rules, which were finalized in August, were posted with little fanfare and no mention of their actual contents in the description on a government webpage unknown to virtually anyone besides policymakers and advocates. Meanwhile, the crackdown on doctors has proceeded via the state’s medical and osteopathic medicine boards, which have held several public meetings and similarly posted their new proposed rules online. But the Board of Osteopathic Medicine screwed up the obligatory 21-day comment period by listing the wrong email address.

The state posted the correct email address on Wednesday, and the public now has until Dec. 28 to chime in.

“It’s unprecedented, and it’s really sneaky,” said Emile Fox, 28.

Fox, who identifies as nonbinary, said they were inspired to attend several medical board meetings to speak out against the proposed restrictions on doctors. And the very first meeting they attended served as a reminder of what might happen if a doctor runs afoul of whatever restrictions they dream up.

“They can lose their license and ability to practice. The first meeting we went to wasn’t just about trans health care. A doctor was appealing the decision to have his license taken away, because he had a date rape drug put in someone’s drink, one he’d prescribed,” Fox recalled.

A federal lawsuit brought by the LGBTQ civil rights group Lambda Legal and others is seeking to stop Florida from restricting its Medicaid this way, with a trial set for May 2023—in front of the same judge who once struck down Florida’s ban on same-sex marriages. Meanwhile, another civil rights group taking part in that lawsuit, the Southern Legal Counsel, is also eyeing a potential challenge to the medical board’s oncoming threat to doctor’s licenses.

The next phase of this government suppression might come from the legislature, where a far-right politician has just been made chair of the committee that could prove decisive in targeting the transgender community: Health and Human Services.

That legislator is Rep. Randy Fine (R-Brevard), a notorious intimidator who recently tried to stir up anti-trans hate by publicly calling for police to investigate a trans girl allegedly beating up a girl at a school bathroom. There is no record of any such incident ever taking place.

“He will wreak whatever damage he can on health care while he’s chair,” warned Rep. Kelly Skidmore (D-Boca Raton). “He can be reasonable about a lot of things, but when he’s unreasonable, he’s diabolical about it.”

Regardless of what plays out in the legislature, advocates and lawmakers say DeSantis’ shadow war on the trans community will plow ahead—and many members of the public may have little chance to weigh in before it’s too late. Skidmore thinks that’s by design, because it also spares others in the GOP from facing voters’ wrath.

“It prevents individual Republican members who might be in swing seats from having to vote on these bills, but still gets the policy enacted,” she told The Daily Beast. “This governor has proven time and time again he is a bully and he will get what he wants.”

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