Evaluations › Florida AHCA · Last reviewed 2026-05-16

Florida AHCA review (2022)

Summary

The Florida Agency for Health Care Administration (AHCA) published an extensive evidence-based review of paediatric gender care for the purposes of Medicaid policy in June 2022. The review concluded that the available evidence was insufficient to demonstrate effectiveness and safety, leading to exclusion from Medicaid coverage and subsequent restrictions by the Boards of Medicine in November 2022. The methodology and conclusions are being challenged in ongoing litigation.

1. Commission and methodology

The AHCA review was conducted at the request of the Florida governor. The report — titled Florida Medicaid: Generally Accepted Professional Medical Standards Determination on the Treatment of Gender Dysphoria — assessed 61 studies and judged that the evidence base was "far from sufficient" to demonstrate effectiveness.¹

2. Policy consequences

Medicaid coverage for GnRHa, CSH and surgery for minors withdrawn (August 2022).
Florida Board of Medicine: ban on new medical interventions for minors (November 2022).
Law SB 254 (May 2023): codification of these restrictions.

3. Methodological criticism

The review has been criticised in academic counter-publications — including in the New England Journal of Medicine and the American Journal of Public Health — for the selection of authors, lack of peer review and policy-driven framework.² The Florida Court of Appeals overturned parts of the subsequent regulation in 2024.