December 21, 2023
Federal Trial Concludes in Challenge to the First State Law Attempting to Deprive Transgender Adults of Healthcare, Florida’s SB 254
Multiple days of powerful testimony highlight the danger and lack of justification for the first law in the country that would seek to deprive transgender adults of healthcare in addition to banning care for adolescents
A three-day federal trial in Doe v. Ladapo, the legal challenge to Florida SB 254 and related Boards of Medicine (BOM) rules that restrict access to medical care for transgender adults and criminally ban medical care for transgender adolescents, concluded Thursday in Tallahassee. While some other states have restricted medical care for transgender adolescents, many of which have been enjoined by federal courts, Florida has taken this to new extremes by targeting healthcare for transgender adults.
Over multiple days of testimony, plaintiffs described the harms of depriving them or their adolescent transgender children of medically necessary care. Parents explained how being able to obtain doctor-recommended care has made their children’s lives better and resulted in happier, healthier kids, and described the intense suffering that SB 254 has caused them. Plaintiff Lucien Hamel testified that SB 254 has prevented him from being able to access necessary care for himself as an adult anywhere in Florida.
The new law imposes a web of restrictions that effectively require most transgender adults to leave the state to obtain care. As Hamel testified, this is not a possibility for many Floridians. “The only answer I kept hearing from the community and others was, ‘Just leave Florida,’” he told the court. “I can’t leave Florida. This is my home. I’ve lived here my entire life. This is my son’s home, and for various reasons, I can’t just up and uproot my family and move across the country.”
Statements from plaintiffs
Jane Doe, on behalf of herself and her daughter Susan Doe (proceeding anonymously):
My worst nightmare is having to watch my child suffer because I can’t get her what she needs. We saw how our daughter Susan suffered before we were able to consult with our team of doctors to understand what she was experiencing and make the most informed decisions about her care. She is a happy, confident child now, but if we can’t get her the medical care her doctors recommend I know that’s going to go away. Seeing Susan’s own fear about what will happen to her because of this ban has been one of the hardest experiences we’ve endured as parents. Nobody with a heart could ever do this to her.
Gloria Goe, on behalf of herself and her son Gavin Goe (proceeding anonymously):
If you have children, you will do anything and everything to protect them, to provide what they need. SB 254 is prohibiting my ability as a parent to do that. My son Gavin is one of those children who simply stands out. He’s big-hearted. He is full of zest. He’s always smiling. But I am unable to get him the care he needs in Florida and am greatly concerned about what that means for his mental health and his overall well-being.
Lucien Hamel, on behalf of himself:
Being forced to abruptly stop my medical care this summer has been devastating for both me and my family. I received my care from a competent medical provider that I really trusted. Then I was told that Florida law suddenly won’t let APRNs and Nurse Practitioners provide the care I need. I can’t get an appointment with a physician anywhere in the state. There’s no medical basis for this change – it’s just preventing transgender Floridians like me from getting care. I’m scared and frustrated because I know my health will continue to decline the longer I have to wait, putting incredible stress on me, my wife, and our child.
Multiple medical experts also testified about the well-established standards and guidelines for transition-related care for adolescents and adults, the decades of clinical evidence proving its safety and efficacy, and the damaging impact of the state’s unjustified restrictions on adult patients and providers and, in the case of adolescents, complete ban on care, including criminal penalties for doctors and other health care providers.
The well-established standards of transgender medical care for adolescents and adults have been endorsed and adopted by every major U.S. medical and mental health association.
