Scathing federal injunction blocks Florida ban on trans youth healthcare

Statements of relief

The parents are claiming that SB 254 and the Boards of Medicine rules effectively remove their constitutional rights to make informed decisions regarding their children’s healthcare. They also argue that the laws impinge on the equal protection rights of trans adolescents to access necessary and effective medical treatment.

Jane Doe, the lead plaintiff, is fighting the ban on behalf of her daughter. She said:

My husband and I have been heartbroken and worried sick about not being able to care for our daughter in the way we know she needs. I’m sure most any parent can imagine the sense of powerlessness that comes from being unable to do something as basic as get medical care for your child. Today my entire family is breathing a huge sigh of relief knowing we can now access the treatment that we know will keep Susan healthy and allow her to continue being the happy, confident child she has been.

The plaintiffs are being represented by Southern Legal Counsel, the National Center for Lesbian Rights, GLBTQ Legal Advocates and Defenders, and the Human Rights Campaign. Together, they stated that:

Today’s ruling is a powerful affirmation of the humanity of transgender people, the efficacy of well-established, science-based medical care, and of the rights of parents to make informed healthcare decisions for their children. The court recognized the profound harm the state of Florida is causing by forcing parents to watch their kids suffer rather than provide them with safe and effective care that will allow them to thrive. We are incredibly relieved that these Florida parents can continue to get healthcare for their children while we proceed to challenge these bans and eventually see them fully overturned.

Florida court slams trans ban

The case against the SB 254 and Boards of Medicine healthcare bans will now proceed to trial. This process should be quite rapid – and the court indicated that the plaintiffs are likely to succeed. What’s more, the court was searing in its dismissal of the motives behind the ban itself.

For a start, the court outright refused attempts to deny the fact that trans people exist:

Any proponent of the challenged statute and rules should put up or shut up: do you acknowledge that there are individuals with actual gender identities opposite their natal sex, or do you not? Dog whistles ought not be tolerated.

Likewise, when the defendants repeatedly resorted to blatant falsehoods, the court rebuked them:

The defendants have asserted time and again that Florida now treats GnRH agonists and cross–sex hormones the same as European countries. The assertion is false. And no matter how many times the defendants say it, it will still be false.

‘GnRH agonists’ are, in this context, more commonly known as ‘puberty blockers’. Their use is, as the court recognised, not under a blanket ban in Europe.

More subtle arguments: still wrong

Moreover, when the state’s side tried to argue that the use of puberty blockers and hormones is wrong because they are ‘off label’, the court was having none of it. ‘Off label’ here refers to the fact that puberty blockers are primarily used for other purposes, such as cancer treatment. The injunction retorted:

That the FDA has not approved these drugs for treatment of gender dysphoria says precisely nothing about whether the drugs are safe and effective when used for that purpose. Off–label use of drugs is commonplace and widely accepted across the medical profession. The defendants’ contrary implication is divorced from reality.

The district court also addressed – and outright dismissed – an argument against puberty blockers which has become regrettably familiar in the UK. The Cass Review of UK trans youth healthcare questioned the use of puberty blockers because an overwhelming majority of users go on to take hormone replacement therapy.

The injunction noted that this effect was likely a demonstration that the treatment was prescribed appropriately. It stated:

The defendants note that 98% or more of adolescents treated with GnRH agonists progress to cross–sex hormones. That is hardly an indictment of the treatment; it is instead consistent with the view that in 98% or more of the cases, the patient’s gender identity did not align with natal sex, this was accurately determined, and the patient was appropriately treated first with GnRH agonists and later with cross–sex hormones.

There’s the catch

The court’s conclusion was simple and powerful:

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 evaluation and treatment by a multidisciplinary team. Proper treatment begins with mental–health therapy and is followed in appropriate cases by GnRH agonists and cross–sex hormones. Florida has adopted a statute and rules that prohibit these treatments even when medically appropriate.

Here’s the catch both for Florida legislators and for anyone working to oppose trans healthcare: trans people exist. Many trans people have gender dysphoria. Some of those trans people are children. There is a broad consensus among actual healthcare professionals regarding the appropriate treatment for gender dysphoria.

Anyone seeking to oppose those treatments will have to come equipped to tackle established, evidence-based science. Courts of law have a far higher standard of evidence than the court of public opinion. It will take far more than emotive language to successfully strip healthcare from the young people who need it.

Featured image via Wikimedia Commons/Elsa Paulson, made available under the Creative Commons CC0 1.0 Universal Public Domain Dedication, resized to 1910*1000