In the wake of the Florida Board of Medicine's new proposed guidelines for the treatment of trans people, and the increasingly dangerous Climate in Florida for trans people (Erin Reed's anti-trans legislative map has created a new category for Florida: Do Not Travel. This is just one in a series of travel warning issued by major organizations, including Equality Florida.), I sat down with transgender activist Zinnia Jones. She also, alongside Heather McNamara, hosts Genderanalysis.net , a web series that began in 2014 and is based around "exploring transgender science and life experiences in depth, and revealing the many insights to be found at their intersection.". Gender Analysis "goes beyond the 101s to educate both trans and cis viewers on some of the most fascinating dimensions of our lives – and the pressing issues we face in society."
The pressing issues angle has become more and more prevalent over the years. Zinnia is a transgender woman living in Florida, and as result has been caught in the cross fire of the recent anti-trans movements, such as Senate Bill 254, a bill that effectively bans Hormone Replacement Therapy for minors and places heavy restrictions on care for adults. On Gender Analysis you can find pages upon pages of documentation and breakdowns of the people and groups involved in pushing anti-trans legislation, such as this piece. Zinnia also runs the website Floridaban.com that consistently updated information surrounding the effects of SB 254 on queer Floridians. With this in mind, I sat down with her to talk about the effects of SB 254, and the people responsible for it.
Here's our full interview:
So, just to start us off here today, can you tell us just a little bit about yourself, your name, your pronouns and anything else that people should know about you and what you do?
I'm Zinnia Jones. She/her, I'm a trans woman living here in Orlando, Florida since 2011 with my wife and my two stepsons. I've been transitioning for over 10 years now and I run the blog Gender Analysis which covers trans health care questions, trans rights issues, especially more recently, just taking a deeper dive into the background and history of various claims, looking into the literature to see whether those claims that are made about trans people, our community and our healthcare in the public sphere are accurate information that trans people need to know for their own health, that they might not otherwise know, that providers might not be even informed about. And most recently, in this past year since we are here in Florida, focusing especially on Florida's policy actions from 2022 to present, focusing on restricting trans healthcare.
Yeah. And on that topic of trans health care, are you currently undergoing or have you undergone hormone replacement therapies?
Yes. Since, gosh, it's been over 10 years now and it's good that I was able to find people who, like, are able to prescribe ahead of time for their patients in advance of anything like this happening. You know, if you won't have access to your medications for a while. But this is something that- that's not something that is just sustainable at all or is it something that should have to be the case? So this needs to be resolved urgently for everyone.
Have there been any specific challenges you've faced as far as getting your medication and continuing care goes since SB 254 has passed or generally, since the climate in Florida has begun to trend in this direction?
(A Protest outside the Florida House of Representatives as they pass SB 254 for the second reading.)
Honestly, it's something where we're so unsure of where this is going to land or what is going to be the case. I'm almost not even in a position where I can find another provider yet and know that, oh, they're going to be able to just continue prescribing this as it had been prescribed to me for 10 or more years or whether they're going to be affected by an additional restriction or whether after I go find someone there, I will then have to go find somewhere else.
This is completely disruptive to any physician, any provider(‘s) patient relationship. And that, that's terrible for the trans community overall. Just having established a relationship with a provider that we trust for ongoing care and then being told arbitrarily and suddenly for no reason that we have to find someone else we don't even know, who is probably very scared of being targeted for offering this right now and would in any case be swamped by patients who are now left with nowhere else to go. This was deliberate targeting.
Yeah. And you say this is deliberate targeting. And I think that's gonna confuse a lot of our audience because a lot of people are confused about the ways in which SB 254 affects adult patients. After all, it never explicitly mentions banning their care in the bill text in the same way that talks about minors. But in effect from what you're saying and what other people have said it's done something very similar. Why and how has the bill affected adult patients?
Well, one thing that it's served to do is create the misconception in the public eye. And I see this being circulated on Twitter by supporters of Ron DeSantis and just anti trans people. Generally, they're just saying: “oh, it's not banned at all. You just need to get a form signed by a physician who prescribes it.” And such a simple statement is so reductive and deliberate currently. It emits all of the relevant facts about this when they say physician, they mean MDs or DOs.