Medical experts providing testimony
- Dr. Aron Janssen MD, Vice Chair of Clinical Affairs, The Pritzker Department of Psychiatry and Behavioral Health and Associate Professor of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
- Dr. Daniel Shumer MD, Pediatric Endocrinology Specialist, Associate Professor in the Department of Pediatric Endocrinology, University of Michigan;
- Dr. Dan Karasic MD, Professor Emeritus, Psychiatry, University of California San Francisco Weill Institute for Neurosciences;
- Dr. Loren Schechter MD, Plastic Surgery Services, RUSH University Medical Center, Chicago IL
- Dr. Kenneth Goodman, PhD, FACMI, FACE, Director, Institute for Bioethics and Health Policy; Director, UM Ethics Programs
- Dr. Vernon Langford, DNP, Autonomous APRN, FNP-C, President of the Florida Association of Nurse Practitioners;
- Dr. Brittany Bruggeman MD, Pediatric Endocrinologist, Assistant Professor of Pediatrics, University of Florida
Plaintiffs’ attorneys from GLBTQ Legal Advocates & Defenders (GLAD), Human Rights Campaign Foundation (HRC), National Center for Lesbian Rights (NCLR), Southern Legal Counsel (SLC), and Lowenstein Sandler LLP presented evidence that SB 254 and the BOM rules were motivated by the state of Florida’s disapproval of transgender people, have no rational justification, and deny Florida transgender individuals and parents of transgender individuals equal treatment as guaranteed by the U.S. constitution.
Statements from attorneys
Jennifer Levi, Senior Director of Transgender and Queer Rights, GLBTQ Legal Advocates & Defenders
It’s been a privilege to be able to stand up and represent transgender Floridians and their families. The record could not be more clear. SB 254 and the related Boards of Medicine rules reflect invidious discrimination against transgender people. There is no legitimate purpose for these extraordinary restrictions, which do nothing but create suffering for parents, families, and transgender people across the Sunshine State.
Shannon Minter, Legal Director, National Center for Lesbian Rights
As the testimony presented in this trial overwhelmingly showed, there is no medical basis for this dangerous and unprecedented law, which has taken the extreme step of restricting medically necessary care even for adults and imposing criminal penalties on doctors and other health care professionals simply for doing their jobs. This is massive government overreach, and it should be permanently enjoined.
Simone Chriss, Director of Transgender Rights Initiative, Southern Legal Counsel:
The rules and law challenged in this case are part of an orchestrated campaign by the state of Florida seeking to deny fundamental rights and basic healthcare to its transgender citizens. After putting the state’s justifications for the cruel bans and restrictions on trial, we hope to have demonstrated to the court and the public that discriminatory measures such as these cannot survive constitutional muster. We stand with every transgender individual in the state of Florida and their right to make healthcare decisions free from government interference.
Sarah Warbelow, Legal Director, Human Rights Campaign Foundation:
Despite living in a state that has shown blatant discriminatory intent toward transgender people, the families and plaintiffs involved in this case have put their bravery, resilience and humanity center stage. This trial showed that there is no sound reason to deprive people of the ability to make best-practice, medically-necessary healthcare decisions for themselves—especially when the trade-off is the heartache and distress of children and parents.
Thomas Redburn, Lowenstein Sandler LLP:
We believe we presented a compelling case that demonstrates the severe harm to Floridians by allowing the healthcare restrictions in SB 254 to proceed. As we await the court’s decision, we’re hopeful for a ruling in favor of an individual’s ability to make informed decisions about their own, personal medical treatments without discrimination by the State.
About Florida’s ban on transgender medical care
Florida’s adolescent transgender healthcare ban was first enacted in March 2023 through the adoption of rules by the state Board of Medicine and state Board of Osteopathic Medicine, at the urging of the Governor, Surgeon General Joseph Ladapo, and the state Department of Health. SB 254, which was passed by the legislature, signed by the governor and took effect in May 2023, cemented into state law the ban on essential medical care for transgender minors, subject to a narrow continued-use exception for minors who had started treatment before the ban. SB 254 also created felony criminal and civil penalties for medical providers.
In addition, SB 254 added severe restrictions that effectively block access to essential medical care for transgender adults and transgender minors who would be eligible for the continued-use exception, including requiring that care be provided exclusively by physicians, barring telehealth, and requiring patients to complete unique, onerous and misleading consent forms.
The case was heard in the U.S. District Court for the District of Northern Florida on December 13, 14, and 21. The Court has certified two plaintiff classes in the case: all transgender adults in Florida who seek gender-transition medical care and all transgender minors in Florida who seek gender-transition medical care, and the parents of those minors. The Court also certified a subclass of the second class consisting of all transgender minors in Florida who are totally prohibited from receiving treatments because they did not initiate them before the effective dates of SB 254 and the BOM rules (and thus were not “grandfathered”), and are prohibited by state law from obtaining such care during puberty and adolescence.
Learn more about the case, Doe v. Ladapo
