US appeals court hears oral arguments on Florida ban on transgender care for minors

MIAMI (AP) — Attorneys for the state of Florida argued before a federal appeals court Wednesday that a lower-court judge was wrong to block a law last year that bans gender-affirming care for minors and restricts similar care for adults, though a pending U.S. Supreme Court case creates uncertainty.

Attorneys presented oral arguments before the 11th U.S. Circuit Court of Appeals in Miami. Meanwhile, the Supreme Court is already reviewing a similar ban in Tennessee, and the conservative court's ruling could affect laws in about two dozen other states.

Florida's law, which is still in effect, prohibits transgender minors from being prescribed puberty blockers and hormonal treatments, even with their parents’ permission. It also requires that transgender adults only receive treatment from a doctor and not from a registered nurse or other qualified medical practitioner. Adults who want the treatment must be in the room with the physician when signing the consent form.

U.S. District Judge Robert Hinkle had blocked the law in June, but a three-judge panel last fall stayed the lower court order against the ban while the matter is appealed, meaning the ban is currently being enforced.

For minors, the only treatments at issue are puberty blocking treatments and cross-sex hormones — giving testosterone to someone assigned female at birth, for example. Those who were undergoing treatment when the law was adopted in May 2023 were allowed to continue. Surgery, which is rare for minors, was still blocked.

As part of the state's appeal, attorney Mohammad Jazil told a three-judge appeals panel on Wednesday that Hinkle was wrong to conclude that the law was based on hostility from state officials and lawmakers against transgender people, rather than sound medical science.

“The district court itself recognizes that there are concerns with this treatment, that guardrails are appropriate, stringent regulation is appropriate," Jazil said.

The district judge was wrong to prioritize the views of a few lawmakers over the meritorious reasons to regulate treatment, Jazil said.

“The district court relied on the statements of seven or so legislators to paint the entire Florida Legislature with a discriminatory animus towards transgender individuals and the two independent boards of medicine,” Jazil said. “And I think that that was wrong. That was an error.”

A group of Florida families, represented by GLAD Law and other civil rights groups, filed the initial lawsuit challenging the ban. They were later joined by four adult plaintiffs. Hinkle sided with the group, ruling that the ban is unconstitutional on equal protection grounds and motivated by purposeful discrimination against transgender people.

Adam Unikowsky, an attorney representing the plaintiffs, told the judges Wednesday that Hinkle relied on more than just the statements of seven lawmakers.

“I think it considered that as one piece of circumstantial evidence in the overall evidentiary picture alongside other types of circumstantial evidence,” Unikowsky said.

As an example, Unikowsky referenced another Florida law, signed by Republican Gov. Ron DeSantis the same day as the gender-affirming care restrictions, that prevents public school employees from using their preferred pronouns if they don't correspond to that employee's birth sex.

“And what the district court inferred from that was that the Legislature’s goal was to deter people from transitioning,” Unikowsky said. “And it felt that it was hostile to the concept of people transitioning. It just didn’t want people to do that.”

The Supreme Court heard arguments in December on Tennessee’s ban on gender-affirming care for minors, though the justices’ decision is not expected for several months. The case is being weighed by a conservative-dominated court after a presidential election in which Donald Trump and his allies promised to roll back protections for transgender people.

Both attorneys at Wednesday's hearing were asked whether the appeals court should wait until the Supreme Court ruled before the lower court made a decision. Jazil said the appeal process should be paused because the Florida and Tennessee laws are so similar. Unikowsky said the Florida case should move forward because of differences in the legal arguments against both laws.

At least 26 states have adopted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. The states that have passed laws restricting or banning gender-affirming medical care for transgender minors are: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia and Wyoming.