Of interest, for obvious reasons.
Florida can no longer enforce its ban against transgender youth receiving gender-affirming care, or its restrictions against adults accessing gender-affirming care, after a federal district court ruling on Tuesday found those rules to be unconstitutional and fueled by animus against trans people. The ruling is effective immediately.
Although federal courts have blocked many state anti-LGBTQ+ laws, this ruling carries extra significance because Florida was the first state to push for gender-affirming care restrictions for transgender adults. The ruling is also unique because it blocks restrictions enacted through multiple channels: through laws passed in the statehouse as well as restrictions passed through the state’s medical boards.
U.S. District Judge Robert Hinkle’s order is also significant for its admonishment of the state for trying to regulate gender-affirming care based on “anti-transgender animus” instead of medical standards. Florida “cannot flatly deny transgender individuals safe and effective medical treatment — treatment with medications routinely provided to others with the state’s full approval so long as the purpose is not to support the patient’s transgender identity,” Hinkle wrote.
The Florida Surgeon General and the Florida boards of medicine have admitted that impeding transgender people from pursuing their identities is not a legitimate state interest, he wrote — but state legislators and others involved in the state’s gender-affirming care restrictions have still pursued this goal.
“Gender identity is real. Those whose gender identity does not match their natal sex often suffer gender dysphoria. The widely accepted standard of care calls for appropriate evaluation and treatment,” Hinkle wrote, noting that for minors, such care begins with mental health therapy and is followed, when appropriate, with hormone replacement therapy. “Florida has adopted a statute and rules that ban gender-affirming care for minors even when medically appropriate. The ban is unconstitutional.”
Hinkle also found that the state’s rule preventing nurse practitioners from providing gender-affirming care to adults is unconstitutional, as is requiring trans adults to jump through multiple hoops to access care — like signing consent forms that include false information and requiring follow-ups more frequently than medically necessary. These rules led to physicians and pharmacies turning away patients, preventing trans adults across the state from being able to access gender-affirming care.
A similar law in Alabama, though it only involved care for minors, was blocked by a federal district court judge and then later allowed to go into effect by an appeals court. Florida is in the same appellate district as Alabama, and the judge’s ruling addressed that case as well. I recommend you read Law Dork for a detailed analysis of that, as this ruling will be appealed to that same appellate court, the 11th District Court of Appeals.
And while the importance of that case should be clear to us in Texas, it’s more urgent now.
Texas Attorney General Ken Paxton has sued the Biden administration over a new federal rule that he says would require states to pay for gender care procedures for transgender people through their Medicaid programs and require health care providers to perform them.
“This is yet another example of Joe Biden trying to sidestep the Constitution and use agency rulemaking to advance unpopular, unlawful, and destructive policies,” Paxton wrote in a press release.
At issue is a new Biden administration rule regarding a section of the Affordable Care Act that pertains to nondiscrimination. The section particularly bans discrimination based on gender.
In 2016, the Obama Administration interpreted it to protect against gender identity and sex stereotyping but not sexual orientation. Four years later, the Trump administration didn’t change the section but suggested it would interpret sex to mean only sex assigned at birth.
But the Biden administration in March issued rules that said the protections apply to gender identity and sexual orientation.The administration, through the U.S. Department of Health and Human Services, included specific protections for transgender people, including saying that providers can’t deny transition care that would be provided to other people for other purposes. It does, however, allow for some providers to make religious freedom claims.
The story doesn’t say, but I assume this will go before one of Paxton’s handmaiden judges, so we know how the script will play out. At some point, this will be back before SCOTUS. At least we have Judge Hinkle’s order to go on. CNN and the Associated Press have more.
Some interesting polling data on the issue:
https://uh.edu/news-events/stories/2023/august-2023/08292023-transgender-rights-survey.php