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Ruling on gender-affirming care is 'cruel' to the transgender community, advocates say

A transgender pride flag being waved at an LGBTQ pride march
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Lawyers for transgender plaintiffs and their families call Monday's ruling to temporarily reinstate Florida's restrictions on gender-affirming treatments a "brutal, cruel blow."

A district judge had blocked Florida's law restricting access to gender-affirming care earlier this year. Lawyers for trans plaintiffs and their families say even a temporary rollback on that decision is "devastating."

The fight over transgender health care in Florida is far from over after an appeals court ruled to allow the state to resume restrictions on gender-affirming treatments such as puberty blockers and hormone therapy.

A law that prevents doctors from prescribing these treatments to trans youth and also makes it harder for adults to get care has now gone back into in effect while an appeal continues.

“It’s temporary, but it’s really devastating for the community,” said Simone Chriss, an attorney with Southern Legal Counsel. The organization is part of a coalition of legal groups representing the plaintiffs, who include a transgender man and the parents of children affected by the restrictions.

Monday’s ruling by a panel of the 11th U.S. Circuit Court of Appeals stays a June ruling by U.S. District Judge Robert Hinkle that struck down the law as unconstitutional. In his injunction of the law, Hinkle said the state officials were motivated by a sense of “anti-transgender animus” when they passed it in 2023. 

For the past couple of months, trans residents and their families were able to feel some relief and vindication after the lengthy and emotional legal battle, said Chriss. This week’s ruling, she said, thrust them back into a state of fear and confusion.

“I am so sorry that anyone is having to endure this type of mistreatment and please be assured that we will never stop fighting these cruel bans. We will do whatever it takes to get this decision reversed and to get people back in the position where they are treated as equal members of this society and can get health care they need.”
Shannon Minter, attorney with the National Center for Lesbian Rights

“Within hours of the order coming out, I heard from — I can't count the number of people who reached out via text, email, calling — asking, ‘What does this mean? How could they do this?’ ” she said.

In the 2-1 ruling from the appellate court, judges argued that Hinkle likely misapplied a legal presumption that the legislature “acted in good faith” when it passed the law. They determined the defendants, who include Florida Surgeon General Joseph Ladapo and the Florida Board of Medicine, are likely to succeed in the appeal, which Gov. Ron DeSantis has said is about “protecting the innocence” of kids.

The 2023 law allowed minors who had already started gender-affirming treatments before it went into effect to continue care, and Chriss said that won’t change.

What’s less clear is whether adolescents who may have started treatment this summer following Hinkle’s injunction will have to stop, Chriss said, adding that she’s working on clarifying that for families as soon as possible.

The law also restricts transgender adults’ ability to get care, requiring they see a doctor for hormone prescriptions rather than a nurse practitioner or other qualified health provider. They also can’t use telehealth to access treatments. 

Some providers affected by the ban had resumed services these past couple months, working to get through a backlog of a patients whose care had been disrupted, the Associated Press reports. Following the appellate court's order, they’ve had to pause services.

The abrupt change is a “brutal, cruel blow” to patients, said Shannon Minter, an attorney with the National Center for Lesbian Rights who is also representing the plaintiffs.

“I am so sorry that anyone is having to endure this type of mistreatment and please be assured that we will never stop fighting these cruel bans," Minter said. "We will do whatever it takes to get this decision reversed and to get people back in the position where they are treated as equal members of this society and can get health care they need.”

Attorneys for the plaintiffs say they’re exploring “every possible option” to respond to Monday’s stay.

The court also ordered to expedite the full appeal, instructing the clerk to schedule oral arguments on the next available date.

“It’s still way too long for people who are having their health care interrupted,” said Minter. 

In the last few years, 26 states have enacted laws or policies limiting access to gender-affirming care and most are facing legal challenges to those restrictions, according to a KFF analysis. The U.S. Supreme Court has agreed to review a legal challenge against a Tennessee ban on care for transgender youth that could have widespread implications on access to care nationally, but it’s not expected to hear arguments in the case until next year.

I cover health care for WUSF and the statewide journalism collaborative Health News Florida. I’m passionate about highlighting community efforts to improve the quality of care in our state and make it more accessible to all Floridians. I’m also committed to holding those in power accountable when they fail to prioritize the health needs of the people they serve.
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