Providers halt services after court allows Florida to enforce ban on transgender care for minors

TALLAHASSEE, Florida — Advocates say transgender patients face barriers to “potentially life-saving health care” after a federal appeals court ruled that a Florida law banning gender-affirming care can be struck down forced while a legal challenge is underway.

The decision The ruling, handed down Monday by the 11th U.S. Court of Appeals in Atlanta, clears the way for Florida to ban transgender minors from being prescribed puberty blockers and hormone treatments, even with parental consent. The law also requires transgender adults to receive treatment only from a physician, not a registered nurse or other qualified health care provider.

Jon Harris Maurer, public policy director for the LGBTQ+ rights group Equality Florida, described the law as a government intrusion into “essential health care.”

“We have parents who are understandably very concerned about the welfare of their children, who want to make sure that they have the right to make the best decisions for their children,” Maurer said. “This ruling puts a law in the way of that. And it puts their children and their families at risk.”

Suicide is a leading cause of death among young peopleand transgender and non-binary youth are at a significant increased risk.

At least 26 states have passed laws restricting or banning gender-affirming medical care for transgender minors, according to the LGBTQ+ advocacy group Human Rights Campaign. However, Florida was the first state to restrict health care for transgender adults.

Enforcement of the law in Florida has been at a standstill since June, after U.S. District Judge Robert Hinkle overturned the ban. unconstitutional.

Governor Ron DeSantis, who is the law in May 2023, has made anti-LGBTQ+ legislation a major part of his agenda and his national political profile. Asked to comment on the decision, a spokesman pointed to statements DeSantis made in June predicting that Hinkle’s ruling would be overturned.

“We’re going to stand up for the duly enacted laws. We’re going to stand up to protect the innocence of these children,” DeSantis said. “We’re going to win that appeal.”

The American Academy of Pediatrics has repeatedly affirmed gender-affirming care for children, noting that transgender adolescents and adults have high rates of depression, self-harm and suicide, and that health care providers play a “vital role” in supporting patients and their families in making evidence-based decisions.

“The AAP opposes all laws and regulations that discriminate against transgender people and people with gender diversity, or that disrupt the relationship between doctor and patient,” the organization said in a statement. proposition in August 2023, in which it reaffirmed its gender-affirming healthcare policy.

For nurse practitioner Joseph Knoll, Monday’s 2-1 verdict was a disappointment, but not a surprise.

While the law has been on hold for the past two months, Knoll and other health care providers at Spektrum Health in Orlando have been working hard to clear the backlog of patients who were denied care under the provision.

Spektrum specializes in primary care for LGBTQ+ patients, and the majority of the clinic’s 5,000 patients come for gender-affirming care and medical transition services, said Knoll, who is also Spektrum’s CEO.

“During this little window of freedom as I call it 
 we used that time well to make sure that all of our patients were adequately supplied with medications,” Knoll told The Associated Press. “While I had hoped it wouldn’t have been necessary, at least now we can say I’m glad we did everything we did.”

Just last week, the clinic was accepting new patients and scheduling their appointments. This week’s ruling changed that.

“Now we’re telling them we can’t book them for that appointment. Or we can book a consultation appointment, but we can’t prescribe anything at this time,” Knoll said.

Knoll said he hopes the work the clinic has done in recent months to fill prescription refills will be enough to get patients through the next phase of the legal battle. But he fears that state lawmakers who want to ban procedures they deem harmful, even contrary to best medical practices, won’t stop gender-affirming care.

“If they’re going to use this technology to restrict health care that they don’t like or don’t agree with, where does that stop?” Knoll said. “What are they going to do next?”

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This story contains a discussion of suicide. If you or someone you know needs help, call the National Suicide Prevention Lifeline at 988.

___ Kate Payne is a staff member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on under-reported issues.