Trans Services Halted in Fla. After Court Allows Ban

A decision handed down by the 11th U.S. Circuit Court of Appeals in Atlanta on Monday cleared the way for Florida to prohibit transgender minors from being prescribed puberty blockers and hormonal treatments, even with their parents’ permission.

The law also requires that transgender adults only receive treatment from a doctor and not from a registered nurse or other qualified provider.

At least 26 states have adopted laws restricting or banning gender transition medical care for transgender minors, but Florida was the first state to restrict services for transgender adults, according to the LGBTQ+ advocacy group the Human Rights Campaign.

Enforcement of the Florida law had been on hold since June, after U.S. District Judge Robert Hinkle struck down the ban as unconstitutional.

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

“We are going to stand up for duly enacted statutes. We’re going to stand up for protecting the innocence of these kids,” DeSantis said. “We'll win that appeal.”

The American Academy of Pediatrics has repeatedly affirmed gender transition care for children, noting that transgender adolescents and adults have high rates of depression, self-harm and suicide, and stating that providers have an “essential role” in supporting patients and their families in evidence-based decision making.

“The AAP opposes any laws or regulations that discriminate against transgender and gender-diverse individuals, or that interfere in the doctor-patient relationship,” the organization said in a statement in August of 2023.

For nurse practitioner Joseph Knoll, the 2-1 ruling handed down on Monday was a disappointment but not a surprise.

While the law has been on hold for the past two months, Knoll and other providers at Spektrum Health in Orlando have been racing the clock to work through a backlog of patients who had been denied care under the provision.

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

“During this little freedom period as I call it … we made good use of that time to make sure all of our patients were well supplied with medication,” Knoll told The Associated Press. “Although I had hoped that it wouldn’t have been necessary, at least now we can say, I’m glad we did all the things that we did."

As recently as last week, the clinic was onboarding new patients and scheduling them for their appointments. The ruling this week changed that.

“Now it’s telling them that we can’t book them for that appointment. Or we can do a consultation appointment, but we won’t be able to prescribe anything at this time,” Knoll said.