(Ron DeSantis signs the "Slate of Hate" as it was deemed by Equality Florida, including SB 254)
And that completely disregards the fact that nurse practitioners and APRNS are practitioners, they can prescribe everything that a doctor or a physician, an MD or a DO can prescribe, they can prescribe schedule three medications like testosterone, they can prescribe schedule two medications in some circumstances. That's the case in all 50 states for nurse practitioners and APRNs and there had never before been any specific restriction on nurse practitioners and APRNs who have full prescribing authority just like any doctor, being suddenly marked aside and excluded from providing specifically gender affirming care for the purposes of transition. And keep in mind these same NPs and APRNs, they're still being trusted to prescribe estrogen, testosterone, puberty pausers, (and) other hormone blockers. Those, however, are something they can prescribe only to cis people and only when not for the purpose of gender affirming care.
(A graphic about what Nurse Practitioners can do. Source: https://nurseslabs.com/nurse-practitioner-career-guide/ )
So they're being trusted to prescribe those same medications but specifically not to help trans people transition. And so the reason that this targeting is so insidious is because most of the prescribing of gender affirming hormone therapy in Florida does come from nurse practitioners and APRNs rather than physicians and MDs and DOs.
And that's fine and that's normal too because NPs and APRNs have millions of patients who have them as their primary provider across the country in all 50 states because an NP can provide all of the same prescriptions. There's never been a restriction like this before. It is so new and disruptive to an entire field of practitioners who have not been treated in this way before and especially not about medications that are not even scheduled.
So that is why it is a huge problem and an effective ban. And there's also a ban on just initial appointments via telehealth from out of state. There's an in person form signing requirement. It's not something that you can fill out online in the same way that patients can already fill out other forms ahead of time for their appointments through a patient portal, which is very common.
Nowadays, this is a deliberate restriction on access, just like requirements for just all sorts of information being provided when someone seeks an abortion. And all of this is so burdensome and so arbitrary and so designed to target every last way that trans adults could get their continuing established H RT prescriptions in Florida.
It is deliberate to say it's not a ban is something that can be met with. Ok. Then I can continue getting my same prescriptions through my same provider and nothing has changed, Right? Well, no, that's not the case for almost anyone in Florida right now who is trans and on HRT. There is no reliable access anymore that our provider will be able to prescribe it or that a pharmacy will be willing to refill it or how that policy will change day by day.
(Zinnia Jones)
So it's an overall, completely chaotic and disruptive situation. The disruption itself was the point and this has just been so terrible and confusing for people and it's- I've tried to make sense of it all. There are parts where I am at a loss and I don't know what to tell people and I also don't know who to ask or who knows about it. So it's created a serious problem for us in just about every applicable way.
Yeah. That's what I heard expressed at the Board of Medicine meeting that I attended last week as well. And I noticed something that was said at that meeting, which was- there's been a lot of talk about the Board of Medicine being an apolitical entity, right? That's what they say at the very beginning of their meetings, but almost every person at that meeting who was on the side of queer people that were trying to kind of push these forms into getting created so there could be a continuation of care and were asking what to do in the interim between those forms, they were saying that it was politically motivated. I mean, it was practically being screamed there. And I know you've done a lot of tracking on the actual people behind these policies and bills such as Board of Medicine members, such as representatives like Randy Fine and so in as broad or as specific a sense as you would like, could you tell us about the personal motivations and histories of some of these anti trans legislators and policymakers here in Florida?
Of course, and I can tell you some of the ways where at least three or four individuals, their presence on the boards was itself a politically motivated act for Ron DeSantis to appoint them there. And this is how we know that Doctor Monica Mortenson, DO on the boards of osteopathic medicine and Doctor Matthew Benson MD on the Board of medicine, they were two co-authors on a letter in September to the Boards of Medicine in advance of their October 28th joint hearing on the Trans Youth Care ban. And in that they and seven other employees who are either pediatric endocrine nurses or pediatric endocrinologists at New Mos Jacksonville, they said they support this policy and they support the board passing a Trans Youth Care ban and they provided a number of references in there where they argued in support of it.
