TALLAHASSEE, Fla. — A federal judge on Wednesday struck down Florida rules championed by Gov. Ron DeSantis restricting Medicaid coverage for gender dysphoria treatments for potentially thousands of transgender people.
“Gender identity is real” and the state has admitted it, U.S. District Judge Robert Hinkle wrote in a 54-page ruling.
He said a Florida health code rule and a new state law violated federal laws on Medicaid, equal protection and the Affordable Care Act’s prohibition of sex discrimination.
They are “invalid to the extent they categorically ban Medicaid payment for puberty blockers and cross-sex hormones for the treatment of gender dysphoria,” Hinkle wrote.
The judge said the state had chosen to block payment for some treatments “for political reasons” using a biased and unscientific process and that “pushing individuals away from their transgender identity is not a legitimate state interest.”
Among the plaintiffs is August Dekker of Spring Hill in Hernando County. Dekker was receiving hormone therapy under Medicaid until the ban took effect last year.
"I was a very suicidal person before I got this care. I was constantly dreaming of ways to not be here anymore," Dekker said. "When I started testosterone and when I got top surgery, it felt like so many doors that opened up for me."
Hinkle’s harsh language echoed that in his ruling two weeks ago over a law that bans transgender minors from receiving puberty blockers. Hinkle, who was appointed by Democratic President Bill Clinton, issued a preliminary injunction so that three children could continue receiving treatment.
The DeSantis administration and the Republican-controlled Legislature had banned gender-affirming treatments for children and a law that DeSantis signed in May made it difficult — even impossible —for many transgender adults to get treatment.
Dekker said while he's now able to seek Medicaid coverage, the law makes it difficult for him to seek hormone therapy. For instance, only physicians may prescribe such care and informed consent forms approved by Florida's Board of Medicine are required, but they haven't been adopted yet.
The latest ruling involved a lawsuit filed last year on behalf of two adults and two minors, but advocacy groups estimate that some 9,000 transgender people in Florida use Medicaid to fund their treatments.
Hinkle also addressed the issue of whether gender-affirming treatments were medically necessary and noted that transgender people have higher rates of anxiety, depression and suicide than the general population.
Florida is among 19 states that have enacted laws restricting or banning treatment. But it has been available in the U.S. for more than a decade and is endorsed by major medical associations.
However, those challenging Florida's law said they feel some hope after earlier this month, Hinkle also temporarily blocked portions of the law that bans transgender minors from receiving puberty blockers.
Hinkle issued a preliminary injunction, saying three transgender children can continue receiving treatment.
On Tuesday, a federal judge also struck down Arkansas’ first-in-the-nation ban on gender-affirming care for children as unconstitutional.
It was the first ruling to overturn such a prohibition as a growing number of Republican-led states adopt similar restrictions.
U.S. District Judge Jay Moody issued a permanent injunction against the Arkansas law, which would have prohibited doctors from providing gender-affirming hormone treatment, puberty blockers or surgery to anyone under 18.
10 Tampa Bay reached out to the governor's office and the Florida Agency for Health Care Administration for comment but has not heard back.