Ella Shepherd, LHMC, NCC is a therapist who is committed to treating young trans patients. What she doesn’t know is whether or not she is breaking the law. She knows that she provides gender-affirming care to minors, but does it fall under the purview of SB 254? Senate Bill 254 prohibits doctors from providing gender-affirming care to minors, but does that apply to medical doctors, alone, or does it also apply to her as a therapist?

Either way, Ella has taken a stand. She insists, “I am bound by ethical rules. I must be an advocate, so I can’t just sit here in my office and hear their struggles, I am under an ethical obligation to advocate for them. I just can’t figure out how to do that.” Between the law and the ethics of her profession, Ella chooses to be ethical. She will do what she must, but she will continue to provide care, even if that involves breaking the law.

When she considers her role as a therapist, she describes it this way. “Trans folks are in the game. I’m on the sidelines as a coach, and I’m watching them get brutally tackled.” She knows that the biggest fear any therapist has is losing a client to suicide. When explaining that fear, she automatically knocked on wood. So far, it hasn’t happened to her.

Still, she knows that gender dysphoria is dangerous to mental health and is closely linked to suicide ideation. Gender dysphoria can loosely be explained as a disconnect between one’s physical body and who a person feels they are. However, Ella explains, disconnect doesn’t adequately describe the feelings, some individuals experience disgust, shame and dissociation. Feelings of dysphoria can affect eating, or it can affect grooming, and in comfort in leaving home to be in public spaces.” Simple and common medical interventions can significantly alleviate the discomfort of dysphoria and reduce suicidal ideation.

Outlawing the simple medical therapies that make trans youth’s lives more bearable can affect other children, as well. Ella explains. An eight-year-old girl, for instance, may find herself starting her menstrual cycle, and her parents may wish to get puberty blockers to delay the onset of her puberty. A nine-year-old boy may start growing a mustache, and his parents may wish to delay that process. Breast size can cause back pain that deems breast reduction medically necessary. Would that surgery now be outlawed?

Still, because this bill is so new, Ella doesn’t know how it is going to be enforced. She has not yet heard of any doctors being fined, fired from their jobs, or jailed. Several of her patients have moved out of state to avoid having their medical care disrupted. Others are considering the move.

When Ella considers this new, more confusing, and dangerous time, she becomes philosophical. “Historically, gay and trans people have always been victimized, but it feels like we’re going through a time warp, a time we’ve only read about. It seems a little surreal that we’re living through it now.” She explains that once a year DeLand Pride observes “Transgender Day of Remembrance.” The Transgender Day of Remembrance (TDOR) is observed annually on November 20th to memorialize those who were murdered due to anti-transgender hatred or prejudice.

Ella believes that in many ways, things have never changed. “We’ve always been in that time. There has never been safety for trans people.” She doesn’t know if the number of deaths of trans people has increased since DeSantis and the Florida legislature have targeted them, but she does believe that his actions “embolden hate crimes and acts of violence.”

Ella fears for her patients. “I fear for their health. I fear for their ability to find safety in community, to continue to live.” 

If you would like to find out more about what it means to be LGBTQ or trans in the State of Florida today and to show your support for this vital part of our community, please attend the June 2, 2023 Speakers Panel “Being LGBTQ in Florida Today.” It will be held at the Rinker Environmental Learning Center, 230 E. Michigan Avenue, DeLand at 10 a.m.


About the flag: Conceived by Monica Helms, an openly transgender American woman, the Trans flag made its debut in 1999. The light blue and light pink are meant to symbolize the traditional colors for baby girls and baby boys, respectively. Meanwhile, the white hue is meant to represent members of the movement who identify as intersex, gender-neutral or transitioning. According to Helms, the flag is symmetrical, so “no matter which way you fly it, it is always correct, signifying us finding correctness in our lives.”

Sandra Haxton is a political writer and Activist, who strongly believes that all change begins on a local level. She is a member of NW Dems of Volusia County.


  1. Donna J Pepin

    Thank you Ella for being such a caring, supportive person. I cannot believe how cruel some of the new laws are and the sentiment of hatred expressed as they are signed into law by our Governor is tragic. They are bully laws meant to hurt people. They are vague enough to make it hard to know when you are breaking them therefore people will avoid supporting Trans, gay etc. and immigrants.

    WVHA supports an agency that might be able to help. Community Legal Services of Mid Florida clsmf.org/
    It is a nonprofit law firm that helps our card members get help with Medicare, disability etc. They gave a talk on the immigration bill on zoom that I listened to a few days ago. I don’t know if they could help or offer advice or even if the law has taken effect yet.

  2. Kimberly Cline

    Thanks for sharing this information. I appreciate the insight to help better understand how deeply people’s lives are affected. Thrilled to have such an amazing young woman as Ella as an advocate in our community and as a member of the NW Club leadership. We are paying attention!