Ron DeSantis’s Florida sues Biden admin for right to deny trans people gender-affirming care

The state of Florida is suing the Biden administration for the right to deny trans folks gender-affirming care.

On Monday, the Department of Health and Human Services (HHS) issued regulations clarifying that Section 1557 of the Affordable Care Act – which prohibits discrimination on the basis of sex – bans anti-transgender discrimination.

Related:

Trans people sue Arkansas over restrictive new drivers license rules

Arkansas has been allowing trans people to correct the gender marker on their licenses easily for over a decade, but that changed recently.

The rules acknowledge, however, that adhering to the anti-discrimination law doesn’t mean states must provide “a specific standard of care or course of treatment” for trans patients.

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The rules state, “There is no part of Section 1557 that compels clinicians to provide a service that they do not believe is medically appropriate for a patient or that they are not qualified to provide.” They add that “Section 1557 prohibits discrimination on certain prohibited bases and does not interfere with individualized clinical judgment about the appropriate course of care for a patient.”

The regulations also say that denying gender-affirming care is not discriminatory in and of itself if medical providers have a rationale for doing so.

“We will instead consider claims of discrimination raising non-categorical denials on a case-by-case basis… Since Section 1557 only prohibits discrimination and does not prescribe any specific standard of care, such denials will violate the final rule only where they entail discrimination on the basis of sex. As stated throughout this section, covered entities will have the opportunity to provide a legitimate, nondiscriminatory reason for such exclusions or restrictions.”

The rules also say that “religious freedom and conscience laws continue to apply.”

Florida Attorney General Ashley Moody (R) argues in her complaint that the regulations would force the state to violate its own gender-affirming care ban and require it to “fund drugs and surgeries for ‘gender transition’ for children,” according to a press release. In reality, children almost never undergo gender-affirming surgery and are typically prescribed reversible treatments like puberty blockers that have proven to cause vast improvements in the mental health of trans youth.

“Florida passed a law to protect our children from dangerous, irreversible gender-transition drugs and surgeries,” Moody nevertheless claimed in a statement.

“Now, Biden and his federal bureaucrats are trying to go around our child-protection law to force the state to pay for puberty blockers and gender-transition surgery for children. These rules trample states’ power to protect their own citizens and we will not stand by as Biden tries, yet again, to use the force of the federal government to unlawfully stifle Florida’s effort to protect children.”

The complaint refers to gender-affirming surgery as “experimental” solutions “to persons suffering from psychological distress.”

The regulations take effect July 5. Moody has requested a preliminary injunction that would exempt Florida from following the policy while litigation proceeds.

Moody argued in the complaint, “The implied threat is clear: Any medical provider that categorically refuses to follow OCR’s preferred ‘standards or guidelines’ of care — i.e., gender transition — risks crippling enforcement proceedings and punishment.”

Florida Gov. Ron DeSantis (R) signed S.B. 254 into law in May, along with a slate of other anti-LGBTQ+ bills. The law bans minors from accessing gender-affirming healthcare like puberty blockers, hormone replacement therapy (HRT), and gender-affirming surgeries (which are almost never performed on people under the age of 18). It also requires transgender adults to access gender-affirming care through physicians rather than certified nurse practitioners, who make up the majority of healthcare professionals providing such care in the state.

In June, Judge Robert Hinkle temporarily blocked the portions of the law affecting minors while the lawsuit challenging S.B. 254 plays out. However, he denied a motion in September to block the restrictions on adult access to gender-affirming care.

Florida is also among the 14 states currently suing the Biden administration for the right to discriminate against trans kids in schools. The states have taken issue with new rules interpreting Title IX, which bans discrimination on the basis of sex in education, as a legal protection against anti-LGBTQ+ school policies. 

Florida Gov. Ron DeSantis (R) wrote on X that President Joe Biden is “abusing his constitutional authority to push an ideological agenda that harms women and girls and conflicts with the truth.”

“We will not comply,” DeSantis continued, “and we will fight back against Biden’s harmful agenda.”

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