Trial begins in a constitutional challenge to Florida restrictions on medical treatments for transgender people

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By Jim Saunders ©2023 The News Service of Florida

TALLAHASSEE — With the mother of a transgender girl testifying that it would be “devastating” if the child could not get treatment, a federal judge Wednesday began a trial in a constitutional challenge to Florida restrictions on such things as puberty blockers and hormone therapy for transgender people.

The mother, a St. Johns County resident identified by the pseudonym Jane Doe, was the first witness in what is expected to be a multi-day trial in the challenge to a state law and rules approved by the Florida Board of Medicine and Florida Board of Osteopathic Medicine.

The law and rules block transgender minors from receiving puberty blockers and hormone therapy to treat gender dysphoria while placing additional restrictions on treatments for adults.

Jane Doe, a plaintiff in the case, said her 12-year-old daughter was identified as a male at birth but was diagnosed by a pediatrician with gender dysphoria at age 4. The girl has not started treatment with puberty blockers but has received care from endocrinologists as the family prepares for such a step.

The mother testified that her child has “never, ever wavered from who she is” and that her life would be “turned upside down” if she was denied treatment.

“It would force her to be someone that she’s not,” Jane Doe testified.

Gov. Ron DeSantis and the Republican-controlled Legislature passed the law (SB 254) during this spring’s legislative session. In part, it barred doctors from approving puberty blockers and hormone therapy for the treatment of minors with gender dysphoria.

It also required adults seeking hormone therapy or surgeries for gender dysphoria to sign informed-consent forms crafted by the medical boards. Also under the law, only physicians — not nurse practitioners — are allowed to approve hormone therapy, and it banned the use of telehealth for new prescriptions.

Florida is among numerous Republican-controlled states that in recent years have approved proposals targeted at transgender people, with some of the highest-profile debates about banning treatments for transgender minors. Florida contends that such treatments are unproven and risky for minors — despite support for the treatments from major medical organizations.

DeSantis has called such treatments “child mutilation.”

During opening arguments Wednesday, Mohammad Jazil, an attorney for the state, said the “state has every right to dictate some of the norms for medical treatment” for gender dysphoria, which the federal government defines clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity,”

But Thomas Redburn, an attorney for the plaintiffs, accused the state of “invidious discrimination” against transgender people. He said, for example, the state has not barred puberty blockers and hormone therapy to treat other types of conditions.

“The state has singled out transgender people for disparate treatment without any adequate justification,” Redburn said.

Redburn also pointed to statements by Republican lawmakers, including the use of words such as “mutilation.” He said the state has “decided people should not be transgender.”

But Jazil said the plaintiffs will not be able to prove that the restrictions were motivated by “animus” toward transgender people. He said, for instance, that the plaintiffs only cited statements from a few of the 160 lawmakers.

“Animus is a pretty high bar,” Jazil said.

While it was not addressed during the opening arguments, the state also is pointing to an August ruling by a panel of the 11th U.S. Circuit Court of Appeals in an Alabama case known as Eknes-Tucker v. Governor of the State of Alabama. The panel overturned a preliminary injunction that a district judge had issued against an Alabama ban on puberty blockers and hormone therapy for transgender minors.

“Plaintiffs don’t have a case after Eknes-Tucker v. Governor of the State of Alabama,” Florida’s attorneys wrote in an opening line of a brief filed last month in advance of the trial.

But attorneys for the plaintiffs wrote in a brief that a request is pending for the full 11th U.S. Circuit Court of Appeals to hear the Alabama case and that “the Florida law is different both in scope and history.” The 11th Circuit hears cases from Florida, Alabama and Georgia.

Hinkle in September cited the Alabama ruling as he declined to issue a preliminary injunction against the parts of the Florida restrictions affecting transgender adults.

Hinkle in June issued a preliminary injunction against the part of the law preventing puberty blockers and hormone therapy for children, with the injunction applying to minors who are plaintiffs in the lawsuit. The state has appealed the decision.

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