And then in December, Doctor Matthew Benson and Doctor Monica Mortenson were appointed to the board. Doctor Gregory Coffman also sent in a similar letter much shorter but expressing his support. He's an Orlando health physician associate and he was appointed to the board as well by Ron DeSantis and even earlier than that, Patrick Hunter, who was the one who at the past meeting said that transition treatments lower our IQ which is not proven not even slightly proven. It's just a baseless insinuation to slur us as mentally incompetent and incapable of deciding our own care and needing protection from that and from ourselves. Patrick Hunter, he was on June 14th or earlier already scouting out experts for the Board of Medicine to support the Trans Youth Care ban and getting in touch with other experts who were being recruited by a Florida Medicaid to just serve in support of their Medicaid exclusion at the same time. And that happened June 14th or earlier. June 17th is when Ron DeSantis appointed Patrick Hunter to the board. and I've covered how just in his past activities on October 28th and at the joint hearing on November 4th. At the joint hearing, he has recited statements that seem extremely similar to submitted statements from the anti trans group SEGM, his recent statement that transitioning lowers IQ that's been promoted by a group called Advocates Protecting Children, which is is led by Doctor Michelle Cretella and doctor Andre Van Mol, who are two of the experts that (were) recruited in their process as well just to use them to find more experts too. And advocates protecting Children hosts this 240 page bizarre manual for parents to basically impose anti trans conversion therapy on their trans kids coercively.
(Gregory Coffman)
So none of this is just really surprising at all to see what they're doing. But it is overt that they, that these people specifically were placed there on this board, which is supposed to be an apolitical body, by clearly political actions and clearly supporting conversion therapy, which is all of this. None of this is apolitical at all. All of this is about queer and trans people being able to continue to exist without being subjected to conversion therapy versus the Florida Boards of Medicine saying that queer and trans people should be subjected to conversion therapy. And that was what Doctor Benson and Doctor Mortenson said in that very same letter, that an exploratory psychodynamic therapy should be rapidly expanded for trans youth so that they are able to access this as some kind of alternative to transition.
But the sources they cited, one of them was a case report from 1977 where one adolescent trans boy who was misgendered throughout this report was forced into an involuntary psychiatric hold in a facility for at least 20 months until he would no longer say that he was a boy. At which point they finally let him out after forcing him to pretend to be feminine and all of that.
And this was something that these two people who are now again appointed to and serving on the boards of medicine cited in support of this exploratory therapy as an alternative to the transition treatment we were all already taking until it was completely disrupted by this law, Benson, Mortenson, Coffman, Hunter, all four of them are all involved in the process of making sure these forms get out there or don't or everything in between, how much they choose to disrupt this, how much of an onerous body of restrictions they choose to impose upon us further these people being involved in. This is a nightmare. Patrick Hunter is someone who received his advanced degree in bioethics as part of a master's program that the Catholic University of Mary offers in partnership with the National Catholic Bioethics Center and the National Catholic Bioethics Center says as a specific example in their own position, statements that if a trans person is incapacitated Is in a serious car accident and the nearest hospital that they're taken to is a Catholic hospital. Then because that's a Catholic hospital and because of their religious beliefs or rather than any medical reason, that person who has already been seriously injured would also be arbitrarily and capriciously taken off their HRT and forcibly medically detransitioned for the entire duration of when they're in Catholic hospital network at all.
(Patrick Hunter)
So this is someone who already believes in, that is happy to enact that on anyone who comes into contact with his organizations. The Florida Board of Medicine is one of his organizations. This is a total threat and it's a fusion of the arms of the state with the beliefs of a specific partisan religion. This, this isn't just not apolitical, this is political and sectarian.
Wow. Yeah, absolutely.
I can provide substantiating documents that clarify all of that. However, you can likely search for any of those terms at gender analysis dot net and find a great deal of supporting documentation.
Absolutely, we'll probably source you endlessly. And kind of going from the scope of those political players and their movements and histories down into your everyday life, how have these bills and pieces of legislation affected you personally as just a person, as a trans person, and as a human being living here in Florida and having to continue living here.
So first of all, I am highly stressed out at essentially all times because what we're witnessing is an ongoing escalation in the community around us of what are amounting to genocidal acts such as forced deprivation of basic rights to medical care that's required by an identifiable group, trans people who require treatment for gender dysphoria.
As a result, there's also been a forced relocation mostly among LGBT youth and elders out of states passing these bans and into states that do not have these bans. That kind of forced relocation is itself a crime. All of this is extremely serious and all of this is the first thing on my mind at all times from the moment I wake up every morning and remember where I am and recall what's happened up to this point.
