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Florida pediatrician group loses first round in subpoena fight over trans care standards

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A judge says a House panel “has shown a legitimate interest" in obtaining the state American Academy of Pediatrics' documents on the development of care standards for minors diagnosed with gender dysphoria.

A federal judge has rejected an initial request to block a Florida House effort to obtain internal communications about how the Florida Chapter of the American Academy of Pediatrics developed standards of care for children diagnosed with gender dysphoria.

The pediatricians group sought a preliminary injunction after House Health & Human Services Chairman Randy Fine, R-Brevard County, issued a subpoena seeking information from the chapter.

Fine issued the subpoena during the final week of this spring’s legislative session and asked the chapter to provide the documents before the session ended on May 5, prompting the lawsuit.

Lawyers for the chapter argued that the communications sought were protected by the First Amendment and asked U.S. District Judge Allen Winsor for a preliminary injunction to block the subpoena.

But Winsor ruled that the Republican-controlled Health & Human Services Committee “has shown a legitimate interest in the requested records” and that the pediatricians had “not shown any harm that the interest would not overcome.”

“That is not to say that FCAAP (the Florida Chapter of the American Academy of Pediatrics) could not succeed with a different record, but on the limited record now before the court, I cannot conclude that FCAAP is substantially likely to prevail on the merits,” Winsor wrote in a decision posted Monday on the court’s website.

The House committee “has shown a connection between the information it seeks and a sufficiently important governmental interest,” Winsor, who was appointed by former President Donald Trump, wrote.

“The issue of appropriate medical standards of care, and of how those establishing those standards of care reach their conclusions, is within the realm of appropriate legislative inquiry,” the judge added.

Winsor’s order gave the House committee and the pediatricians group 21 days to file a joint report setting up a litigation schedule for the case.

The lawsuit argued that compliance with the subpoena would result in “disclosure of the position of individual members with respect to a controversial political issue.” Such disclosure “not only violates the First Amendment rights of those individuals but can reasonably be expected to discourage future membership in the association,” Tallahassee attorney Barry Richard, who represents the pediatricians, wrote in the challenge filed May 1.

The subpoena is aimed at getting information related to guidelines established by the World Professional Association for Transgender Health, or WPATH, and the Endocrine Society. Dozens of medical groups point to the WPATH guidelines, which have been revised eight times over the past two decades, to support the treatments.

The subpoena seeks communications about “the development, endorsement, and recommendation” of the standards or “reflecting disagreement or skepticism” by the group’s members or other health-care practitioners of the standards of care. Fine’s committee is also asking for communications related to the group’s “consideration and rejection of the view that the standards of care should not include gender-affirming care.” The House also is requesting communications “that reference social media, peer influence, or other social influences relating to gender dysphoria in children and adolescents.”

The pediatricians group contends that the effort to compel it to disclose “communications, positions, and thought processes among its members with respect to a matter that has become the subject of public and political controversy” violates the doctors’ speech rights.

But in a response filed May 17, the House committee argued that the state “has well-established, compelling interests in the practice of medicine within its borders and in the health and welfare” of Florida children.

“If a group of Florida practitioners are employing and promoting the use of novel and seemingly harmful procedures on minors, the House undoubtedly has authority to investigate,” David Axelman, general counsel for the Florida House, wrote. “The House’s concern, of course, is that medical organizations in Florida may be parroting and promoting ideological standards that are thinly disguised as medical standards and then manufacturing a false ‘consensus’ to encourage the widespread adoption of harmful medical practices. That is profoundly a matter of state concern.”

The House investigation is among a number of steps Gov. Ron DeSantis’ administration and lawmakers have taken on transgender treatments for children and adults.

The Legislature approved measures prohibiting venues from admitting children to drag shoes; requiring people in government buildings — such as airports, city halls and courthouses — to use bathrooms that line up with their sex assigned at birth; and banning doctors from using puberty blockers or hormone therapy to treat children diagnosed with gender dysphoria. The federal government defines gender dysphoria clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”

The ban on treatments enshrined in state law rules recently adopted by the state Board of Medicine and the Board of Osteopathic Medicine.

But U.S. District Judge Robert Hinkle last week temporarily blocked the ban on using puberty blockers and hormone therapy to treat three children diagnosed with gender dysphoria, calling the prohibition “an exercise in politics, not good medicine.” Those children are plaintiffs in a lawsuit challenging the ban.

DeSantis, who recently entered the 2024 Republican race for president, has fiercely opposed gender-affirming care for children, which he has called “child mutilation,” and has made it a campaign issue.