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U.S. Court of Appeals for the Eleventh Circuit Hears Challenge to Florida’s Ban on Healthcare for Transgender Individuals

Families and adult plaintiffs urge the Court to affirm previous ruling blocking enforcement of healthcare bans and restrictions.

This morning, the U.S. Court of Appeals for the Eleventh Circuit heard oral arguments in Doe v. Ladapo, a constitutional challenge to Florida’s law and rules that bar families from accessing medical care for their transgender adolescent children, and place unprecedented restrictions on care for transgender adults. 

After conducting a full trial, U.S. District Judge Robert Hinkle issued a final ruling on June 11, 2024, finding the law and rules unconstitutional and unenforceable on equal protection grounds. Applying the framework established in Village of Arlington Heights v. Metropolitan Housing Development Corp., the District Court found that the evidence demonstrated the Florida law and rules were motivated by purposeful discrimination against transgender people and could not survive constitutional scrutiny.

The Florida defendants appealed the case to the Eleventh Circuit, which temporarily stayed Judge Hinkle’s order in September 2024. This means the challenged bans and restrictions are currently in effect, blocking access to needed medical care for some transgender Floridians while the appeal proceeds. The Eleventh Circuit’s decision will have significant implications for how courts analyze similar restrictions being enacted across the country.

Jane Doe, on behalf of herself and her daughter Susan Doe (proceeding anonymously): “It is demoralizing and heart-wrenching to live in a state that has politicized my child’s very existence, weaponizing the power of the state to attack her basic rights and dignities. As a mother who simply wants to protect and love my child for who she is, I pray that the Eleventh Circuit will affirm the district court’s thoughtful and powerful order, restoring access to critical healthcare for all transgender Floridians. No one should have to go through what my family has experienced.” 

Lucien Hamel, on behalf of himself: “As a transgender adult just trying to live my life and care for my family, it is so demeaning that the state of Florida thinks it’s their place to dictate my healthcare decisions. Members of the legislature have referred to the high quality healthcare I have received, which has allowed me to live authentically as myself, as ‘mutilation’ and ‘an abomination’ and have called the providers of this care ‘evil.’ We hope the appellate court sees these rules and laws for what truly are: cruel.” 

The plaintiffs in Doe v. Ladapo are represented by GLBTQ Legal Advocates & Defenders (GLAD Law), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), Lowenstein Sandler LLP, and Jenner and Block LLP. Adam Unikowsky, partner at Jenner and Block LLP, argued for the plaintiffs-appellees today.

“The state has invested inordinate sums of time, energy, and taxpayer dollars into eroding the rights of transgender Floridians in recent years,” said Simone Chriss, Director of the Transgender Rights Initiative at Southern Legal Counsel. “The state has loudly and proudly enacted bans on transgender people accessing healthcare, using bathrooms, transgender teachers using their pronouns and titles, and a slew of other actions making it nearly impossible for transgender individuals to live in this state. The District Court reviewed the extensive record evidence in this case to conclude that the rules and law banning medically necessary healthcare for transgender minors and restricting access to such care for transgender adults were motivated by animus, not science or evidence. The state has not and cannot justify its intrusion into the medical decision making between patients, families, and medical providers.”   

“Every parent just wants what’s best for their kids. By denying access to critical medical care for transgender youth, the state of Florida is causing unnecessary harm and cruelly forcing families to navigate heartbreaking circumstances simply for supporting their children,” said HRC Vice President of Legal Sarah Warbelow. “These bans ignore science and unfairly target transgender youth—and the district court agrees. When presented with the facts about these healthcare bans, courts overwhelmingly recognize their unconstitutionality. We urge the U.S. Court of Appeals for the Eleventh Circuit to do the same.” 

“The district court’s finding of purposeful discrimination by the Florida defendants is solidly grounded in the evidence it heard during a three-day trial,” said Thomas Redburn, partner at Lowenstein Sandler LLP. “The defendants have offered nothing on appeal that could serve as a valid basis for overturning that finding.”

“The record is clear that this ban was not based in medical science, it was passed to harm transgender adults, children and their families in Florida,” said Jennifer Levi, Senior Director of Transgender and Queer Rights at GLAD Law. “Not only does this dangerous law take away parents’ freedom to make responsible medical decisions for their child, it inserts the government into private health care matters that should be between adults and their providers.”


“Transgender adults don’t need state officials looking over their shoulders, and families of transgender youth don’t need the government dictating how to raise their children,” said Shannon Minter, Legal Director of NCLR. “The district court heard the evidence and found that these restrictions are based on bias, not science. The court of appeals should affirm that judgment.” 

Learn more about Doe v. Ladapo.

News

Florida Families File Brief Against Arbitrary Ban on Healthcare for Transgender Youth

“As a parent, it is heartbreaking to see my right to make healthcare decisions for my child taken away by political bullies, and the hurt and harm that has caused my child.” 

