By Emily Johnson
Florida’s Legal Crackdown on Gender-Affirming Care
Over the past few years, Florida has emerged as a battleground for legislative attacks on gender-affirming care, setting a precedent for other states seeking to restrict access to transgender healthcare. These laws have impacted transgender individuals and also created widespread fear, uncertainty, and legal battles that continue to shape the national conversation on LGBTQ+ rights.
In 2022, the Florida Agency for Healthcare Administration prohibited Medicaid coverage for gender-affirming care, in 2023 the Florida Board of Medicine voted to ban gender-affirming care for minors and imposed penalties for providers that were not compliant, and later that year Florida took it a step further by passing SB 254. SB 254 went further than most anti-trans laws that were enacted in the United States.. It banned all gender-affirming care for minors, including puberty blockers and hormone therapy; and, made it nearly impossible for adults to receive gender-affirming care by requiring in-person consent from physicians. It also granted the state the power to take emergency custody of trans minors that are receiving care, while suspending the license and pursuing criminal charges against healthcare practitioners found in violation of the law.
One of the most damaging misconceptions about SB 254 is the aspect of the bill that gives the state the power to take emergency custody of children from parents who allow their children to receive gender-affirming care. In reality, the law doesn’t do that, but it was written to make people believe it could. This vague language caused many families to panic and stop their children from receiving treatment or conforming at all with their gender. What it actually means, for example, is that if there is a custody dispute in another state it allows a parent, the parent that is not allowing their child to conform, to bring their child to Florida and get temporary emergency jurisdiction. However, the judge from the other state would still have to approve of this move, the parent cannot just override custody orders.
Federal-Level Attacks on Gender-Affirming Care
Since the administration changed, it is not just Florida cracking down on gender-affirming care.We have seen a litany of Executive Orders, many of which are attacking the LGBTQ+ community. One of the most alarming orders, has cut off federal funding for gender-affirming care for anyone under 19 titled “Protecting Children from Chemical and Surgical Mutilation.” In the few weeks following the Executive Order, the effects have been swift. Hospitals across the country are halting all gender-affirming care to minors. It’s not just hospitals that are being affected, the vague language of the Executive Order has caused a chilling effect in academia and research as well, choosing to halt their research. Even private institutions, that are typically shielded from federal policies, are proactively self-censoring out of fear of scrutiny from the current administration.
The Legal Battles Against These Laws
Despite these attacks, advocates and legal organizations are fighting back. Multiple lawsuits have been filed against Florida’s restrictions and the federal executive orders. One in 2023, where a court ruled that Florida’s ban on Medicaid coverage for gender-affirming care violated the Equal Protection Clause and the Affordable Care Act’s ban on sex discrimination, however that decision is now being appealed. Another case in June of 2024, a judge issued a permanent injunction blocking Florida’s gender-affirming care ban;however, the win was briefly felt as on a appeal the State was granted a stay, meaning the harmful bans were back in effect and are still in effect. Another major lawsuit is challenging the federal order cutting funding for trans healthcare, arguing that it unfairly denies necessary medical care based on gender identity. Several organizations and private law firms have successfully secured temporary restraining orders blocking parts of these laws, however, given the current legal climate, many of these cases are expected to be appealed, prolonging uncertainty for trans individuals and healthcare providers.
Impact on Doctors and Patients
The impact of these laws and executive orders have been devastating. Many doctors have stopped offering gender-affirming care altogether, worried about legal repercussions. Clinics are relocating to states with “shield laws,” that protect providers who treat out-of-state patients. But, with Florida making it impossible to get telemedicine care for gender-affirming treatment, many trans individuals are left with no options. These laws have also forced medical clinics that provide a wide range of hormonal therapies to shut down entirely leaving children who rely on hormone treatments for conditions like diabetes, growth disorders, and other medical necessities struggling to access the treatment they need.
Gender-affirming care is widely recognized as necessary and has been shown to reduce depression, anxiety, and suicidality among trans people. Denying access to this care means worsening mental health crises, forcing families into impossible situations, and putting trans youth at an even greater risk. Some families have already packed up and left Florida in search of states where their children can get the care they need, but many don’t have that option.
What Next?
The future of gender-affirming care in Florida, and across the country, is uncertain. Litigation is ongoing, and while some temporary wins have been secured, the battle is far from over. Advocates, medical professionals, and legal experts continue to push back against these laws, while opponents double down on restrictions. While money is being poured into this litigation, funding for the medical procedures, that are critical for the health of trans youth, is feeling the effects. The fight isn’t just about healthcare—it’s about basic human rights. And as the courts, lawmakers, and medical community grapple with these issues, the lives and well-being of countless transgender individuals hang in the balance.
