Judge Sides With Families Fighting Florida’s Ban on Gender Care for Minors

Jul 26, 2023

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A federal judge wrote that the plaintiffs suing to block the new law are "likely to prevail on their claim that the prohibition is unconstitutional."

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By Rick Rojas and Azeen Ghorayshi

A federal judge in Florida issued a scathing assessment on Tuesday of the state's ban on gender transition care for minors, asserting in a ruling that the families with transgender children who sued the state are "likely to prevail on their claim that the prohibition is unconstitutional."

Judge Robert L. Hinkle of Federal District Court in Tallahassee ruled specifically that three transgender children can be prescribed puberty blockers despite the new state law, which also adds new hurdles for adults who seek similar care.

But as legal challenges have been mounted to new restrictions on transition care that have been enacted across the country, Judge Hinkle's ruling exemplifies the kind of chilly reception that the bans may receive from judges.

"Gender identity is real," Judge Hinkle wrote, adding that "proper treatment" can include mental health therapy followed by puberty blockers and hormone treatments. "Florida has adopted a statute and rules that prohibit these treatments even when medically appropriate."

The judge issued a preliminary injunction in response to an emergency request by the families of the three children. They and others had sued the state of Florida in March over an administrative ban on gender transition care for minors, and then widened their suit to take in the new law after Gov. Ron DeSantis, a Republican, signed it May 17.

The plaintiffs had urged Judge Hinkle specifically to block one part of the law that bars doctors and nurses from prescribing or administering transition-related medication to children, and another part that exposes medical providers to criminal liability and professional discipline for doing so.

The injunction granted by Judge Hinkle does not apply to other aspects of the far-reaching legislation, which also bars gender-transition surgery for minors, alters child custody statutes to treat transition care as equivalent to child abuse, and forbids the use of state funds to pay for transition care.

Even so, the judge wrote dismissively of the arguments offered by the state, calling them "a laundry list of purported justifications for the statute and rules" that were "largely pretextual and, in any event, do not call for a different result."

Concerning the state's claim that professional associations that endorsed gender transition care had done so for political reasons, the judge wrote: "If ever a pot called a kettle black, it is here. The statute and the rules were an exercise in politics, not good medicine."

Lawyers for the plaintiffs’ families interpreted the ruling on Tuesday as possibly extending to other transgender minors throughout the state.

"The court addressed the specific question in front of it, but also issued a very strong ruling that says the bans are unlikely to survive constitutional scrutiny," said Jennifer Levi, a lawyer for the plaintiffs and the senior director of transgender rights at GLBTQ Legal Advocates & Defenders.

She noted that Judge Hinkle's 44-page ruling drew conclusions far beyond the scope of the three families in the case. "The power of the ruling is to make clear that the law is unconstitutional," she said.

The Florida Department of Health declined to comment on the ruling, citing the continuing litigation.

The legislation codifies policies adopted last year by the Florida Board of Medicine and Board of Osteopathic Medicine — whose members are appointed by the governor — that banned hormone treatments for people under 18 unless they were already receiving such care. Judge Hinkle's order also temporarily blocked those rules as they pertain to the three plaintiffs.

The law also includes penalties for doctors who violate it, including prison terms of up to five years. It goes beyond similar legislation in other states by adding new restrictions for adults receiving transition care, including requirements that consent forms be signed and prescriptions for hormone treatments be obtained in person instead of through a telemedicine appointment.

Under the new law, only doctors are allowed to prescribe transition-related medication; nurse practitioners and physician assistants, who have been providing the treatments for many patients, can no longer do so. Those provisions were not blocked by the judge's order, and remain in effect.

More than a dozen states have adopted bans or other restrictions on transition-related care for children and teenagers in the past year. Proponents say the bans protect children from medical treatments they see as harmful and unproven. But that stance defies much of the medical establishment, which views the care as medically necessary and beneficial for some children who have gender dysphoria.

Opponents of the Florida law say it stands out for being "particularly meanspirited," as the Human Rights Campaign described it.

Lawyers for the families argued that the law threatened to cause irreparable harm, because parents would be "deprived of their fundamental right to make medical decisions for their children" and the children themselves would "suffer a cascade of mental and physical injuries" from being denied care.

After the bill was passed, Planned Parenthood warned patients that it would suspend providing gender transition care in its Florida clinics until mid-June, so that it could develop new consent forms for adults receiving the care and change its practices to comply with the new law. Other clinics that relied on nurse practitioners to provide care have stopped prescribing it indefinitely.

Before he signed the legislation, Mr. DeSantis, who has since announced a presidential bid, criticized puberty blockers and other forms of gender transition care for children. "That is wrong, and we’re glad that we put a stop to that in the state of Florida," he said.

"It is wrong to be sexualizing these kids," he added. "It's wrong to have gender ideology and telling kids that they may have been born in the wrong body."

The legislation was part of an avalanche of measures focused on L.G.B.T.Q. people that Florida's Republican-controlled State Legislature passed during its annual session.

Lawmakers advanced bills that require public school employees to call students by the pronouns matching the gender on their birth certificate, no matter the child's preference; that make it a misdemeanor to use restrooms in public buildings that do not correspondent to the person's gender at birth; and that punish businesses that admit minors to "adult live performances," including drag shows.

Now that a preliminary injunction has been issued, the plaintiffs’ legal challenge to the law will move forward.

It remains unclear how bans on gender transition care for minors will ultimately fare in the courts. One indication could be imminent: A judge is expected to rule soon on a lawsuit to overturn legislation passed in Arkansas in 2021 that was the first to forbid medical treatments for children and teenagers seeking gender transitions.

Rick Rojas is a national correspondent covering the American South. He has been a staff reporter for The Times since 2014. @RaR

Azeen Ghorayshi covers the intersection of sex, gender and science for The Times.

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