Yesterday, Florida families challenging the state’s ban on medical care for transgender youth urged the Eleventh Circuit to strike down the ban because it was based on animosity toward transgender people and has no basis in medical science. Striking down the ban would affirm the earlier lower federal court decision, which took this action based on this reasoning.

Federal district court Judge Robert Hinkle issued an order on June 11 declaring that Florida’s ban on medical care for transgender youth and its unprecedented restrictions of care for transgender adults are unconstitutional and may not be enforced. Judge Hinkle issued his order after a multi-day trial including multiple witnesses and experts. In a 105-page decision, Judge Hinkle found that the evidence, including statements made by sponsors and key supporters of the law, overwhelmingly showed that a majority of legislators who voted for these restrictions on healthcare were “motivated by anti-transgender animus.”

“I love my child and want to get her the healthcare she needs,” said Plaintiff Jane Doeparent of Susan Doe. “As a parent, it is heartbreaking to see my right to make healthcare decisions for my child taken away by political bullies, and the hurt and harm that has caused my child.”

Following Judge Hinkle’s order, the State of Florida appealed his decision to the Eleventh Circuit Court of Appeals, which will decide whether to affirm or reverse his decision. Last month, a panel of the Eleventh Circuit stayed Judge Hinkle’s order pending its resolution of the appeal, which means that the challenged laws are currently in effect, depriving Florida families and transgender adults of the ability to obtain medical care.

As Judge Hinkle noted in his order, “the overwhelming weight of medical authority” supports making these treatments accessible to transgender people, and permitting Florida to enforce these arbitrary restrictions “will cause needless suffering for a substantial number of patients.”

Judge Hinkle also found that the administrative process that resulted in Board of Medicine and Board of Osteopathic Medicine rules banning medical care for transgender minors was riddled with bias and radical departures from the Boards’ ordinary practices, noting that “the Boards departed from their usual procedures, orchestrated public hearings, and single-mindedly pursued the predetermined outcome sought by the Governor and Surgeon General.” Judge Hinkle further noted that the State of Florida had failed to identify even a single person who has been harmed by the provision of this healthcare in Florida. 

The families and adults challenging Florida’s restrictions are represented by GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP.

Learn more about the case Doe v. Ladapo, including the July 11 order denying the State’s request for a stay and the June 11 decision finding Florida’s health care ban unlawful and blocking its enforcement.

News

Statement on 11th Circuit Order Allowing Florida Transgender Health Ban to Take Effect

 In 2-1 ruling, 11th Circuit Allows Florida Transgender Health Ban to Take Effect Pending Action on State’s Appeal of Decision Blocking the Law

Today a divided panel of the 11th Circuit Court of Appeals stayed a federal district court decision blocking enforcement of the Florida laws banning health care for transgender minors and restricting it for transgender adults. The 2-1 ruling allows the state to enforce the laws while the Court hears Florida’s appeal of the June 11 decision finding that SB 254 and the Boards of Medicine rules unlawfully targeted transgender people. 

Writing in dissent, Judge Wilson found that the district court had “identified sufficient record evidence to support concluding that the act’s passage was based on invidious discrimination against transgender adults and minors,” and that “withholding access to gender-affirming care would cause needless suffering.”

The organizations representing the plaintiffs in Doe v. Ladapo, GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP, issued the following statement in response to today’s ruling:

“We are deeply disappointed by this decision and the panel’s disregard for the district court’s careful findings and adherence to the Eleventh Circuit’s recent precedent. Allowing these discriminatory restrictions to go back into effect will deny transgender adults and adolescents lifesaving care, and prevent Florida parents from making medical decisions that are right for their children. As the district court found based on voluminous evidence, the record shows that these extraordinary restrictions were based on disapproval of transgender people and serve no purpose other than to harm transgender Floridians. The plaintiffs in this case are considering their options and will take every step possible to protect their right to equal treatment under Florida’s laws, which these restrictions egregiously violate. We will continue fighting for transgender Floridians and their families, and for everyone’s right to make healthcare decisions without government interference.”

Learn more about Doe v. Ladapo

News

Federal Court Continues to Block Enforcement of Florida’s Ban on Medical Care for Transgender Youth, Rebukes State Defendants for “Misleading Assertions”

“With legislators having loudly and proudly proclaimed their [anti-transgender] bias, the defendants ought not be allowed to hide from it now”

Yesterday, federal district court judge Robert Hinkle denied the State of Florida’s request to stay a June 11 decision blocking enforcement of Florida’s law banning health care for transgender minors and restricting it for transgender adults. 

In a sharply worded opinion Thursday, Judge Hinkle rebuked the State of Florida for making “misleading assertions,” stating:  

“With all the state’s resources and the full range of discovery available under the Federal Rules of Civil Procedure, the state was unable to present evidence of even a single instance of improper provision of care in Florida. The state was unable to present evidence of even a single departure in this state from the widely accepted Endocrine Society and WPATH standards of care. Perhaps most importantly, the state was unable to present evidence of even a single patient who suffered adverse consequences or came to regret care received in this state.” 

