After a district judge found 鈥渁nimus鈥� toward transgender people, a federal appeals court Wednesday heard arguments in a battle about a Florida law and regulations that restrict treatments for people with gender dysphoria.
A three-judge panel of the 11th U.S. Circuit Court of Appeals took up Florida鈥檚 appeal of a decision last year by U.S. District Judge Robert Hinkle that the restrictions were unconstitutionally discriminatory.
The restrictions prevented minors from beginning to receive puberty blockers and hormone therapy for treatment of gender dysphoria. Also, they allowed only physicians 鈥� not nurse practitioners 鈥� to approve hormone therapy for adults and barred the use of telehealth for new prescriptions. Opponents argue the restrictions reduced access to hormone therapy for adults.
Mohammad Jazil, an attorney for the state, disputed that Florida officials showed animus toward transgender people in approving the restrictions. He said the restrictions focus on gender-dysphoria treatments that Gov. Ron DeSantis and other Republican leaders frequently questioned, especially for minors.
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鈥淚 think it鈥檚 wrong to treat gender dysphoria as a proxy for transgender individuals,鈥� Jazil told the appellate panel.
But Adam Unikowsky, an attorney for plaintiffs who challenged the restrictions, said the animus reflected a view by state officials that transgender people should not transition.
鈥淚 think it鈥檚 expressed in the view a certain class of individuals shouldn鈥檛 exist,鈥� Unikowsky said.
Florida and other Republican-led states in recent years have approved numerous 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 鈥渟ignificant distress that a person may feel when sex or gender assigned at birth is not the same as their identity.鈥�
The lawsuit challenges a state law passed in 2023 and related regulations approved by Florida medical boards. While Hinkle ruled against the state, a separate three-judge panel of the Atlanta-based appeals court in August issued a stay of Hinkle鈥檚 decision. The stay allowed the restrictions to be in effect while the underlying appeal continued.
Among the issues that the judges probed Wednesday were comments that some Republican lawmakers made in 2023 before the restrictions passed. Critics of the treatments for minors, for example, have likened them to mutilation.
Hinkle ruled that such descriptions illustrated animus behind the policies.
鈥淧erhaps all this talk about castration and mutilation is just political hyperbole. But it casts at least some doubt on the assertion that these decision makers鈥� motivation was sound regulation of medical care in the best interest of transgender patients rather than outright disapproval of transgender identity,鈥� Hinkle wrote. 鈥淎ny suggestion that animus of this kind did not motivate at least some legislators blinks reality.鈥�
But during Wednesday鈥檚 hearing, Jazil argued that Hinkle should have applied what is known as a 鈥減resumption of good faith鈥� to the actions of lawmakers. He said, for example, that only a handful of lawmakers made such comments.
Judge Adalberto Jordan asked attorneys from both sides about the good-faith issue. Jordan said a U.S. Supreme Court decision last year in a South Carolina redistricting case made it increasingly difficult to overcome the presumption of good faith.
Appeals courts typically take months to rule in such cases. But Jordan and Judge Andrew Brasher raised questions Wednesday about whether the panel should put the Florida case on hold while the U.S. Supreme Court considers a dispute about a similar Tennessee case.
The Supreme Court heard arguments last month in the Tennessee case and likely will rule in the coming months.
