Lead plaintiff August Dekker

For the second time in two days, a U.S. District Court judge has ruled against a state law attacking gender affirming care for trans people.

Today (Wednesday, June 21) Judge Robert Hinkle struck down Florida’s anti-transgender health care rule that denied the state’s transgender Medicaid beneficiaries coverage for gender-affirming medical care, saying the prohibition of Medicaid coverage for gender dysphoria treatments is unlawful and unconstitutional.

Yesterday (Tuesday, June 20), U.S. District Judge James M. Moody Jr., judge for the United States District Court for the Eastern District of Arkansas, ruled that Arkansas’s ban on gender-affirming care for transgender youth violates the constitutional rights of trans youth, their parents and their medical providers.

Today’s ruling in Florida came in Dekker v. Weida, a federal lawsuit filed by Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, the National Health Law Program, and Pillsbury Winthrop Shaw Pittman LLP.

Judge Hinkle ordered the Florida Agency for Health Care Administration to end enforcement of the discriminatory ban, which was promulgated last August. The ruling also nullified the section of Florida’s recently-enacted SB  254 that similarly banned state funding for Medicaid coverage of gender-affirming health care.

Plaintiff August Dekker, a 29-year-old trans man from Hernando County, Fla., said, “I am extremely relieved and pleased with this decision so I don’t have to worry about whether I will be able to get the medical care I need.

“Florida’s policy effectively denied me the treatment my doctors recommended, because as a low-income Floridian with disabilities, I rely on Medicaid to afford my health care,” Dekker noted. “I am also happy for other transgender Floridians that get care through Medicaid, as now access to that lifesaving, critical care can continue.”

A press release from Lambda Legal explained that today’s ruling comes after the same judge relied in large part on the trial record developed in Dekker to temporarily halt enforcement of the Florida Board of Medicine’s ban on gender-affirming health care and related aspects of SB 254 in Doe. v. Ladapo, the lawsuit filed by Southern Legal Counsel, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and Human Rights Campaign.

Omar Gonzalez-Pagan, counsel and health care strategist at Lambda Legal, said, “Gender-affirming medical care is evidence-based care. In court, what matters are the facts and the law, not fearmongering and heated rhetoric. Over a two-week trial, the court heard from our clients, who have benefited from gender-affirming medical care, and from a contingent of medical and scientific experts from various disciplines. Through overwhelming evidence, we demonstrated that gender-affirming care is not experimental but rather essential, safe, and effective medical care.”

Gonzalez-Pagan continued, “We are gratified by today’s result which protects access to care for some of the most vulnerable Floridians, transgender Medicaid beneficiaries. It is unfortunate that Florida politicians like Ron DeSantis have sought to attack the most vulnerable to score political points. However, today’s ruling makes clear that discrimination is wrong and recognizes that every person in Florida, including transgender people, deserves equal access to evidence-based and lifesaving medical care.”

Simone Chriss, director of the Transgender Rights Initiative at Southern Legal Counsel, called the order “a much-needed win for Floridians amidst a climate where the rights of transgender individuals are being relentlessly attacked by the state. Judge Hinkle said it best: ‘The statute and the rule were an exercise in politics, not good medicine.’ And today’s ruling sends a strong message that the state of Florida cannot continue to play politics with people’s lives. We are so grateful to the courageous plaintiffs who made this case possible, and so grateful to the court for holding the state accountable for its unapologetic bigotry.”

Abbi Coursolle, senior attorney at the National Health Law Program, added that the ruling is “a victory for the mission of Medicaid: guaranteeing essential health care access for low-income individuals and families. It’s not only a win for our plaintiffs, but also for every Floridian who depends on Medicaid to access essential health care. This decision ensures that transgender individuals throughout Florida will have the ability to receive the care they require.”

And speaking for the Florida Health Justice Project, the agency’s legal director, Katy DeBriere, said, “We are proud to have fought alongside our state and national partners to combat the politically motivated decision of Florida’s Medicaid agency to ban coverage of gender affirming care. And, we are extremely grateful to our clients, Medicaid beneficiaries and their caring parents who stood up to the state’s discriminatory acts and prevailed. At the end of the day, justice was done.”

Dekker, et al., v. Weida, et al., was filed in 2022 in the U.S. District Court for the Northern District of Florida against the Florida Agency for Health Care Administration and AHCA’s Secretary Jason Weida on behalf of four plaintiffs: August Dekker (he/him) and Brit Rothstein (he/him), and two minors identified under pseudonyms Susan Doe (represented by her parents Jane and John Doe) and K.F. (represented by his mother, Jade Ladue).

AHCA, which oversees Florida’s Medicaid Program, adopted a discriminatory rule on Aug. 21 last year denying Medicaid coverage for, and therefore access to, necessary and evidence-based medical care for thousands of transgender people in Florida, notwithstanding that this is medical care was long covered by Florida Medicaid and has been proven over decades to be safe and effective, according to the Lambda Legal press release. Gov. Ron DeSantis, signed SB 254 into law last month on May 17 SB 254, among other things, prohibits the expenditure of state funds for the provision or coverage of gender-affirming care. The next day the Dekker case was amended to include a challenge to Section 3 of SB 254, using the same evidence developed at trial.

— Tammye Nash