by Erin Reed

After a court ruling from the 11th Circuit Court of Appeals allowed an anti-trans law in Florida targeting youth and adults go back into effect, many providers were forced to end care. Read on Substack

*With thanks to Janet.*

Several transgender youth and adults are being told their care will be terminated following a ruling from the 11th Circuit Court of Appeals by a majority-Trump appointed panel. The court ruled that a 2023 law, which restricts transgender care at any age, can go back into effect after being permanently blocked in June 2024.

The ruling, released late Monday, stated that transgender people are not a “quasi-suspect class,” meaning they do not receive the same level of equal protection under the Constitution as other categories such as race, ethnicity, religion, or sex. This decision implies that laws discriminating against transgender people are likely to be considered valid and constitutional by the 11th Circuit Court.

One such law, SB254, was passed in 2023. The law banned gender-affirming care for transgender youth but went further than similar legislation passed in several Republican-led states that year by also restricting care for transgender adults. The bill mandated that care for transgender adults could only be provided by physicians and required that patients receive forms outlining the “risks” of gender transition. Many proposed versions of these forms are filled with disinformation about transgender care.

The physician requirement has proven especially burdensome for transgender adults, as the majority of their care is provided by nurse practitioners. This is because the number of transgender adults far exceeds the capacity of physicians who offer gender-affirming care. Planned Parenthood, the largest hormone therapy provider in the United States, explains, “Most gender-affirming hormone care is provided at PPSP by advanced practice providers (physician assistants, certified nurse midwives, and nurse practitioners) in our health centers or over telemedicine.”

Now, with the law fully in effect, transgender adults who previously had access to care are being notified that their care will no longer be provided.

One anonymous patient shared an email from their provider, QueerMed, which stated, “Unfortunately, Florida has reinstated the ban on care for minors and the restrictions for adults… We can no longer see any patient of any age who is located in Florida.”

See that email here:

Spektrum, a major provider in Florida, was also forced to terminate care and cancel new patient appointments. However, during the period when the law was blocked, the organization reportedly took steps to ensure patients were well-supplied with medication in case the law went back into effect:

“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. 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,” said Joseph Knoll, a nurse practitioner at the clinic, as reported by the Associated Press.

Healthcare bans are currently a contentious issue in courts across the United States, with some courts blocking bans on transgender healthcare coverage or provision. A major point of contention is whether discrimination against transgender people qualifies as sex discrimination, which would subject these laws to higher scrutiny regarding their constitutionality.

The Supreme Court is poised to rule on such questions later this year in a case stemming from Tennessee’s trans care ban. If the Supreme Court were to rule that transgender people are not entitled to equal protection under the law, many forms of discrimination against transgender youth and adults could be deemed fully legal.

For trans people in Florida, many cannot afford to wait for such a decision, and many have already fled the state. For those unable to leave, disruptions to their care will likely have significant impacts on their mental and physical health.

“We are deeply disappointed by this decision and the panel’s disregard for the district court’s careful findings and adherence to the Eleventh Circuit’s recent precedent. Allowing these discriminatory restrictions to go back into effect will deny transgender adults and adolescents lifesaving care, and prevent Florida parents from making medical decisions that are right for their children. As the district court found based on voluminous evidence, the record shows that these extraordinary restrictions were based on disapproval of transgender people and serve no purpose other than to harm transgender Floridians. The plaintiffs in this case are considering their options and will take every step possible to protect their right to equal treatment under Florida’s laws, which these restrictions egregiously violate. We will continue fighting for transgender Floridians and their families, and for everyone’s right to make healthcare decisions without government interference,” said the organizations representing the plaintiffs in the case.