United States: A recent adjudication in the case of Doe v. Ladapo has invalidated SB 254 along with associated medical board mandates, asserting these measures infringe upon the equal protection rights of transgender individuals and the guardians of minors in Florida.
Federal Court Intervenes
A federal judiciary has interdicted the state of Florida from implementing a statute that prohibits gender-affirming healthcare, specifically targeting puberty blockers and hormone replacement therapy for minors while imposing restrictions for adults. This injunction also encompasses pertinent directives from Florida’s medical boards, according to reports by wusf.org.
Judicial Process
This verdict emerges half a year subsequent to a three-day tribunal for Doe v. Ladapo, during which the court was presented with testimonies from experts in psychiatry, endocrinology, medical ethics, and pediatric medicine.
“It reverts Florida to a state of pre-SB 254 Board of Medicine-rules sanity before this absurdity was enacted,” articulated Simone Criss of Southern Legal Counsel. “This essentially reinstates the prerogative of medical decision-making to adults regarding their own bodies and healthcare.”
“It similarly restores the decision-making process for minors to the adolescent, their guardian, and their physician,” Criss elaborated. “That is the appropriate locus for medical care decisions, as per wusf.org.
A spokesperson for Governor Ron DeSantis indicated the state’s intention to contest the ruling.
Medical Consensus
Gender-affirming care for both minors and adults receives endorsement from all major medical and mental health associations in the United States.
Historical Context
For numerous years, Florida sanctioned the use of puberty blockers and hormone replacement therapy, referenced as “cross-sex hormones” in the ruling, for treating gender dysphoria. A report from the Florida Agency for Health Care Administration had previously endorsed the utilization of these treatments.
In the summer of 2022, Florida Surgeon General Dr. Joseph Ladapo and the Department of Health prompted the state boards of Medicine and Osteopathic Medicine to institute a prohibition on all gender dysphoria treatments for individuals under 18, according to wusf.org.
Legislative Action
SB 254 was ratified by the Legislature, signed by Governor DeSantis, and enacted in May 2023. This law enshrined the ban on gender-affirming care for minors, except for those already undergoing treatment, and imposed severe criminal and civil penalties on medical practitioners.
For adults and the few minors already receiving treatment, it mandated that care be administered solely by physicians, prohibited telehealth, and required patients to sign consent forms replete with inaccuracies and transphobic language. Consent forms were already a prerequisite before commencing treatment.
Judicial Pronouncement
US District Judge Robert L. Hinkle’s recent ruling declared last year’s care restrictions unconstitutional, asserting that while Florida can regulate treatments, it cannot deprive transgender individuals of “safe and effective medical treatment,” especially given that similar medications are administered to cisgender patients with state endorsement.
“Opponents of transgender rights may hold their beliefs, but they are not entitled to discriminate against transgender individuals merely for being transgender,” the ruling stated. “Over time, discrimination against transgender individuals will diminish, akin to the reduction of racism and misogyny. To paraphrase a civil rights advocate from a previous era, the arc of the moral universe is long, but it bends towards justice,” as mentioned by wusf.org.
“Medical decisions should be guided by sound medical practice and not political agendas,” affirmed Jennifer Levi, senior director of transgender and queer rights at GLBTQ Legal Advocates & Defenders.
Anticipated Developments
Florida intends to appeal the decision at the US Court of Appeals for the 11th Circuit in Atlanta. The state had previously contested the preliminary injunction in this case, which temporarily lifted the ban on minors last June.
The state has also appealed the ruling in Dekker v. Weida, which invalidated a healthcare rule that denied coverage for transgender Medicaid beneficiaries, a case still pending in the appeals court.
“We disagree with the court’s erroneous rulings on the law, on the facts, and on the science,” stated Julia Friedland, the deputy press secretary for DeSantis, in a communiqué to the News Service of Florida.
Additional Legal Challenges
Another appeal from Florida concerns the use of personal pronouns and titles by educators. State education officials have signaled an intention to appeal a court ruling that blocked the enforcement of a 2023 law compelling a transgender teacher in Hillsborough County to use pronouns consistent with her sex assigned at birth.
The resolution of these appeals could extend beyond a year.
Criss also noted ongoing efforts to challenge state “policies” that prevent trans-Floridians from amending the gender markers on their birth certificates, driver’s licenses, and state IDs.
“I hesitate to term their policies as they bypassed the rulemaking and legislative processes. They emerged surreptitiously by these agencies,” Criss remarked.
Additionally, the case of Claire v. Department of Management Services contests a longstanding rule from the 1970s that excludes coverage for gender-affirming care in state health insurance plans.