- The Washington Times - Thursday, June 22, 2023

A federal judge has struck down Florida’s restrictions on Medicaid payments for transgender medical treatments, dealing a blow to Republican Gov. Ron DeSantis.

“Gender identity is real,” U.S. District Judge Robert L. Hinkle wrote in a 54-page ruling, released Wednesday, that noted that Florida also recognized it despite “bigotry directed at transgender individuals” by state lawmakers.

A Florida health code rule and a new state law that “categorically ban” public funding for puberty blockers, cross-sex hormone therapy and gender reassignment surgery violated federal prohibitions against sex discrimination, added Judge Hinkle, a Clinton appointee.



He issued an injunction allowing the plaintiffs, two transgender adults and two transgender minors, to receive Medicaid payments for their treatments.

In a separate ruling two weeks ago, Judge Hinkle rejected a portion of the state law that bans minors from receiving gender-transition care and issued a preliminary injunction allowing three children to keep taking puberty blockers.

The Washington Times has reached out to the governor’s office and the Florida Agency for Health Care Administration for comment.

Florida is one of 19 states that have passed laws restricting transgender treatments since President Biden, a Democrat, took office in 2021. The Republican-led state efforts come in response to Biden administration efforts to expand transgender access to cross-sex restrooms, pronouns and sports participation.

Transgender treatments have been available in the U.S. for more than a decade, and most leading medical organizations have come to endorse them. An estimated 9,000 transgender people in Florida use Medicaid to pay for their treatments.

On May 17, Mr. DeSantis signed the ban on transgender care for minors and public funding for the procedures. He signed it along with three separate measures expanding a state ban on gender identity education in public schools, banning minors from attending drag shows and requiring transgender people to use public restrooms corresponding to their sex assigned at birth.

Effective that same day, the law restricting gender-transition care also gave the state temporary custody of children whose parents sought the treatments and threatened doctors who administered them with up to five years in prison.

Mr. DeSantis, who is running for president, said the law would “outlaw the mutilation of minors.”

“You have actually some states in this country that want to be a haven for these types of procedures and even welcome minors without their parents’ consent and to some of their jurisdiction,” Mr. DeSantis said at the signing, referring to 10 other states that had passed measures protecting transgender health care. “We’re obviously doing the opposite here.”

On June 1, Florida’s AHCA issued a 46-page report that questioned the medical necessity of transgender treatments as a pretext for a new rule denying Medicaid coverage to all patients.

Florida Surgeon General Joseph Ladapo, a DeSantis appointee, then asked the Florida Board of Medicine to establish a new standard of care barring youths from receiving transgender treatment.

In his letter to the board, Dr. Ladapo said the American Academy of Pediatrics and other leading medical organizations had offered “extraordinarily weak” support for “complex medical interventions.”

“The current standards set by numerous professional organizations appear to follow a preferred political ideology instead of the highest level of generally accepted medical science,” Dr. Lapado wrote. “Florida must do more to protect children from politics-based medicine.”

In his ruling on Wednesday, Judge Hinkle said Florida was the party acting “for political reasons” by banning even adults from receiving health coverage for transgender procedures. 

He also defended the necessity of the procedures by saying that denying treatment “will increase anxiety, depression and the risk of suicide” for transgender people.

The judge accused Florida health officials of ignoring these concerns and staging “well-choreographed” hearings aimed at “pushing individuals away from their transgender identity” without a compelling state interest. 

“The conclusion was not supported by the evidence and was contrary to generally accepted medical standards,” Judge Hinkle wrote, referring to the state report on transgender care.

• Sean Salai can be reached at ssalai@washingtontimes.com.

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