In addition, Judge Hinkle noted that “the evidence that animus motivated at least some legislators is overwhelming, indeed undisputed,” citing evidence “that a legislator loudly called transgender individuals ‘demons’ and ‘imps,’ another called them ‘evil,’ and a sponsor said ‘good riddance’ to any transgender individual who left the state.” 

“With legislators having loudly and proudly proclaimed their bias,” Judge Hinkle concluded, “the defendants ought not be allowed to hide from it now.”

The plaintiffs in Doe v. Ladapo are represented by GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP.

“We are profoundly grateful that Judge Hinkle denied the state of Florida’s request to stay the order that restored access to gender-affirming healthcare for all transgender Floridians,” said Simone Chriss, Director of the Transgender Rights Initiative at Southern Legal Counsel. “I have the privilege of working with many of the providers in the state of Florida who provide medical care to the transgender community, and I am so grateful for the Court’s strong repudiation of the state’s misleading assertions and baseless attacks on these providers. This is a good day for Floridians.”

“The Court continues to find that this transgender healthcare ban was absolutely rooted in anti-LGBTQ+ animus and discrimination—not medicine,” said Sarah Warbelow, Human Rights Campaign Vice President of Legal. “This strong repudiation from Judge Hinkle is just another example of how laws targeting and attacking transgender youth are abuses of political power by discriminatory lawmakers. Transgender adults, youth, and their families deserve the same access and ability to make healthcare decisions with their own medical providers and we are glad to see that preserved in Florida.”

“The Court correctly denied the defendants’ request for permission to continue enforcing clearly unconstitutional restrictions on access to needed care based on pretextual government interests they never substantiated at trial,” said Thomas Redburn, partner at Lowenstein Sandler LLP. “ We are very pleased with the decision.”  

“Today’s ruling forcefully reiterates that health care access must be based on sound principles of medicine, not politics or bias,” said Jennifer Levi, Senior Director of Transgender and Queer Rights at GLAD. “As the court found, the state of Florida has not been able to provide a single instance of a Florida transgender adolescent or adult receiving inappropriate treatment or experiencing regret over care they have received in the state. We are relieved that transgender people and their families in Florida will continue to be able to make the health care decisions that are right for them.”


“We are pleased the court will continue to enforce this important decision, which correctly found that Florida’s ban on lifesaving medical care for transgender youth and adults was based on bias, not facts,” said Shannon Minter, legal director of NCLR. “Like other similar laws around the country, Florida’s ban was passed impulsively, without any attempt to genuinely understand this area of health care or the best interests of transgender youth and their families. The State of Florida continues to ignore the facts and make unsupported and, in some cases, outlandish claims. We are grateful to Judge Hinkle for calling these state officials to task for their misrepresentations.”   

Further information about the case Doe v. Ladapo, including the July 11 order denying the State’s request for a stay and the June 11 decision finding Florida’s health care ban unlawful and blocking its enforcement are available here.

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Southern Legal Counsel, Inc. (SLC) is a Florida statewide not-for-profit public interest law firm that is committed to the ideal of equal justice for all and the attainment of basic human and civil rights. SLC’s Transgender Rights Initiative protects the rights of Florida’s LGBTQ+ community through federal impact litigation, policy advocacy, and individual representation. www.southernlegal.org

The Human Rights Campaign (HRC) is America’s largest civil rights organization working to achieve lesbian, gay, bisexual and transgender equality. HRC envisions a world where LGBTQ+ people are embraced as full members of society at home, at work and in every community. www.hrc.org 

The National Center for Lesbian Rights (NCLR) is a national legal organization committed to advancing the human and civil rights of the lesbian, gay, bisexual, transgender, and queer community through litigation, public policy advocacy, and public education. Since its founding, NCLR has maintained a longstanding commitment to racial and economic justice and the LGBTQ community’s most vulnerable. www.nclrights.org 

Through strategic litigation, public policy advocacy, and education, GLBTQ Legal Advocates & Defenders (GLAD) works to create a just society free of discrimination based on gender identity and expression, HIV status, and sexual orientation. www.glad.org

News

Federal Court Blocks First State Law Restricting Health Care for Transgender Adults; State of Florida Loses Federal Challenge as Court Blocks Law Targeting Adults and Adolescents

Ruling in Doe v. Ladapo, permanently blocks adult and minor health care restrictions in Florida SB 254 and finds that Florida unlawfully targeted transgender people, in challenge brought by GLAD, NCLR, the Human Rights Campaign Foundation, Southern Legal Counsel, and Lowenstein Sandler

June 11, 2024 (TALLAHASSEE) — A federal district court has permanently blocked Florida from enforcing a law that bans medical care for transgender adolescents and restricts it for transgender adults. The ruling in Doe v. Ladapo found that Florida SB 254 and the related Boards of Medicine (BOM) rules were motivated by disapproval of transgender people and violate the equal protection rights of transgender individuals and parents of transgender minors in Florida. Florida was the first state to pass a law restricting access to health care for transgender adults. Today’s ruling permanently blocks those restrictions as well as the ban on care for adolescents, which the Court preliminarily blocked last June.

