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Florida is allowed to restrict transgender health care, appeals court rules

Ron DeSantis
The Old Major/Shutterstock
Ron DeSantis

A lower court had ruled that the law should be permanently blocked, but this decision reverses that.

trudestress

A federal appeals court ruled Monday that Florida’s ban on gender-affirming care for transgender youth and restrictions on it for trans adults can be enforced while a lawsuit against it proceeds.

A three-judge panel of the U.S. Court of Appeals for the 11th Circuit ruled 2-1 that the state is likely to win the case, known as Doe v. Ladapo, so the injunction against the law should be stayed. Doe is one of the anonymous plaintiffs who sued, and Ladapo is the Florida surgeon general.

“The district court likely misapplied the presumption that the legislature acted in good faith when it concluded that the prohibition and regulation provisions, and the implementing rules, were based on invidious discrimination against transgender minors and adults,” the majority opinion states. Judges Britt C. Grant and Robert J. Luck were in the majority.

Judge Charles R. Wilson dissented, writing that the district court had “identified sufficient record evidence to support concluding that the act’s passage was based on invidious discrimination against transgender adults and minors” and that “withholding access to gender-affirming care would cause needless suffering.”

In a June 11 ruling, U.S. District Judge Robert Hinkle issued a permanent injunction against the law and the restrictions, finding them unconstitutional. He found that Florida Senate Bill 254 and the related Boards of Medicine rules were motivated by disapproval of transgender people and violate the equal protection rights of transgender individuals and parents of transgender minors in Florida. Florida was the first state to pass a law restricting access to health care for transgender adults. In July, Hinkle refused to put his ruling on hold during the appeals process.

The ban on gender-affirming care for minors was first enacted in March 2023 through the adoption of rules by the Florida Board of Medicine and Florida Board of Osteopathic Medicine at the urging of Gov. Ron DeSantis, Joseph Ladapo, and the Florida Department of Health. SB 254, which was passed by the legislature, signed by the governor, and took effect in May 2023, wrote the ban into state law, subject to a narrow continued-use exception for minors who had started treatment before the ban. SB 254 also created felony criminal and civil penalties for Florida medical providers.

It further added severe restrictions that effectively blocked access to essential medical care for trans adults and minors who would be eligible for the continued-use exception, including requiring that care be provided exclusively by physicians, barring telehealth, and requiring patients to complete unique, onerous, and misleading consent forms.

The Floridians who sued are represented by GLBTQ Legal Advocates & Defenders, the Human Rights Campaign Foundation, the National Center for Lesbian Rights, Southern Legal Counsel, and Lowenstein Sandler LLP. The organizations issued the following statement in response to the ruling:

“We are deeply disappointed by this decision and the panel’s disregard for the district court’s careful findings and adherence to the Eleventh Circuit’s recent precedent. Allowing these discriminatory restrictions to go back into effect will deny transgender adults and adolescents lifesaving care, and prevent Florida parents from making medical decisions that are right for their children. As the district court found based on voluminous evidence, the record shows that these extraordinary restrictions were based on disapproval of transgender people and serve no purpose other than to harm transgender Floridians. The plaintiffs in this case are considering their options and will take every step possible to protect their right to equal treatment under Florida’s laws, which these restrictions egregiously violate. We will continue fighting for transgender Floridians and their families, and for everyone’s right to make healthcare decisions without government interference.”

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Trudy Ring

Trudy Ring is The Advocate’s senior politics editor and copy chief. She has been a reporter and editor for daily newspapers and LGBTQ+ weeklies/monthlies, trade magazines, and reference books. She is a political junkie who thinks even the wonkiest details are fascinating, and she always loves to see political candidates who are groundbreaking in some way. She enjoys writing about other topics as well, including religion (she’s interested in what people believe and why), literature, theater, and film. Trudy is a proud “old movie weirdo” and loves the Hollywood films of the 1930s and ’40s above all others. Other interests include classic rock music (Bruce Springsteen rules!) and history. Oh, and she was a Jeopardy! contestant back in 1998 and won two games. Not up there with Amy Schneider, but Trudy still takes pride in this achievement.
Trudy Ring is The Advocate’s senior politics editor and copy chief. She has been a reporter and editor for daily newspapers and LGBTQ+ weeklies/monthlies, trade magazines, and reference books. She is a political junkie who thinks even the wonkiest details are fascinating, and she always loves to see political candidates who are groundbreaking in some way. She enjoys writing about other topics as well, including religion (she’s interested in what people believe and why), literature, theater, and film. Trudy is a proud “old movie weirdo” and loves the Hollywood films of the 1930s and ’40s above all others. Other interests include classic rock music (Bruce Springsteen rules!) and history. Oh, and she was a Jeopardy! contestant back in 1998 and won two games. Not up there with Amy Schneider, but Trudy still takes pride in this achievement.