A federal appeals court has been asked to reconsider a decision that at least temporarily allowed Florida to move forward with restrictions on treatments for gender dysphoria.
The 38-page motion argued a panel of the 11th U.S. Circuit Court of Appeals erred last week when it granted Florida’s request for a stay of a ruling by U.S. District Judge Robert Hinkle that blocked the restrictions.
The stay effectively means the restrictions on treatments such as puberty blockers and hormone therapy can be in effect while the Atlanta-based court considers an underlying appeal of Hinkle’s ruling.
The motion was filed Tuesday by attorneys for plaintiffs in the case: a transgender man and the parents of children diagnosed with gender dysphoria.
“The stay order threatens immediate and severe harm to a vulnerable population and raises fundamental questions about the proper application of constitutional principles,” Tuesday’s motion said. “Plaintiffs respectfully request that the court vacate its stay order and deny defendants’ (state officials’) request for a stay pending appeal.”
Hinkle in June issued an injunction against the restrictions, finding, in part, that they were motivated by “animus” toward transgender people and violated equal-protection rights.
But in a 2-1 decision, the appeals court panel said Hinkle likely misapplied a legal presumption that the Legislature “acted in good faith” when it passed the restrictions in 2023.
The plaintiffs’ attorneys contended in Tuesday’s motion, however, that the panel’s decision “mischaracterizes the district court's careful and nuanced analysis of the evidence of discriminatory intent. The district court did not, as the stay order suggests, improperly impute the animus of a few legislators to the entire body.”
“The district court’s order on the merits meticulously documented numerous statements by bill sponsors, high-ranking administration officials and other legislators that evinced clear anti-transgender bias,” the motion said, referring to officials in Gov. Ron DeSantis’ administration.
But in a brief filed last week in the underlying appeal, attorneys for the state wrote that Hinkle’s decision “turned the presumption of good faith into a presumption of bad faith” and that it resulted in a “judicial veto of the state’s policy choices for the treatment of gender dysphoria.”
“It took the words of seven or so of Florida’s 160 state legislators and concluded that a significant number of the Legislature, the governor, and two separate boards of medicine, targeted transgender individuals — and didn’t target a psychiatric diagnosis,” the state’s brief said.
The 2023 law prevented minors from beginning to receive puberty blockers and hormone therapy for treatment of gender dysphoria. Also, it allowed only physicians — not nurse practitioners — to approve hormone therapy for adults and barred the use of telehealth for new prescriptions. Opponents argued that the restrictions reduced access to hormone therapy for adults.
DeSantis’ administration has long disputed arguments about the effectiveness of gender dysphoria treatments, particularly for minors. In granting the stay of Hinkle’s ruling, the majority of the appeals court panel said Florida would suffer harm if it could not enforce the restrictions.
“As to harm to others, even with the law in effect, physicians may continue to prescribe and administer puberty blockers and hormones to adults,” said the Aug. 26 majority opinion shared by Judges Britt Grant and Robert Luck. “And minors who were already receiving them may continue to do so.”
But Judge Charles Wilson dissented, saying he would “not find that the district court misapplied the law nor abused its discretion.”
The Republican-controlled Legislature passed the restrictions as Florida and other GOP-led states in recent years have approved numerous laws and regulations focused on transgender care. One of the highest profile issues has been restricting use of puberty blockers and hormone therapy for minors 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 plaintiffs’ attorneys filed a class-action lawsuit challenging the Florida restrictions. In a 101-page ruling, Hinkle wrote that “gender identity is real” and likened opposition to transgender people to racism and misogyny.
“The state of Florida can regulate as needed but 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,” he wrote.
Florida appealed and sought a stay of Hinkle’s injunction.
In the motion for reconsideration Tuesday, the plaintiffs’ attorneys argued that Hinkle’s conclusions also included evidence of bias by the state Department of Health and medical boards that approved rules about treating gender dysphoria.
“The district court’s animus findings were based not only on the statements of legislators but also on extensive evidence of bias and irregularity in this administrative process, which influenced both the boards’ rules and legislators considering the statute,” the motion said.