In issuing its ruling the Court found the health care restrictions in SB 254 to be motivated unlawfully by disapproval of transgender people, not by science, writing:

“Transgender opponents are of course free to hold their beliefs. But they are not free to discriminate against transgender individuals just for being transgender. In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished. To paraphrase a civil-rights advocate from an earlier time, the arc of the moral universe is long, but it bends toward justice.

“In the meantime, the federal courts have a role to play in upholding the Constitution and laws. The State of Florida can regulate as needed but 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.

Florida restricted medical care for transgender people in 2023 along with enacting a host of other anti-transgender laws. In addition to completely banning medical care for transgender adolescents, Florida restricted health care even for transgender adults, marking the first time any state passed such an extreme law. 

At a three-day trial in December 2023, plaintiffs presented extensive expert testimony that these restrictions have no medical basis. The court heard testimony from experts in psychiatry, endocrinology, medical ethics, and pediatric medicine regarding the well-established standards for providing this medical care, the decades of evidence proving its safety and efficacy, and the severe harms caused  when care is denied.

Plaintiff parents also described how being able to obtain doctor-recommended care has benefitted their children and the suffering Florida’s ban has caused them. Adult Plaintiff Lucien Hamel testified that he has been unable to get the medical care he needs anywhere in Florida since SB 254 went into effect.

Jane Doe, on behalf of herself and her daughter Susan Doe (proceeding anonymously):

“This ruling means I won’t have to watch my daughter needlessly suffer because I can’t get her the care she needs. Seeing Susan’s fear about this ban has been one of the hardest experiences we’ve endured as parents. All we’ve wanted is to take that fear away and help her continue to be the happy, confident child she is now.”

Gloria Goe, on behalf of herself and her son Gavin Goe (proceeding anonymously):

“This ruling lifts a huge weight and worry from me and my family, knowing I can keep getting Gavin the care he needs and he can keep being the big-hearted, smiling kid he is now. I’m so grateful the court saw how this law prevented parents like me from taking care of our children.”

Lucien Hamel, on behalf of himself:

“I’m so relieved the court saw there is no medical basis for this law—it was passed just to target transgender people like me and try to push us out of Florida. This is my home. I’ve lived here my entire life. This is my son’s home. I can’t just uproot my family and move across the country. The state has no place interfering in people’s private medical decisions, and I’m relieved that I can once again get the healthcare that I need here in Florida.”

The plaintiffs in Doe v. Ladapo are represented by GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP.

Jennifer Levi, Senior Director of Transgender and Queer Rights, GLBTQ Legal Advocates & Defenders:

“Today’s ruling is a huge win for transgender people and their families. It confirms that health care access must be based on principles of good medicine, not politics.  The court today found there is no legitimate purpose for the extraordinary restrictions Florida has put on transgender people’s ability to obtain needed medical care. The decision will no doubt bring huge sighs of relief across Florida by transgender people and those who love them.”

Shannon Minter, Legal Director, National Center for Lesbian Rights:

”As today’s decision clearly holds, the Constitution does not permit Florida or other states to selectively deny medical care to transgender people. We are grateful to the court for protecting our clients and other transgender people in Florida from this dangerous law, and we hope this decision will deter other states from seeking to impose similar restrictions.”    

Simone Chriss, Director of Transgender Rights Initiative, Southern Legal Counsel:

“The federal court saw Florida’s transgender minor healthcare ban and adult restrictions for what they are—discriminatory measures that cannot survive constitutional review. Today’s ruling blocks the state of Florida’s cruel campaign to deny fundamental rights and basic healthcare to its transgender citizens. We are so proud of our brave plaintiffs, without whom we could not have achieved this victory for the state of Florida.”

Sarah Warbelow, Vice President of Legal, Human Rights Campaign Foundation:

“The state of Florida has shown blatant discriminatory intent toward transgender people, and today’s ruling makes clear that is not permissible. There is no sound reason to deprive people of the ability to make best-practice, medically necessary healthcare decisions for themselves—especially when the trade-off is the heartache and distress of children and parents.”

Thomas Redburn, Lowenstein Sandler LLP:

“The federal court recognized the severe harm to Floridians caused by the healthcare restrictions in SB 254 and the related Boards of Medicine rules. Today’s ruling affirms the principle that individuals should be able to make informed decisions about their own personal medical treatments without discrimination by the State.”

About Florida’s Ban on Transgender Medical Care

Florida’s minor transgender healthcare ban was first enacted in March 2023 through the adoption of rules by the Florida Board of Medicine and Florida Board of Osteopathic Medicine, at the urging of the Governor, Surgeon General Joseph Ladapo, and the Florida Department of Health. SB 254, which was passed by the legislature, signed by the governor and took effect in May 2023, cemented into state law the ban on essential medical care for transgender minors, subject to a narrow continued-use exception for minors who had started treatment before the ban. SB 254 also created felony criminal and civil penalties for Florida medical providers.

