Trans advocates say ruling is an important first step in ending care ban

Families of transgender youth and their advocates are celebrating after a federal judge allowed three adolescents challenging a state ban on gender-affirming care for minors to access care while the lawsuit is underway.

U.S. District Court Judge Robert Hinkle issued a preliminary injunction on Tuesday that prevents the state from enforcing a law that punishes doctors for providing treatments like puberty blockers and hormones to new patients who are younger than 18.

While the ruling only applies to the three families involved in the lawsuit, Jennifer Levi, an attorney with GLBTQ Legal Advocates and Defenders, called it an “very important initial step in taking down the law completely.”

"This is a really huge decision that prevents the state from standing in the way of these families from getting the medical care that their transgender adolescents need," said Levi, who is the group’s senior director of transgender and queer rights.

What the families are saying

The injunction offers comfort for the families challenging the ban, all of who have kids who are either nearing puberty or have already started. They argued in court that without urgent access to gender-affirming care, their kids could suffer irreparable harm.

“My husband and I have been heartbroken and worried sick about not being able to care for our daughter in the way we know she needs,” said one of the anonymous plaintiffs, who is listed in the suit as Jane Doe filing on behalf of her daughter Susan Doe, in a press release.

“I’m sure most any parent can imagine the sense of powerlessness that comes from being unable to do something as basic as get medical care for your child. Today, my entire family is breathing a huge sigh of relief knowing we can now access the treatment that we know will keep Susan healthy and allow her to continue being the happy, confident child she has been," she said.

The ruling comes as existing patients — who were supposed to be exempt from both the medical board rules and the new law — have been dealing with disruptions in care. The law requires medical boards to revise existing consent forms for gender-affirming treatments with state-approved language about the risks of care, but the boards haven't created them yet. For weeks, patients were in limbo as providers held off continuing treatment, waiting on the forms.

On Friday, the Florida Board of Medicine passed an emergency rule allowing current patients to continue care until those consent forms are complete, after which they will have six months to sign them in the presence of a doctor to move forward with treatment.

What the judge said

In his 44-page order, Hinkle blasted the state’s ban, calling it “an exercise in politics, not good medicine.”

He acknowledged there are “well-established standards of care” for treatment of gender dysphoria, which is the medical term for the distress a person feels when their body does not align with their identity.

Hinkle said the medical experts who testified on behalf of the plaintiffs did a better job showing gender-affirming treatments can be beneficial for minors when administered appropriately than the state’s medical experts did at arguing the risks outweigh those rewards.

Included in the record was testimony from a two-week trial that wrapped up last month in a similar case challenging the state’s ban on Medicaid coverage for gender-affirming care.

Though his injunction was narrowed in scope to focus on the three plaintiffs, Hinkle argued that they were “likely to succeed” in their claims that the state’s ban violates transgender rights and parents’ ability to make informed healthcare decisions for their children.

“I find that the plaintiffs’ ability to evaluate the benefits and risks of treating their individual children this way far exceeds the ability of the State of Florida to do so. I find that the plaintiffs’ motivation is love for their children and the desire to achieve the best possible treatment for them. This is not the State’s motivation,” Hinkle wrote.

What happens next

Simone Chriss, a lawyer for Southern Legal Counsel representing the parents, told the Associated Press she hopes health care providers and prosecutors see the ruling as applying statewide, like when Hinkle issued an injunction in 2014 declaring the state's same-sex marriage ban unconstitutional as it applied to a single couple.

“The state no longer has any valid interest in enforcing something that's unconstitutional," Chriss said.

As she spoke, DeSantis's office issued a statement saying the opposite, and the law will be enforced for all except the three children.

“Wow! Jiminy Crickets! I have no words,” Chriss said.

She said her hope is that regardless of DeSantis' position, state attorneys won't prosecute doctors for providing care "that is aligned with every major medical organization — not a rogue few, but all of them.”

In addition to GLBTQ Legal Advocates and Defenders and Southern Legal Counsel, the families are also represented by the National Center for Lesbian Rights and the Human Rights Campaign, which collectively issued the following statement:

“Today’s ruling is a powerful affirmation of the humanity of transgender people, the efficacy of well-established, science-based medical care, and of the rights of parents to make informed healthcare decisions for their children. The court recognized the profound harm the state of Florida is causing by forcing parents to watch their kids suffer rather than provide them with safe and effective care that will allow them to thrive. We are incredibly relieved that these Florida parents can continue to get healthcare for their children while we proceed to challenge these bans and eventually see them fully overturned.”

Defendants in the case include DeSantis administration officials and members of the Florida Boards of Medicine and Osteopathic Medicine, which in March issued rules barring doctors from providing these treatments to minors. A state law that went into effect in May bolstered those restrictions.

“The Governor’s pursuit of unconstitutional laws and personal vendettas comes at the direct expense of taxpayers,” the LGBTQ advocacy group Equality Florida tweeted in response to the ruling. “Instead of investing in initiatives that promote the welfare of the community, these actions drain valuable resources and undermine the potential for progress.”

The group also thanked the families who stepped forward to challenge the ban and the legal groups representing them, calling Hinkle’s ruling “an unwavering endorsement of the right of transgender people to be treated with dignity and respect.”

Attorneys for the plaintiffs say they expect to quickly go to trial. Hinkle is also preparing to rule on the Medicaid case soon.

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