A federal court has blocked the state of Florida from enforcing a law that bans gender-affirming treatment for transgender minors, specifically puberty-suppressing drugs and hormone replacement therapy, but restricts it for transgender adults.
The block also applies to the Florida Medical Association’s related rules.
The ruling came six months after a three-day trial in Doe v. Ladapo, which heard testimony from experts in psychiatry, endocrinology, medical ethics and pediatrics.
“This bill returns Florida to the crazy world we were in before SB 254, the medical board rules, right before this nonsense went into effect,” said Simone Kriss of Southern Legal Counsel. “It means medical decision-making power is returned to adults, empowering them to make decisions about their own bodies and their own health care.”
“[It also puts it back] “In the case of minors, it’s in the hands of the adolescent, their parents and their physician. Medical decisions should be made there.”
Gender-affirming care for both transgender minors and adults is supported by all major medical and mental health associations in the United States.
How we got here
Florida has long allowed the use of puberty suppressants and hormone replacement therapy (referred to in the ruling as “cross-sex hormones”) to treat gender identity disorder, and a Florida Agency for Health Care Administration report had previously endorsed their use.
In the summer of 2022, Florida Surgeon General Joseph Ladapo and the Department of Health urged the state’s medical association and board of osteopathic medicine to impose a blanket ban on treating people under the age of 18 for gender dysphoria.
SB 254 was passed by the Florida Legislature and signed by Governor Ron DeSantis, taking effect in May 2023. The bill makes into law a ban on gender reassignment treatment for transgender minors, except for patients currently receiving treatment, and establishes felony criminal and civil penalties for medical providers.
For adults, and even the small number of minors already receiving treatment, treatment would be required to be provided only by physicians, telemedicine would be banned, and patients would be required to sign consent forms that contain medically inaccurate and transphobic language. Patients were already required to sign consent forms before treatment could begin.
Tuesday’s ruling
U.S. District Judge Robert L. Hinkle ruled Tuesday that last year’s medical restrictions were unconstitutional, and that while Florida can regulate treatments, it cannot deny “safe and effective medical care” to transgender individuals, especially because treatments with those drugs are still available to cisgender patients with full state approval.
“Opposites are naturally free to hold their beliefs, but they are not free to discriminate against transgender individuals simply because they are transgender,” the ruling states. “Just as racism and misogyny have diminished, discrimination against transgender individuals will likely decline over time. To borrow a phrase from an old civil rights activist, the arc of the moral universe is long, but it is leaning toward justice.”
“Medical decisions should be driven by good medicine, not politics, and that’s what the judge said in his decision today,” said Jennifer Levy, senior director of transgender and queer rights at GLBTQ Legal Advocates & Defenders.
What’s next?
Criss said the state has already vowed to challenge the ruling from the 11th U.S. Circuit Court of Appeals in Atlanta. Florida appealed a preliminary injunction in the case last June that blocked underage drinking and driving restrictions.
They also appealed the Decker v. Weida decision that struck down a health care rule that denied coverage to transgender Medicaid recipients. The case is still before the Court of Appeals.
Another complaint from Florida concerns the use of personal pronouns and titles by educators in schools.
Lawyers for state education officials filed a notice in April saying they would appeal a court decision that blocked transgender teachers in Hillsborough County from implementing a 2023 law requiring them to use pronouns that match the sex they were assigned at birth.
It could take more than a year for the appeal to be heard in court.
Chris said he is also working to challenge a state “policy” that no longer allows transgender people in Florida to amend the gender on their birth certificates, driver’s licenses and state-issued identification cards.
“I don’t want to call these policies because they haven’t gone through a rulemaking or legislative process. They’ve just been made in the dark by these government agencies,” Chris said.
The other case, Clare v. Department of Management Services, challenges rules that have been in place since the 1970s that exclude gender-affirming care from coverage in state health insurance plans.