Judge strikes down Florida gender-affirming care restrictions for minors and adults

A transgender Pride flag features the names of transgender Black women from Louisiana who have been killed. The flag was carried at the front of a march Friday, March 31, 2023, through the French Quarter in New Orleans for Transgender Day of Visibility. (Greg LaRose/Louisiana Illuminator)

Florida can no longer enforce its ban against transgender youth receiving gender-affirming care, or its restrictions against adults accessing gender-affirming care, after a federal district court ruling Tuesday found those rules to be unconstitutional and fueled by animus against trans people. The ruling is effective immediately.

Although federal courts have blocked many state anti-LGBTQ+ laws, this ruling carries extra significance because Florida was the first state to push for gender-affirming care restrictions for transgender adults. The ruling is also unique because it blocks restrictions enacted through multiple channels: through laws passed in the statehouse as well as restrictions passed through the state’s medical boards.

U.S. District Judge Robert Hinkle’s order is also significant for its admonishment of the state for trying to regulate gender-affirming care based on “anti-transgender animus” instead of medical standards. Florida “cannot flatly deny transgender individuals safe and effective medical treatment — treatment with medications routinely provided to others with the state’s full approval so long as the purpose is not to support the patient’s transgender identity,” Hinkle wrote.

The Florida Surgeon General and the Florida boards of medicine have admitted that impeding transgender people from pursuing their identities is not a legitimate state interest, he wrote — but state legislators and others involved in the state’s gender-affirming care restrictions have still pursued this goal.

“Gender identity is real. Those whose gender identity does not match their natal sex often suffer gender dysphoria. The widely accepted standard of care calls for appropriate evaluation and treatment,” Hinkle wrote, noting that for minors, such care begins with mental health therapy and is followed, when appropriate, with hormone replacement therapy. “Florida has adopted a statute and rules that ban gender-affirming care for minors even when medically appropriate. The ban is unconstitutional.”

Hinkle also found that the state’s rule preventing nurse practitioners from providing gender-affirming care to adults is unconstitutional, as is requiring trans adults to jump through multiple hoops to access care — like signing consent forms that include false information and requiring follow-ups more frequently than medically necessary. These rules led to physicians and pharmacies turning away patients, preventing trans adults across the state from being able to access gender-affirming care.

The lawsuit, involving four transgender adults and seven parents of transgender minors representing broader plaintiff classes across the state, was brought against the Florida Surgeon General and the Florida boards of medicine in March 2023 by the Southern Legal Counsel, GLAD (GLBTQ Legal Advocates & Defenders), the National Center for Lesbian Rights (NCLR), the Human Rights Campaign Foundation and Lowenstein Sandler LLP.

Simone Chriss, attorney with the Southern Legal Counsel in Florida and director of the organization’s transgender rights initiative, said in a statement that Hinkle’s order restores access to gender-affirming care for all transgender Floridians, since the lawsuit is a class action. Transgender adults can resume receiving care from their medical providers, including nurse practitioners, who had been prohibited from providing gender-affirming care under state law last year, she said.

The lawsuit was initially filed to challenge the state’s board of medicine rules, and later amended to include a challenge to the gender-affirming care ban for trans minors that became law in May last year.

“I’m so relieved the court saw there is no medical basis for this law — it was passed just to target transgender people like me and try to push us out of Florida. This is my home. I’ve lived here my entire life,” said Lucien Hamel, a 27-year old transgender man and one of the plaintiffs in the case, in a statement on Tuesday. “This is my son’s home. I can’t just uproot my family and move across the country. The state has no place interfering in people’s private medical decisions, and I’m relieved that I can once again get the healthcare that I need here in Florida.”

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