Florida judge allows restrictions on adult transgender care to take effect

A Florida judge has denied a motion to temporarily block a portion of a state law that restricts access to gender-affirming health care for adults, dealing a blow to transgender individuals in a state whose medical care has been significantly disrupted by a slate of policies adopted by Gov. Ron DeSantis (R).

Florida in May joined more than a dozen other states in banning gender-affirming health care for transgender minors under legislation signed by DeSantis. The law, Senate Bill 254, also set up significant barriers for transgender adults to get needed treatment.

District Court Judge Robert Hinkle in June partially blocked the law’s restrictions on gender-affirming health care for transgender youths, ruling that the Florida law prohibits the administration of care “even when medically appropriate” and there is “no rational basis for a state to categorically ban these treatments.”

But the law does “not prohibit adults from obtaining treatments of the kind the plaintiffs seek,” Hinkle wrote in an order filed Monday, responding to a motion seeking an emergency block on the law’s restrictions on adult care.

Four transgender adults in July joined an ongoing lawsuit against Senate Bill 254, arguing that their medical care was unlawfully disrupted by the measure.

Two of the adult plaintiffs, according to the complaint, are currently unable to obtain hormone replacement therapy from providers they have previously relied on, including certified nurse practitioners, because Senate Bill 254 only allows physicians to provide gender-affirming health care.

Two other adult plaintiffs claim their scheduled gender-affirming surgeries were canceled by surgeons who cited Senate Bill 254 as the reason.

Hinkle in his order Monday said adult plaintiffs denied care by certain providers “may be able to obtain the treatment from others” and that a surgeon’s unwillingness to perform a procedure is not related “to anything a preliminary injunction would cure.”

“In short, the adult plaintiffs have not shown they will suffer irreparable harm, between now and the date of a final judgment, caused by any part of the statute or rules as to which the plaintiffs’ challenge is likely to succeed on the merits,” Hinkle wrote.

He added that the adult plaintiffs’ likelihood of success is “significantly lower” following an August decision from the 11th Circuit Court of Appeals that allowed Alabama’s felony ban on gender-affirming health care to take effect.

The Alabama law, which had been blocked by a preliminary injunction for more than a year, makes it a felony punishable by up to a decade in prison for doctors to prescribe puberty blockers or hormones to transgender people younger than 19.

“The use of these medications in general — let alone for children — almost certainly is not ‘deeply rooted’ in our nation’s history and tradition,” a three-judge panel for the 11th Circuit wrote in the Aug. 21 ruling, citing the Supreme Court decision overturning Roe v. Wade.

Legal advocates who brought the challenge to Florida’s Senate Bill 254 did not comment on Hinkle’s ruling directly but said they are prepared to “lay out the full evidence of the state’s deliberate targeting of transgender Floridians” at a trial scheduled for November.

“This case is far from over and we will continue to take every legal step to challenge this law that takes away Floridians’ ability to make important decisions about their own lives and hands it over to the government instead,” attorneys for the plaintiffs said Tuesday in a joint statement.

Since 2021, 23 states have passed laws that heavily restrict or ban gender-affirming health care for transgender individuals, including 20 that have done so this year. While a majority of laws target care for transgender minors, measures passed in states including Florida and Missouri also limit how transgender adults are able to access care considered medically necessary by every major medical organization.