Federal judge to weigh temporary halt on transgender health care rules, law

Gov. Ron DeSantis has taken a pincer grip to transgender care by using his administrative power to halt minors from accessing it, prevent state dollars from being used to pay for it, and using his sway over lawmakers to codify the high-profile rules into law.

These changes, which have been roundly criticized as cruel and discriminatory by transgender advocates, will have a key moment in court on Friday.

U.S. District Judge Robert Hinkle is scheduled to hold a hearing in a lawsuit that is challenging rules adopted by medical boards at the insistence of the DeSantis administration as well as the new law (SB 254) that bans minors from receiving gender-affirming care.

DeSantis signed the bill into law Wednesday in a signing ceremony held at a Christian school in the Tampa Bay area.

“Florida is proud to lead the way in standing up for our children,” the Governor said. “As the world goes mad, Florida represents a refuge of sanity and a citadel of normalcy.”

The lawsuit was first filed back in March, but this week attorneys for the groups suing amended it to include a challenge against the new law that was put in place this week by DeSantis. The group had already asked for a preliminary injunction to block the rules but now they also want Hinkle to issue a temporary restraining order to block the law from taking effect as well.

The challenge was filed by three Florida parents and their transgender children: Jane Doe and her daughter Susan Doe; Gloria Goe and her son Gavin Goe; and Linda Loe and her daughter Lisa Loe who argue that the bans violate parents rights to make medical decisions for their children and deny them equal protection under the law.

The request for a TRO in that challenge, Doe v. Ladapo, comes as Hinkle is also considering the legal merits of an Agency for Health Care Administration (AHCA) rule that bans state Medicaid dollars from being spent on transgender health care services for minors and adults. The suit, Decker v. Weida, alleges the rule violates a federal Medicaid rule that requires children be provided access to medically necessary treatment.

“It’s incredibly disingenuous. They pushed all of this through the rulemaking process, which has much less oversight, and it was all carried out by political appointees rather than elected officials who the public can vote out of office,” said Simone Chriss, Director of Transgender Rights Initiative for the Southern Legal Counsel. “They built this record through the back-channel rulemaking process, and are now trying to rely on that record to justify what was just enacted yesterday. It was so strategic and planned and really insidious the way that they carried this out. And what Florida did is different than the way they’ve created these bans in any other state.”

Medical organizations and associations, including the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, American Medical Association and the Endocrine Society, support allowing minors to access gender-affirming care.

Chriss noted that former Rep. Anthony Sabantini filed bills transgender care bills in the 2020, 2021 and 2022 Sessions. They were never heard in committee.

But State Surgeon General and Department of Health Secretary Joseph Ladapo last summer said treatments, such as puberty blockers and hormones, or gender-conforming surgeries, such as mastectomies, should be banned for minors.

Shortly thereafter, Florida Medicaid Director Tom Wallace issued a report deeming the care experimental, and, as such, not covered by Medicaid. In reaching that conclusion, Wallace relied on the same data Ladapo included in his recommendation.

Ladapo then petitioned the Florida Board of Medicine and Board of Osteopathic Medicine, to alter their rules to make it a violation for physicians to provide minors access to health care. The boards, which had been working on increasing regulation over Brazilian Butt Lifts, abandoned their work on those rules to work on Ladapo’s request.

DeSantis had to replace some members with new ones, but ultimately the boards agreed to alter their rules.

“He found an alternative route. And that alternative route allowed him to put in place people who were handpicked to come to this particular outcome — banning the coverage for and provision of gender-affirming care,” Chriss said. “And I think that other states that may not be able to do this through the traditional legislative process are taking note of what the state of Florida did here, and honestly that is what scares me the most. Transgender children need and deserve access to medically necessary, evidence-based health care in our state and all others.”