And so that's the state that I'm in. I'm also highly motivated. I'm around a lot of people who understand all of this, who are trans as well. And they understand the stakes here in ways that cis people frankly, almost all the time do not or at least aren't always willing to listen. A few are and we are very grateful for them, but we are motivated to work at this really night and day because we do have the information that we need to show what is happening here, how this is being carried out, how it was being carried out up to now and how the steps of this are proceeding. What to look out for? Why this is a problem, how we can explain it to others. There's a lot of work to do. There's a task at hand and there's a kind of battlefield energy to it because we know that this is a matter of our survival against the application of state forces that are otherwise going to make our continued lives as physically alive, human beings impossible for some portion of us.
That's completely unacceptable. Every trans person who was alive yesterday should be alive today. No action of the state should do anything to interfere with that. That's the bottom line. That's what we're all fighting for. And there's no way that I can even allow myself or even force myself to stop until this is addressed totally and this is reversed and the pre May 17th state of affairs is restored to Florida as a state that's in conformance with the prescribing authority of all other states and with the basic human rights of trans people as recognized under the Federal United States government.
(A Florida Trans rights protest)
I've seen that and like, with that battlefield energy, I feel like a lot of people are kind of lost on how to fight back in any way. So what does resistance look like now? I mean, given that all of the laws that and policies that activists have attempted to prevent from passing have passed, what can the everyday person do to help the trans struggle in Florida? Where should their effort and goodwill go to?
I would first of all say support the trans people around you. If you know a trans person in your life who is in need, who needs help with something, one of the most effective ways that people in communities can be supported by each other is through direct cash transfers. This is known globally in developed and developing nations. So if you know someone who needs help, help them out, you don't need to wait for that to go through an intermediary.
One thing you can do is just help out your friends or help out someone you know is in need. There are legal groups, nonprofits right now who are actually fighting this law SB 254 and its provisions as well as the Board of Medicine's Trans Youth Care ban and that is Southern Legal Counsel. They are the ones who have been at the forefront of this with the Medicaid exclusion, with the Board of Medicines Trans Youth Care ban and now with the challenges to SB 254 being rolled into this including the adult care restrictions because those are restrictions that would even if the Medicaid plaintiffs were to prevail, they would still be affected by the adult care restrictions of SB 254. And that makes this relevant to those ongoing challenges. So I would want everyone to remember- Keep in mind if you're wondering “What is anyone doing about this? Who is gonna do anything about this?” Well, the answer is just first and foremost, they have a name. It's Southern Legal Counsel. They work with other groups as well like GLAD not to be confused with GLAAD and they can be supported on their site, Southern Legal Counsel, that goes completely to just support their legal efforts against anti trans laws in Florida.
You can also support the Spektrum health clinics that are in Orlando and Melbourne. This is a chain of clinics that is led and run entirely by nurse practitioners and APRNs, this was possible, they have been open since 2018 because again, NPS and APRNs have full prescribing authority for essentially all medications as doctors and physicians and MDs and DOs including HRT, including testosterone and including puberty pausers.
That has always been the case for five years. This has been so disruptive to a status quo that it fundamentally threatens their business model in a way that could put them out of business. They are an important clinic chain because they provide primary care generally that is gender aware and LGBTQ affirming, they're someone you can go to as a trans person.
And I say this from personal experience, you can go there as a trans person. Have them, look at your body, have them take care of things for you and be understood. It is also a sexual health clinic. They also provide counseling and a range of referral services as well as psychiatric medicine and HIV management. They provide a- well, a Spectrum of services you could say. They are also a nonprofit, 100% of donations to Spektrum Health also go to their patient assistance fund.
They help support low income communities and provide low cost or free of charge health care to low income communities which are trans people. If you want to support trans people directly, if you want to support the providers and nurse practitioners affected by this directly, Spektrum health is the place to go. If you want to support the legal challenges to this law, that's keeping us from getting our HRT again, support Southern legal counsel. If you see trans people around you who are struggling, support them, just open your wallet to them. So those are three points I think we can always get this from. And those are three things that I think people can do today. And you know what? You don't even have to have any money. If nothing else, just talk about it, just say something, just talk about what we know, just post it anywhere, just post something you found out about what these people have done that shocked you. That would appall most people. Just don't stop talking about it and talking about it becomes more and more powerful. The reason it becomes more and more powerful, especially now and increasing into the future is because before, although we might have seen this and it only might have been early indications others were not willing to see clearly how this path was mapped out and where it would lead.
