Federal judge throws out Florida law blocking treatment for trans children

Florida Gov. Ron DeSantis gives his State of the State address during a joint session of the Senate and House of Representatives in Tallahassee, Fla., Jan. 9, 2024.
Florida Gov. Ron DeSantis gives his State of the State address during a joint session of the Senate and House of Representatives in Tallahassee, Fla., Jan. 9, 2024.
AP Photo/Gary McCullough

FORT LAUDERDALE, Fla. (AP) — A federal judge on Tuesday struck down a 2023 Florida law that blocked gender-affirming care for transgender minors and severely restricted such treatment for adults, calling the statute unconstitutional.

Senior Judge Robert Hinkle said the state went too far when it barred transgender minors from being prescribed puberty blockers and hormonal treatments with their parents’ permission. He also stopped the state from requiring that transgender adults only receive treatment from a doctor and not from a registered nurse or other qualified medical practitioner. And he barred a ban on online treatment for transgender adults.

Hinkle said transgender people are constitutionally entitled to the legitimate treatment they need and, quoting the late Rev. Martin Luther King Jr., compared those who oppose it to those who were once against equality for minorities and women.

“Some transgender opponents invoke religion to support their position, just as some once invoked religion to support their racism or misogyny,” Hinkle wrote in his 105-page decision. “Transgender opponents are of course free to hold their beliefs. But they are not free to discriminate against transgender individuals just for being transgender.

“In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished,” he continued. “To paraphrase a civil-rights advocate from an earlier time, the arc of the moral universe is long, but it bends toward justice.”

Republican Gov. Ron DeSantis’ office blasted Hinkle’s ruling, issuing a statement calling it “erroneous,” and vowing to appeal.

“Through their elected representatives, the people of Florida acted to protect children in this state, and the Court was wrong to override their wishes,” the statement said. “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.”

But those who sued the state celebrated the decision.

Lucien Hamel, a transgender adult, issued a statement saying, “I’m so relieved the court saw there is no medical basis for this law — it was passed just to target transgender people like me and try to push us out of Florida.”

“This is my home. I’ve lived here my entire life,” he said. “This is my son’s home. I can’t just uproot my family and move across the country. The state has no place interfering in people’s private medical decisions, and I’m relieved that I can once again get the healthcare that I need here in Florida.”

A mother of one of the children who sued said, “This ruling means I won’t have to watch my daughter needlessly suffer because I can’t get her the care she needs.”

“Seeing Susan’s fear about this ban has been one of the hardest experiences we’ve endured as parents,” said the woman. She was identified in court documents only as Jane Doe and her daughter as Susan Doe to protect their privacy. “All we’ve wanted is to take that fear away and help her continue to be the happy, confident child she is now.”

DeSantis had signed the law last year as he was gearing up for a presidential campaign that was highly based on culture wars.

“We never did this through all of human history until like, what, two weeks ago? Now this is something?” he told cheering supporters as he signed the bill. “They’re having third graders declare pronouns? We’re not doing the pronoun Olympics in Florida.”

At trial, Florida’s attorneys had conceded that the state cannot stop someone from pursuing a transgender identity, but said it can regulate medical care.

For minors, the only treatments at issue are puberty blocking treatments and cross-sex hormones — giving testosterone to someone assigned female at birth, for example. Those who were undergoing treatment when the law was adopted in May 2023 were allowed to continue. Surgery, which is rare for minors, was still blocked.

For adults, treatment was still allowed but could only be done by a physician instead of an advanced practice registered nurse or other professional. It required the patient to sign a consent form in person while in the same room with the doctor, meaning the treatment couldn’t be done on a video call or otherwise online — something not normally required with other medical procedures. Violators could be charged criminally and medical providers could lose their licenses.

Hinkle wrote that Florida had long allowed treatment for gender dysphoria, the feeling that one’s gender identity does not match one’s sex as registered at birth.

“But then the political winds changed,” Hinkle wrote. He was appointed to the bench by Democratic President Bill Clinton in 1996.

For 99% of people, Hinkle wrote, their biological sex and their gender identity are the same. But for a few, they differ. Hinkle said the state admitted that during the trial, even if some won’t believe it and think transgender people are making a choice like “whether to read Shakespeare or Grisham.”

“Many people with this view tend to disapprove of all things transgender and so oppose medical care that supports (it),” he said.

He said even though the state concedes it cannot constitutionally block people from identifying as transgender and presenting themselves as they wish, several legislators made it clear in their comments that this was their goal.

At least 25 states have adopted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits.

The only other one to be struck down so far as unconstitutional is the ban in Arkansas, which the state has appealed to the 8th U.S. Circuit Court of Appeals.

Advocates are asking the U.S. Supreme Court to block Tennessee’s ban on gender-affirming care for minors.

Judges’ orders are in place temporarily blocking enforcement of a ban in Montana and aspects of the ban in Georgia.