Later, SB 254 added severe restrictions that effectively blocked access to essential medical care for transgender adults and transgender minors who would be eligible for the continued-use exception, including requiring that care be provided exclusively by physicians, barring telehealth, and requiring patients to complete unique, onerous and misleading consent forms.

The case was heard in the U.S. District Court for the Northern District of Florida on December 13, 14, and 21. 

Additional information about the case, Doe v. Ladapo, is available at www.glad.org/ladapo 

News

Federal Trial Concludes in Challenge to the First State Law Attempting to Deprive Transgender Adults of Healthcare, Florida’s SB 254

Multiple days of powerful testimony highlight the danger and lack of justification for the first law in the country that would seek to deprive transgender adults of healthcare in addition to banning care for adolescents

A three-day federal trial in Doe v. Ladapo, the legal challenge to Florida SB 254 and related Boards of Medicine (BOM) rules that restrict access to medical care for transgender adults and criminally ban medical care for transgender adolescents, concluded Thursday in Tallahassee.  While some other states have restricted medical care for transgender adolescents, many of which have been enjoined by federal courts, Florida has taken this to new extremes by targeting healthcare for transgender adults.

Over multiple days of testimony, plaintiffs described the harms of depriving them or their adolescent transgender children of medically necessary care. Parents explained how being able to obtain doctor-recommended care has made their children’s lives better and resulted in happier, healthier kids, and described the intense suffering that SB 254 has caused them. Plaintiff Lucien Hamel testified that SB 254 has prevented him from being able to access necessary care for himself as an adult anywhere in Florida. 

The new law imposes a web of restrictions that effectively require most transgender adults to leave the state to obtain care. As Hamel testified, this is not a possibility for many Floridians. “The only answer I kept hearing from the community and others was, ‘Just leave Florida,’” he told the court. “I can’t leave Florida. This is my home. I’ve lived here my entire life. This is my son’s home, and for various reasons, I can’t just up and uproot my family and move across the country.”

Statements from plaintiffs

Jane Doe, on behalf of herself and her daughter Susan Doe (proceeding anonymously):

My worst nightmare is having to watch my child suffer because I can’t get her what she needs. We saw how our daughter Susan suffered before we were able to consult with our team of doctors to understand what she was experiencing and make the most informed decisions about her care. She is a happy, confident child now, but if we can’t get her the medical care her doctors recommend I know that’s going to go away. Seeing Susan’s own fear about what will happen to her because of this ban has been one of the hardest experiences we’ve endured as parents. Nobody with a heart could ever do this to her.

Gloria Goe, on behalf of herself and her son Gavin Goe (proceeding anonymously):

If you have children, you will do anything and everything to protect them, to provide what they need. SB 254 is prohibiting my ability as a parent to do that. My son Gavin is one of those children who simply stands out. He’s big-hearted. He is full of zest. He’s always smiling. But I am unable to get him the care he needs in Florida and am greatly concerned about what that means for his mental health and his overall well-being.

Lucien Hamel, on behalf of himself:

Being forced to abruptly stop my medical care this summer has been devastating for both me and my family. I received my care from a competent medical provider that I really trusted. Then I was told that Florida law suddenly won’t let APRNs and Nurse Practitioners provide the care I need. I can’t get an appointment with a physician anywhere in the state. There’s no medical basis for this change – it’s just preventing transgender Floridians like me from getting care. I’m scared and frustrated because I know my health will continue to decline the longer I have to wait, putting incredible stress on me, my wife, and our child.

Multiple medical experts also testified about the well-established standards and guidelines for transition-related care for adolescents and adults, the decades of clinical evidence proving its safety and efficacy, and the damaging impact of the state’s unjustified restrictions on adult patients and providers and, in the case of adolescents, complete ban on care, including criminal penalties for doctors and other health care providers.

The well-established standards of transgender medical care for adolescents and adults have been endorsed and adopted by every major U.S. medical and mental health association.

Medical experts providing testimony

  • Dr. Aron Janssen MD, Vice Chair of Clinical Affairs, The Pritzker Department of Psychiatry and Behavioral Health and Associate Professor of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
  • Dr. Daniel Shumer MD, Pediatric Endocrinology Specialist, Associate Professor in the Department of Pediatric Endocrinology, University of Michigan; 
  • Dr. Dan Karasic MD, Professor Emeritus, Psychiatry, University of California San Francisco Weill Institute for Neurosciences; 
  • Dr. Loren Schechter MD, Plastic Surgery Services, RUSH University Medical Center, Chicago IL
  • Dr. Kenneth Goodman, PhD, FACMI, FACE, Director, Institute for Bioethics and Health Policy; Director, UM Ethics Programs
  • Dr. Vernon Langford, DNP, Autonomous APRN, FNP-C, President of the Florida Association of Nurse Practitioners;
  • Dr. Brittany Bruggeman MD, Pediatric Endocrinologist, Assistant Professor of Pediatrics, University of Florida

Plaintiffs’ attorneys from GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP presented evidence that SB 254 and the BOM rules were motivated by the state of Florida’s disapproval of transgender people, have no rational justification, and deny Florida transgender individuals and parents of transgender individuals equal treatment as guaranteed by the U.S. constitution. 

