An appeals court panel has ruled that Florida can enforce a state law prohibiting doctors from performing cosmetic sex change surgeries or prescribing puberty blockers to minors younger than 18.
In a 2-1 ruling issued Monday, a three-judge panel of the United States Court of Appeals for the 11th Circuit decided to allow a Florida law passed in May 2023 to take effect as litigation continues.
The majority concluded that they “believe the defendants have made a strong showing that they are likely to succeed on the merits,” reversing a lower court decision against the law.
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The panel majority rejected the claim that the plaintiffs would suffer “irreparable harm” if the law remained in effect, noting that it allows doctors to continue to prescribe puberty-blockers and cross-sex hormones to children and teens who are already taking these irreversible, body-deforming drugs.
“The district court itself recognized that there were ‘legitimate concerns’ about some of the treatments’ effects, as well as a ‘risk of misdiagnosis,’ ‘risks attendant to treatment,’ and the potential for ‘additional medical risks,’” continued the majority. “Considering these factual conclusions, we think Florida has satisfied its burden to show that the fourth factor favors a stay.”
Circuit Judge Charles Wilson, a Clinton appointee, authored a dissenting opinion, claiming that there was “sufficient record evidence to support concluding that the act’s passage was based on invidious discrimination against transgender adults and minors.”
“On balance, evidence in the record demonstrates that the plaintiffs and class-members would suffer if the stay were granted — withholding access to gender-affirming care would cause needless suffering,” he argued in defense of performing trans procedures on children.
“In contrast, denying the stay would support a ruling grounded in the public interest. This matter is a medical issue, where patients are best left to make decisions alongside health professionals, with access to complete, unbiased information, as needed.”
In August 2022, the Florida Agency for Health Care Administration enacted a rule that prohibited the use of Medicaid funds to pay for puberty blockers, opposite-sex hormones and body-mutilating surgeries, including elective double mastectomies and chemical and surgical castration.
The state rule came after the agency had announced the findings of a review in June 2022, in which they concluded that such procedures were “not consistent with generally accepted professional medical standards and are experimental and investigational with the potential for harmful long-term affects.”
“Scientific studies supporting hormone replacement therapy, puberty blockers, and sex reassignment surgery for treating gender dysphoria are weak to very weak,” stated the agency at the time.
“The evidence showing benefits from hormone replacement therapies for gender dysphoria is very weak … Scientific studies do not show that the use of puberty blockers improves mental health.”
In June of last year, U.S. District Judge Robert Hinkle issued an injunction against Florida’s ban on the Medicaid funding of drugs like puberty blockers for those suffering from gender dysphoria.
“These plaintiffs are Medicaid beneficiaries who are entitled to payment, as a matter of medical necessity, for puberty blockers or cross-sex hormones as appropriately determined by their multidisciplinary teams of providers,” ruled Hinkle at the time.
“The rule and statute violate the federal Medicaid statute, the Equal Protection Clause, and the Affordable Care Act’s prohibition of sex discrimination.”
