A federal appeals court Thursday refused to reconsider a decision that allowed Florida to restrict treatments for people with gender dysphoria while a legal battle about the restrictions plays out.
A three-judge panel of the 11th U.S. Circuit Court of Appeals in August granted Florida’s request for a stay of a ruling by U.S. District Judge Robert Hinkle that blocked the restrictions. The stay effectively meant the restrictions on treatments such as puberty blockers and hormone therapy could be in effect while the Atlanta-based court considers an underlying appeal of Hinkle’s ruling.
Plaintiffs' attorneys challenged the restrictions asked the appeals court last month to reconsider the stay. But the panel, in a 2-1 decision Thursday, rejected the request.
Thursday’s decision did not explain the panel’s reasons, but Judges Britt Grant and Robert Luck were in the majority — as they were in the Aug. 26 opinion that granted the stay. Judge Charles Wilson dissented, as he did in August.
Hinkle in June issued an injunction against the restrictions, which were approved by Gov. Ron DeSantis and the Republican-controlled Legislature in 2023. Hinkle found, in part, that the restrictions were motivated by “animus” toward transgender people and violated equal protection rights.
The state appealed Hinkle’s decision and asked for a stay of the injunction.
The law prevented minors from beginning to receive puberty blockers and hormone therapy for treatment of gender dysphoria. Also, it allowed only physicians — not nurse practitioners — to approve hormone therapy for adults and barred the use of telehealth for new prescriptions. Opponents argued that the restrictions reduced access to hormone therapy for adults.
DeSantis’ administration has long disputed arguments about the effectiveness of gender dysphoria treatments, particularly for minors. In granting the stay of Hinkle’s ruling, the majority of the appeals court panel said Florida would suffer harm if it could not enforce the restrictions.
“As to harm to others, even with the law in effect, physicians may continue to prescribe and administer puberty blockers and hormones to adults,” the Aug. 26 majority opinion said. “And minors who were already receiving them may continue to do so.”
But in a Sept. 3 motion seeking reconsideration, attorneys for the plaintiffs argued that the “stay order threatens immediate and severe harm to a vulnerable population and raises fundamental questions about the proper application of constitutional principles.”
Attorneys for the plaintiffs, a transgender man and the parents of children with gender dysphoria, also argued that Hinkle’s conclusions included evidence of bias by the state Department of Health and medical boards that approved rules about treating gender dysphoria.
“The district court’s animus findings were based not only on the statements of legislators but also on extensive evidence of bias and irregularity in this administrative process, which influenced both the boards’ rules and legislators considering the statute,” the motion said.
In a brief filed in the underlying appeal, however, attorneys for the state wrote that Hinkle’s decision “turned the presumption of good faith into a presumption of bad faith” and that it resulted in a “judicial veto of the state’s policy choices for the treatment of gender dysphoria.”
A panel of the appeals court is scheduled to hear arguments in the underlying appeal during the week of Jan. 13, according to a court docket.
Florida and other GOP-led states in recent years have approved laws and regulations focused on transgender people. One of the highest-profile issues has been restricting use of puberty blockers and hormone therapy for minors with gender dysphoria.
The federal government defines gender dysphoria clinically as “significant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.”
