Judge Rips Florida Kids' Trans Ban Law Into Pieces, Lights Them On Fire, Shoves Them Down DeSantis's Throat
This afternoon a federal judge in Florida issued an injunction on the enforcement of the state's ban on gender-affirming healthcare for minors. And while the order is limited to a small number of plaintiffs seeking hormone treatments on behalf of their children, it's a scathing indictment of the statute's constitutionality, as well as the cruelty of the politicians who advocated for it.
"The elephant in the room should be noted at the outset. Gender identity is real," writes US District Judge Robert Hinkle, hinting at the "unspoken suggestion running just below the surface in some of the proceedings that led to adoption of the statute and rules at issue—and just below the surface in the testimony of some of the defense experts—is that transgender identity is not real, that it is made up."
But you don't get to ban something, particularly gender-based medical care, based on barely concealed bigotry.
"Any proponent of the challenged statute and rules should put up or shut up: do you acknowledge that there are individuals with actual gender identities opposite their natal sex, or do you not? Dog whistles ought not be tolerated," the court bristles.
It's simultaneously bracing and viscerally sad to watch a 71-year-old white guy declare that there is no legitimate state interest in forcing a girl to develop "whiskers" and call out the Florida legislator who looked in the faces of transgender citizens protesting this law and called them "demons and imps who come and parade before us and pretend that you are part of this world.”
And it's so hard to watch Florida Gov. Ron DeSantis and his filthy goons declare themselves the protectors of children, even as they seek to score political points by forcing trans kids to go through puberty, locking them into bodies which feel painfully alien to them. One of the plaintiffs is the parent of an 11-year-old child named Susan who has lived her life as a girl and is under the care of multiple physicians and experts in transgender medicine:
All of Susan’s providers have determined GnRH agonists will be medically necessary when she begins puberty—that is, when she reaches the puberty classification denominated Tanner stage II.
This could happen any day. The statute and rules at issue, unless enjoined, will force Susan to go through male puberty. This will “out” her as transgender to her peers and will have devastating physical, emotional, and psychological effects
The cruelty is the point, always and ever.
Judge Hinkle's order barely manages to contain his obvious rage as the state defendants dismiss the universal medical consensus of every reputable body as "either a 'woke idea' or profiteering by the pharmaceutical industry or doctors." This is, of course, the same playbook the GOP deploys against teachers, accusing dedicated professionals of predation on children for sinister purposes. The court goes on:
The defendants say the many professional organizations that have endorsed treatment of gender dysphoria with GnRH agonists and hormones all have it wrong. The defendants say, in effect, that the organizations were dominated by individuals who pursued good politics, not good medicine. If ever a pot called a kettle black, it is here. The statute and the rules were an exercise in politics, not good medicine.
From a legal perspective, the case isn't a close one.
First, the state makes the facially nonsensical argument that the statute is not rooted in gender-based discrimination, which would trigger intermediate scrutiny.
"Consider an adolescent, perhaps age 16, that a physician wishes to treat with testosterone. Under the challenged statute, is the treatment legal or illegal?" scoffs the court. "To know the answer, one must know the adolescent’s sex. If the adolescent is a natal male, the treatment is legal. If the adolescent is a natal female, the treatment is illegal. This is a line drawn on the basis of sex, plain and simple."
States must prove that gender-based statutes are either substantially related to a sufficiently important interest or rationally related to a legitimate state interest. And animus against trans people and making it really unpleasant for them to come out satisfies neither prong:
The State of Florida’s decision to ban the treatment is not rationally related to a legitimate state interest. Dissuading a person from conforming to the person’s gender identity rather than to the person’s natal sex is not a legitimate state interest. The medical defendants have acknowledged this. But the state’s disapproval of transgender status—of a person’s gender identity when it does not match the person’s natal sex—was a substantial motivating factor in enactment of the challenged statute and rules. Discouraging individuals from pursuing their gender identities, when different from their natal sex, was also a substantial motivating factor. In a “fact sheet,” the Florida Department of Health asserted social transitioning, which involves no medical intervention at all, should not be a treatment option for children or adolescents. Nothing could have motivated this remarkable intrusion into parental prerogatives other than opposition to transgender status itself.
Judge Hinkle is also furious that Florida keeps claiming that its blanket ban on gender-affirming care for minors brings it in line with the "International Consensus.”
"The assertion is false. And no matter how many times the defendants say it, it will still be false. No country in Europe—or so far as shown by this record, anywhere in the world—entirely bans these treatments," the judge continues.
And he's not here for the state defendants' lies about transgender healthcare, including the stuff about it being untested or off-label.
"The defendants stridently assert that the evidence supporting the treatments at issue is 'low' or 'very low' quality as those terms are used in the GRADE system," he writes. "But the evidence on the other side—the evidence purportedly showing these treatments are ineffective or unsafe—is far weaker, not just of 'low' or 'very low' quality. Indeed, evidence suggesting these treatments are ineffective is nonexistent."
But more to the point, the court notes, holding up care for these children because they may suffer some adverse effects from the treatment wholly discounts the injury they'll suffer if they're denied care:
If the three plaintiffs at issue here do not start GnRH agonists soon, they will go through puberty consistent with their natal sex. They will live with the consequences for the rest of their lives. The likelihood is very high that they will suffer attendant adverse mental-health consequences. If, on the other hand, they do get GnRH agonists, they will avoid some of the adverse consequences. They also will face attendant risks. Risks attend many kinds of medical treatment, perhaps most. Ordinarily it is the patient, in consultation with the doctor, who weighs the risks and benefits and chooses a course of treatment. What is remarkable about the challenged statute and rules is not that they address medical treatments with both risks and benefits but that they arrogate to the state the right to make the decision. And worse, the statute and rules make the same decision for everybody, without considering any patient’s individual circumstances. The statute and rules do this in contravention of widely accepted standards of care. That there are risks of the kind presented here is not a rational basis for denying patients the option to choose this treatment.
The court concluded that the law violates the Equal Protection clause and likely the due process rights of the parents.
DeSantis will certainly appeal — if he's learned anything from Trump, it's that pointless litigation is an end in and of itself – and a damn good way to raise money.
But for these children, today, it's a little victory.
[Doe v. Ladopo, Docket via Court Listener]
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