Judge strikes down Florida ban on gender-affirming care

A Florida law banning gender-affirming health care for transgender minors and restricting access to care for certain adults is unconstitutional, a federal judge ruled Tuesday. 

The decision by U.S. District Court Judge Robert Hinkle permanently blocks a law championed by Republican state lawmakers and Florida Gov. Ron DeSantis (R), as well as rules adopted by the state’s medical boards in 2022 that prevent minors from accessing treatments like puberty blockers and hormones. 

The law, signed by DeSantis in May 2023, barred health care providers from administering gender-affirming care to minors and set up significant barriers for transgender adults seeking care. Gender-affirming health care for transgender adults and minors is considered medically necessary by every major medical organization, though not every trans person chooses to medically transition or has access to care. 

“Florida has adopted a statute and rules that ban gender-affirming care for minors even when medically appropriate,” Hinkle wrote Tuesday in a 105-page decision. “The ban is unconstitutional.” 

Hinkle, who temporarily blocked enforcement of the law last June, added that the law was motivated by state lawmakers’ “anti-transgender animus” and a “deeply flawed, bias-driven” report from Florida’s Agency for Health Care Administration that determined gender-affirming care for minors is experimental and should be excluded from Medicaid coverage. 

Florida’s medical boards, for their part, “imposed requirements that have no medical justification and were plainly intended to prevent or impede patients from receiving gender-affirming care,” Hinkle wrote. 

“Transgender opponents are of course free to hold their beliefs. But they are not free to discriminate against transgender individuals just for being transgender,” Hinkle wrote in Tuesday’s ruling. “In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished. To paraphrase a civil-rights advocate from an earlier time, the arc of the moral universe is long, but it bends toward justice.” 

“In the meantime, the federal courts have a role to play in upholding the Constitution and laws,” Hinkle wrote. “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.” 

Florida’s Health Department did not immediately return a request for comment. A spokesperson for DeSantis said the state will appeal Hinkle’s ruling. 

“Through their elected representatives, the people of Florida acted to protect children in this state, and the Court was wrong to override their wishes,” they said in an emailed statement. “We disagree with the Court’s erroneous rulings on the law, on the facts, and on the science. As we’ve seen here in Florida, the United Kingdom, and across Europe, there is no quality evidence to support the chemical and physical mutilation of children. These procedures do permanent, life-altering damage to children, and history will look back on this fad in horror.” 

The state is also appealing a separate decision by Hinkle to strike down Florida’s Medicaid policy excluding coverage for gender-affirming health care.  

Hinkle in Tuesday’s ruling disputed claims frequently made by opponents of transgender health care that European countries have banned gender-affirming care for minors. 

“The assertion is false. And no matter how many times the defendants say it, it will still be false,” he wrote. “No country in Europe—or so far as shown by this record, anywhere in the world—entirely bans these treatments.” 

Transgender advocates celebrated Tuesday’s ruling as a win for LGBTQ rights. 

“The federal court saw Florida’s transgender minor healthcare ban and adult restrictions for what they are—discriminatory measures that cannot survive constitutional review,” Simone Criss, director of the Southern Legal Counsel’s transgender rights initiative, said in a statement.  

“This ruling means I won’t have to watch my daughter needlessly suffer because I can’t get her the care she needs,” said Jane Doe, the mother of plaintiff Susan Doe, a 12-year-old transgender girl. “Seeing Susan’s fear about this ban has been one of the hardest experiences we’ve endured as parents. All we’ve wanted is to take that fear away and help her continue to be the happy, confident child she is now.”