A federal court has blocked Florida from enforcing a law that bans gender-affirming care, specifically puberty blockers and hormone replacement therapy, for transgender minors and restricts it for trans adults.

The block also pertains to related rules from the Florida Boards of Medicine.

The ruling comes six months after a three-day trial for Doe v. Ladapo in which the court heard testimony from experts in psychiatry, endocrinology, medical ethics, and pediatric medicine.

“It restores Florida to a pre-SB 254 Board of Medicine rules insanity world right before all of this nonsense came into effect,” said Simone Criss with Southern Legal Counsel. “What that means is it puts medical decision making back in the hands of adults to make decisions about their own bodies and their own health care.

“[It also puts it back] in the hands of, for minors, the adolescent, their parent and their doctor. That is where the decision-making around medical care should be happening.”

Gender-affirming care for both trans minors and adults is supported by all major U.S. medical and mental health associations.

How we got here

For years, Florida allowed the use of puberty blockers and hormone replacement therapy, referred to as “cross-sex hormones” in the ruling, to treat gender dysphoria. A report from the Florida Agency for Health Care Administration previously supported the use of both.

In the summer of 2022, Florida Surgeon General Joseph Ladapo and the Department of Health asked the state Boards of Medicine and Osteopathic Medicine to adopt a ban on all treatment of gender dysphoria for people under 18 years of age.

SB 254 was passed by the Florida legislature, signed by Gov. Ron DeSantis, and put into effect in May 2023. It codified into law the ban on gender-affirming care for trans minors, with the exception of patients actively undergoing treatment, and created felony criminal and civil penalties for medical providers.

For adults, and those few minors already in treatment, it also required that care be provided exclusively by physicians, barred telehealth, and required patients to sign consent forms that were not medically accurate and contained transphobic language. Patients were already required to sign consent forms before beginning treatment.

Tuesday’s ruling

The ruling by U.S. District Judge Robert L. Hinkle on Tuesday ruled that last year’s restrictions to care are unconstitutional, and that the Florida can regulate treatments, but cannot deny transgender individuals “safe and effective medical treatment,” especially since the treatment with those medications is still provided to cisgender patients with the state’s full approval.

“Transgender opponents are of course free to hold their beliefs. But they are not free to discriminate against transgender individuals just for being transgender.,” the ruling states. “In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished. To paraphrase a civil-rights advocate from an earlier time, the arc of the moral universe is long, but it bends toward justice.”

“Medical decisions should be driven by good medicine and not by politics. And that’s what the judge said in this decision today,” said Jennifer Levi, the Senior Director of Transgender and Queer rights at GLBTQ Legal Advocates & Defenders.

What’s next?

Criss said the state has already vowed to fight the ruling in the United States Court of Appeals for the 11th Circuit in Atlanta. Florida previously appealed the preliminary injunction in this case, which blocked the minor ban last June.

They also appealed the Dekker v. Weida ruling that struck down a health care rule denying coverage for transgender Medicaid beneficiaries. That case is still sitting in the appeals court.

Another appeal from Florida concerns educators’ use of personal pronouns and titles in schools.

Lawyers for state education officials in April filed a notice that they will appeal a court ruling that blocked enforcement of a 2023 law requiring a transgender teacher in Hillsborough county to use pronouns that align with her sex assigned at birth.

It could take more than a year for the appeals to play out in court.

Criss said she’s also working on challenging state “policies “that no longer allow trans Floridians to amend the gender markers on their birth certificates or driver’s licenses and state IDs.

“I don’t want to call them policies because they didn’t go through the rulemaking process or the legislative process. They just kind of happened in the dark by these agencies,” Criss said.

Another case, Claire v. Department of Management Services, is challenging a rule that’s been in place since the 1970s that excludes gender-affirming care coverage in state health insurance plans.