Statements from attorneys

Jennifer Levi, Senior Director of Transgender and Queer Rights, GLBTQ Legal Advocates & Defenders

It’s been a privilege to be able to stand up and represent transgender Floridians and their families. The record could not be more clear. SB 254 and the related Boards of Medicine rules reflect invidious discrimination against transgender people. There is no legitimate purpose for these extraordinary restrictions, which do nothing but create suffering for parents, families, and transgender people across the Sunshine State.

Shannon Minter, Legal Director, National Center for Lesbian Rights

As the testimony presented in this trial overwhelmingly showed, there is no medical basis for this dangerous and unprecedented law, which has taken the extreme step of restricting medically necessary care even for adults and imposing criminal penalties on doctors and other health care professionals simply for doing their jobs. This is massive government overreach, and it should be permanently enjoined.

Simone Chriss, Director of Transgender Rights Initiative, Southern Legal Counsel:

The rules and law challenged in this case are part of an orchestrated campaign by the state of Florida seeking to deny fundamental rights and basic healthcare to its transgender citizens. After putting the state’s justifications for the cruel bans and restrictions on trial, we hope to have demonstrated to the court and the public that discriminatory measures such as these cannot survive constitutional muster. We stand with every transgender individual in the state of Florida and their right to make healthcare decisions free from government interference.

Sarah Warbelow, Legal Director, Human Rights Campaign Foundation:

Despite living in a state that has shown blatant discriminatory intent toward transgender people, the families and plaintiffs involved in this case have put their bravery, resilience and humanity center stage. This trial showed that there is no sound reason to deprive people of the ability to make best-practice, medically-necessary healthcare decisions for themselves—especially when the trade-off is the heartache and distress of children and parents.

Thomas Redburn, Lowenstein Sandler LLP:

We believe we presented a compelling case that demonstrates the severe harm to Floridians by allowing the healthcare restrictions in SB 254 to proceed. As we await the court’s decision, we’re hopeful for a ruling in favor of an individual’s ability to make informed decisions about their own, personal medical treatments without discrimination by the State.

About Florida’s ban on transgender medical care

Florida’s adolescent transgender healthcare ban was first enacted in March 2023 through the adoption of rules by the state Board of Medicine and state Board of Osteopathic Medicine, at the urging of the Governor, Surgeon General Joseph Ladapo, and the state Department of Health. SB 254, which was passed by the legislature, signed by the governor and took effect in May 2023, cemented into state law the ban on essential medical care for transgender minors, subject to a narrow continued-use exception for minors who had started treatment before the ban. SB 254 also created felony criminal and civil penalties for medical providers.

In addition, SB 254 added severe restrictions that effectively block access to essential medical care for transgender adults and transgender minors who would be eligible for the continued-use exception, including requiring that care be provided exclusively by physicians, barring telehealth, and requiring patients to complete unique, onerous and misleading consent forms.

The case was heard in the U.S. District Court for the District of Northern Florida on December 13, 14, and 21. The Court has certified two plaintiff classes in the case: all transgender adults in Florida who seek gender-transition medical care and all transgender minors in Florida who seek gender-transition medical care, and the parents of those minors. The Court also certified a subclass of the second class consisting of all transgender minors in Florida who are totally prohibited from receiving treatments because they did not initiate them before the effective dates of SB 254 and the BOM rules (and thus were not “grandfathered”), and are prohibited by state law from obtaining such care during puberty and adolescence.

Learn more about the case, Doe v. Ladapo

Blog

Taking on Florida’s Transgender Healthcare Ban in Federal Court

When politicians target vulnerable people, civil rights lawyers are on the front lines. Since its founding, GLAD has gone to court to build a factual record to ensure that constitutional guarantees of freedom and equality extend to all of us in the LGBTQ+ community.

Today, Florida is ground zero for a campaign targeting LGBTQ+ people’s right to be ourselves – and three days from now, we’ll be back in a federal courthouse in Tallahassee challenging one of the most restrictive and hostile anti-LGBTQ+ laws in the country, SB 254.

The scope of SB 254 is breathtaking. Brandishing terms like “diabolical,” “evil,” and “bloodsuckers,” Florida legislators cemented into law criminal prohibitions against parents seeking to secure the healthcare transgender adolescents need. The law also, for the first time anywhere in the country, imposed medical restrictions on transgender adults getting the healthcare they need.