However, that path is much further along. Now, it is much further charted. There's practically a topographic map of what is being carried out here. And we can show people that every step along the way, what we said would happen did happen. And in fact, they have less and less room for saying at this point that any of this would never happen because they are now the ones with the track record of having said that things wouldn't happen and being wrong (when) those things did happen.
So when they say that something will never happen, we know what to expect about that. And when we, as the trans community say, this is what this is leading to, people know to listen. That is a seesaw that is tilting in the direction it needs to tilt because there's fundamentally a credibility here that comes from accurately predicting
and accurately observing the genocidal campaign that's being carried out against trans people's basic rights, health care and freedoms in Florida as equal citizens.
So I just wanted to ask you for a second to last question here about gender analysis and by extension, Floridaban.com. Can you tell me a bit about those projects and why they're important?
Yes, Gender Analysis is something I started in August of 2014 when I realized that some of my earlier blogs such as on free thought blogs within the secular community and the Orbit, which was a spinoff of that secular community, as well as my youtube channel had lately turned into mostly trans focused topics and previously LGBT topics generally and secular humanism topics generally.
I realized there needed to be a place for a focus specifically on trans information that was relevant to our lives and that was also well resourced and that was able to provide things that others might not be able to find elsewhere or that hadn't been provided elsewhere at that time in 2014. And still now there were so many unanswered questions about some basics of our care, what we could expect. What does progesterone do? Do I need to be on it? Just things like that, is spiro(nolactone) an effective anti androgen? What do these levels need to be? But also social questions like why are we facing these Madonna horror complexes turned up to 11? And just why are we faced with this incredible policing of stereotypes where we have to enact them perfectly for trans women to be validated as women and yet as enacting that femininity quote unquote perfectly as it's been defined by society we're then guilty of conforming to and enacting a harmful gender stereotype even as it was handed to us and expected of us by society and general problems like that. Cognitive problems like biases in how people perceive the relative height of men and women who are of the same height just because they're men and women or how people will perceive various aspects of a trans person's appearance or voice when they know that they're trans versus when they don't.
And a number of other features like that that are relevant to explaining that passing as it was understood at the time is not an on or off status of an individual person. It's an ongoing heterogenous subjective property of every cis person who's looking at us in any given moment and just a lot of things like that that weren't necessarily known, but that there was literature out there that was applicable to this and that's what I had insisted on getting out there.
And it was very important to me, I also talked about topics like the experience of when I got on HRT in 2012. And what that was like emotionally for me in the context of being someone who had been estranged and distanced and dissociated from my emotions for my entire life. And once I had started taking estrogen within a week, it really surprisingly mitigated that almost totally.
And there was an experience of being 23 years old and suddenly able to start feeling emotions as if they were more complete and real and actually mattered for something instead of feeling hollow or fake or fixed or just not spontaneous. There was just a feeling of being able to act in the world the way I see everyone else acting in the world. It was just a feeling of being able to be like everyone else.
And just the idea of that as something that people would want to take away from us, you know, it makes sense that what they want to take away is trans people can be just like anyone else and we are and that's just become more and more clear throughout from then to now and into the present, just everything on my site has become about the people who have made it their mission to make our lives impossible to imagine in the public mind, impossible to imagine as benign and as a part of their communities. And as a part of our communities and just tracking their activities in the media, politically legally and at all levels where they are trying to wipe us out. They are trying to (erase) anything that acknowledges the existence of trans people as people who are the equals of cis people do exist and are in our communities in perpetuity as any other contributing member is erased. Anything that involves accepting trans people is erased. Anything that involves letting us transition as we do instead of being forced to live as people and not be able to have medical autonomy over our bodies is erased. That is what it is. It is a campaign to erase trans people in every way that distinguishes us as trans people who exist from sis people until there is nothing left but sis people. That's the bottom line here. That's what gender analysis is here to fight now. This wasn't the fight before, but it is the fight now and that's what I'm here for.
This article was written by Samira Burnside. You can reach her for tips, comments or opportunities at sburnside@thequeernotion.com
Zinnia Jones was featured in this article. You can find her work at Genderanalysis.net , Floridaban.com and https://www.youtube.com/@ZinniaJones . You can also follow her at @zjemptv on twitter.