In Florida, families of transgender youth are trying to figure out what a federal judge’s ruling means to them this week.
In harsh termsJudge Robert Hinkle dished into the reasoning behind Florida’s ban on gender-affirming care for trans minors and indicated that going forward, the ban will likely be found unconstitutional.
But when issuing his preliminary injunction, Judge Hinkle only listed the three families who filed the lawsuits.
This has caused both confusion and hope for other families and for health professionals treating trans youth.
A family’s dilemma
When Lisa, the mother of a 13-year-old transgender girl in the Tampa area, learned of Judge Hinkle’s ruling, she allowed herself to feel a modicum of hope. (Lisa asked to use only her first name, for security reasons.)
« You know the expression, ‘there’s a light at the end of the tunnel and I’m pretty sure it’s not a train’? » she says with a rueful laugh. « That’s kind of where we are. You know, we’ve had the slightest glimpse that it’s not a train, that it’s real sunlight. »
Florida’s ban on gender-affirming treatments, such as puberty blockers or cross-sex hormones, carves out an exception for young people who have already started receiving those treatments.
This would include Lisa’s daughter, who started taking puberty blockers just over a year ago. But what isn’t clear from the language of the law and the judge’s ruling is whether her daughter can now switch to HRT.
« I hope that means we can move on and move forward, » says Lisa. « I’m not 100% sure yet… If that means suppliers are putting themselves at risk, then no, we’ll find other solutions. »
In her case, Lisa says it would mean seeking out-of-state care for her daughter, perhaps as far away as Massachusetts. « Things can change in an instant, » she says. « I’m not ruling anything out. We have seriously considered moving. »
« A hostile landscape »
Critics of the Florida law say it was written in a deliberately nebulous way, designed to impede treatment out of fear.
“The state of Florida has created such an impossible situation for these parents,” says Simone Chriss, director of transgender rights initiative with Southern Legal Counsel, one of the advocacy groups that filed the lawsuit against the Florida ban.
« It’s not only a hostile landscape for their children, » says Chriss, « but it’s also so ambiguous and vague and confusing. And there [are] no clear answer as to what is allowed and what is not ».
In response to Judge Hinkle’s ruling, Florida Governor Ron DeSantis’ office released this statement:
This injunction is extremely limited in scope. In this case, a single judge ruled that puberty blockers and cross-sex hormones should be made available to three young children. Otherwise, Florida law remains in effect. …
Obviously we do not agree with the judge’s ruling. We will continue to fight against the rogue elements of the medical establishment who push ideology on evidence and protect against the mutilation of our children.
While opponents of gender-affirming treatments call it experimental and risky, dozens of the country’s leading medical groups, including the American Academy of Pediatrics and the American Medical Association, endorse the treatment as time-tested and clinically necessary. medical view.
The state of Florida is expected to appeal Judge Hinkle’s ruling. According to attorney Chriss, this may explain why the judge worded his injunction that way.
“We would definitely like it to go a little further and clarify in the order that it applies more broadly,” not just to the three plaintiff families, he says. “But,” he adds, “we are all very aware that we have a hostile appellate court, and it is likely that the state will appeal to the 11th Circuit Court of Appeals. I can’t speak for Judge Hinkle, but I suppose that he is trying to be cautious and not go beyond what is necessary in order not to be reversed on appeal ».
Even the suppliers are uncertain
So where does this ambiguity leave providers dealing with trans youth?
Under Florida lawProviding gender-affirming care to new patients under the age of 18 is a crime.
Knowing this, should providers risk jail time and risk losing their medical license assuming even the judge’s injunction protects them?
« I would never tell a doctor or healthcare professional to do something they’re not comfortable with, » says Chriss. « But we are confident that if this is applied against anyone, they should let us know immediately. And we will ask the court for relief, » he says, « because Justice Hinkle has made it clear that these are unconstitutional laws and rules. »
For Dr. Michael Haller, a Gainesville pediatric endocrinologist who works with trans youth, the decision is simple. « These patients and their families have been through a tremendous amount of upheaval and have been used as political pawns over the past couple of years, » he says. « As a straight, white male who has grown up and lived in the state all my life, I feel an obligation to do everything I can to try to protect their rights to receive the care they deem appropriate. And if that means I will have to do things that might get in the way of state interests, then so be it. »
The legal path forward remains uncertain, Haller admits. “But,” he says, “as a physician, I have to treat the patient in front of me right now. And to be able to release the shackles even for a little while and potentially provide relief to patients who need treatment right now. a victory and we have to celebrate it. »
Even before the state’s ban was finalized, Haller says, it had a noticeable chilling effect: A number of Florida clinics stopped provide gender-affirming assistance to trans youth. Many of the patients at those clinics, Haller says, have contacted her office, seeking treatment.
« When they don’t have access to care, » she says, « you can feel and feel that desperation — the words they use in their emails, the vibrato of their voice when they call for help — you can really feel it. It’s palpable. I hope this injunction give people some relief. »
That’s also the hope of Tampa-area mom Lisa, who says her transgender daughter is suffering from pretty severe depression.
« One time, » Lisa recalls, « when she was having pretty deep thoughts about self-harm, she looked at me and said, ‘Well, maybe if I’m successful, Florida will be happy.’ AND … »
Here, Lisa pauses and lets out a heavy sigh. “That-that was hard to hear,” she continues. « And I—you know, how does one argue with that? Because I live in a red county. I live in a neighborhood specifically full of people who voted for all these people who do. And gleefully. How do you fight that? »
Maybe, Lisa says, Judge Hinkle’s ruling this week will help give her daughter some relief. « I hope it eases her pain, » she says. « I hope she relieves it completely, but even if it’s just a little bit, I’ll be happy. »