The fact is, the Governor, state officials, and legislators who pushed this law wanted to stop transgender people from being transgender. That can’t and won’t happen, but SB 254 is causing many people to suffer.

Members of the team defending transgender rights in Florida posing outside of the federal courthouse
Members of the team defending transgender rights in Florida

At the trial last week, three of our plaintiffs gave powerful, moving testimony about the law’s impact on transgender people and their families.

Lucien Hamel hasn’t been able to get medical care anywhere in Florida since June because of SB 254. He described the sense of dread he felt when the law passed. “I was left with no answers, no support, nothing. And as days continued to pass, my fears grew. How would our care continue? What would we do?”

Parent Jane Doe shared the fear and heartbreak she has for her daughter, Susan, if she can’t continue to provide the care that has allowed Susan to flourish as a happy, healthy, and secure child. “[N]obody with a heart could ever do this to her,” Jane said on the stand, telling the court that SB 254 is “devastating” to her family.

Gloria Goe described how being able to transition also allowed her son Gavin to thrive. “He’s big-hearted. He is full of zest. He’s always smiling.” But as GLAD attorney Chris Erchull asked her to explain how the law has impacted her family, she tearfully shared how fearful she is that SB 254 will take all that away. “If you have children, you will do anything and everything to protect them, to provide what they need,” she said, but “[SB 254] prevents that.”

No parent should have to be put on a witness stand and literally cross-examined in order to get the healthcare her child needs. Standing up for parents, and for transgender people all across Florida who are harmed by this law has been a tremendous honor and privilege.

In the face of political actors who label us “evil” and a federal judiciary that has shifted far right in recent years, the work of civil rights lawyers defending democracy on the front lines has become more essential than ever. 

Today, we are experiencing some of the most difficult battles in our decades-long fight for the equal rights of LGBTQ+ people – in Florida and across the country. GLAD is stepping up to the challenge. We won’t back down.

We will do everything in our power to see SB 254 and other laws targeting our community overturned. And we will never stop striving to ensure we can all realize the freedom and equality guaranteed by our constitution.

Blog by Jennifer Levi, Senior Director of Transgender and Queer Rights

News

Statement on Denial of Preliminary Injunction for Florida SB 254’s Restrictions on Healthcare for Transgender Adults

A Florida federal district court judge today issued an order denying a motion to temporarily block state restrictions on access to healthcare for transgender adults contained in SB 254 while the legal challenge to the law continues.

Attorneys for the plaintiffs issued the following statement:

“The state’s restrictions on well-established health care in SB 254 serve no purpose other than to intentionally prevent transgender people from receiving the care they need. This case is far from over and we will continue to take every legal step to challenge this law that takes away Floridian’s ability to make important decisions about their own lives and hands it over to the government instead. 

We are preparing now for the trial in November at which we intend to lay out the full evidence of the state’s deliberate targeting of transgender Floridians through the harmful, arbitrary, and medically unjustified rules enacted in SB 254. We also encourage transgender Floridians and their families to seek out resources and take all the steps they can to get the essential medical care they need to live healthy and happy lives.

Florida’s SB 254 is part of a broader landscape of laws that are hurting transgender people in Florida and across the country. We will continue to challenge these dangerous bans that deliberately single out transgender people for discriminatory treatment and ignore well-established medical research until they are permanently overturned. 

All of us who believe in fairness, science, and freedom must also keep fighting on every level to ensure people in Florida and across the country can live their lives free from draconian and unlawful attacks on their health and wellbeing.”

A full trial addressing both the restrictions on adult care and the state’s bans on care for transgender adolescents is scheduled for November. The federal district court issued a prior ruling on June 6 halting enforcement of the ban on healthcare for transgender minors and saying the ban is likely unconstitutional. That order remains in effect.

The plaintiffs are represented by GLBTQ Legal Advocates & Defenders (GLAD),  the National Center for Lesbian Rights (NCLR), Southern Legal Counsel, and the Human Rights Campaign Foundation.

Learn more about the case.

News

Transgender Floridians Seek Emergency Block on Adult Healthcare Restrictions in SB 254

Motion for a preliminary injunction in Doe v. Ladapo follows the July 21 filing of an amended complaint adding four adult plaintiffs to the suit challenging Florida’s healthcare ban and seeking class-wide relief for all impacted transgender adults and minors

Four Florida residents filed a motion in federal court yesterday seeking an emergency block on provisions in SB 254 that have created arbitrary, harmful, and medically unjustified restrictions on medically-necessary healthcare for transgender adults. Olivia Noel, Kai Pope, Lucien Hamel, and Rebecca Cruz Evia are all facing dangerous disruptions in their ongoing medical care due to the Florida law.

The motion for preliminary injunction filed yesterday follows the filing of an amended complaint on July 21 expanding the case, Doe v. Ladapo, to challenge state law SB 254’s restrictions on medical care for transgender adults and seeking class-wide relief for all transgender minors and adults who require medical care restricted by SB 254.

“I have been following an established healthcare plan for years, but because of SB 254 my care has suddenly stopped and I can no longer see the provider I trust and who knows my medical history,” said plaintiff Lucien Hamel. “I’m terrified because stopping my care is already having a negative impact on my health and on my family.”

“My physician had to cancel my procedure because of SB 254,” said plaintiff Rebecca Cruz Evia. “I can’t even schedule an appointment with a physician because they are all afraid of this law, even though medical providers have determined this care is medically necessary for me. I’m frustrated and scared about what will happen if I can’t get the care I need.

“I wake up every day feeling like I’m in a nightmare. SB 254 has canceled medically-necessary treatment prescribed for me by my medical team,” said plaintiff Kai Pope.  “As a physician myself, SB 254 alarms me not only because of the devastating harm it is causing me and other transgender Floridians, but because of the disruption it is causing to our healthcare system.”

The plaintiffs are represented by Southern Legal Counsel, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and the Human Rights Campaign, which issued the following statement:

“SB 254’s restrictions on well-established medical care cause profound harm, serve no legitimate purpose, and reflect gross legislative overreach. SB 254 takes away Floridian’s ability to make important decisions about their own lives and hands it over to the government instead. That should alarm us all.

“In addition to banning established medical care for transgender adolescents and creating criminal and civil penalties for those providing such care, SB 254 enacted severe restrictions on access to care for adults. Advanced Practice Registered Nurse – Nurse Practitioners (APRN-NPs) are critical providers of transgender healthcare in Florida. SB 254 now completely bars them from continuing to treat transgender patients. SB 254 also arbitrarily restricts the use of telehealth for transgender patients and requires in-person consultation for the initial prescription of all transition-related care, a requirement that can be impossible to meet for Florida residents who don’t live near a providing physician. Pursuant to SB 254,  the Boards of Medicine have also created mandatory, one-size-fits-all consent forms that defeat the purpose of informed consent by requiring providers to convey false information to their patients and by imposing extremely burdensome, unnecessary, and medically unjustified requirements that transgender patients must meet to obtain even routine transition-related care. Rather than protecting transgender patients, these restrictions intentionally make it difficult or impossible for transgender adults to receive needed medical care. 

“These restrictions serve no medical purpose and intentionally prevent transgender people from receiving the care they need.”

The motion filed yesterday by plaintiffs Olivia Noel, Kai Pope, Lucien Hamel, and Rebecca Cruz Evia seeks an emergency block on all provisions in SB 254 and related Boards of Medicine Rules restricting access to established transgender medical care for adults while their legal challenge to SB 254 continues.

The federal district court issued a prior preliminary injunction on June 6 halting enforcement of the ban on healthcare for transgender minors and saying the ban is likely unconstitutional. That order allows Florida parents to access necessary medical care for their transgender children.

News

Organizations Suing to Stop Florida’s Transgender Health Ban Add Challenge to Restrictions on Adult Care and Request for Class-wide Relief

Organizations challenging Florida’s transgender healthcare ban on behalf of seven families with transgender children filed an amended complaint today expanding the case to address state law SB 254’s harmful restrictions on access to care for adults and seeking class-wide relief for all transgender minors and adults who require medical care restricted by SB 254.

The complaint filed today adds four individual adult plaintiffs to the lawsuit, Doe v. Ladapo: Olivia Noel, Kai Pope, Lucien Hamel, and Rebecca Cruz Evia. These plaintiffs are all facing dangerous disruptions in their ongoing medical care due to the Florida law.

In addition to banning established medical care for transgender adolescents and creating criminal and civil penalties for those providing such care, SB 254 enacted severe restrictions on access to care for adults. Advanced Practice Registered Nurse – Nurse Practitioners are critical providers of transgender healthcare in Florida barred by SB 254 from continuing to treat patients. SB 254 also bars telehealth access and requires in-person consultation for all care, a requirement that is impossible to meet for Florida residents who don’t live near a providing physician. The law and related Boards of Medicine rules also created medically unnecessary and harmful barriers to care and require physicians to convey false information to their patients.

These restrictions serve no medical purpose and intentionally prevent transgender people from receiving the care they need.

The plaintiffs are represented by Southern Legal Counsel, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and the Human Rights Campaign, which issued the following statement:

SB 254’s restrictions on well-established medical care cause profound harm, serve no legitimate purpose and reflect gross legislative overreach. SB 254 takes away Floridian’s ability to make important decisions about their own lives and hands it over to the government instead. That should alarm us all.

On June 6, the federal district court issued a preliminary injunction halting enforcement of Florida’s ban on healthcare for transgender minors and saying the ban is unconstitutional. That order allows Florida parents to access necessary medical care for their transgender children while the legal challenge to the ban continues.

The complaint filed today seeks a permanent block on all provisions in SB 254 and related Boards of Medicine Rules restricting access to established transgender medical care for adolescents and adults.

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