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Transgender Floridians remain in limbo as legal fight over gender-affirming care continues

Sage Chelf holds bottles of medications for hormone replacement therapy as part of her gender affirming care as a trans woman at home in Orlando Fla., May 27, 2023. Chelf began making plans to leave the state after Florida legislation caused her to lose access to gender affirming care. (AP Photo/Laura Bargfeld)
Laura Bargfeld/AP
/
AP
Sage Chelf holds bottles of medications for hormone replacement therapy as part of her gender affirming care as a trans woman at home in Orlando Fla., May 27, 2023. Chelf began making plans to leave the state after Florida legislation caused her to lose access to gender affirming care. (AP Photo/Laura Bargfeld)

Editor's Note: This story has been updated since its initial publication.

Seven weeks after Governor Ron DeSantis signed a bill that places heavy restrictions and outright bans on gender-affirming care in Florida, many transgender Floridians feel uncertainty and dread about their future in the state.

Senate Bill 254, signed into law on May 17th, has been criticized for its broad restrictions on healthcare for the estimated 94,900 transgender people who live in Florida.

Under the new law, a ban is placed on all gender-affirming care for minors, and further limits are put into place on how transgender adults can receive care.

Provisions of the bill include restrictions on the types of medical providers that are able to prescribe hormone replacement therapy, banning the use of telehealth for gender-affirming care, and the new requirement of an informed consent form - something the Florida Board of Osteopathic Medicine still has not provided.

Citing the uncertain legality of continuing treatment without the state-mandated informed consent form, clinics providing gender-affirming care ceased treatment for new and returning patients for several weeks. For people in the process of transitioning, this sudden halt in treatment left them feeling stranded.

JT Saenz, a clinical psychology graduate student at FGCU and transgender man, says that he’s feeling both physical and psychological effects from not being able to refill his prescription for hormone replacement therapy, which he’s been taking for four years.

“Right now being off hormones, it's having a huge effect. My mood is all over the place, my emotions are all over the place. As far as what it does to the body — I mean, you're thinking of taking away something that affects every part of your body — how you think, affects how tired you are, things like that. And so, it's dangerous.”

Although they have now resumed treatment for returning patients following an emergency rule by the Florida Board of Osteopathic Medicine, clinics like Planned Parenthood are still unable to admit any new patients.

For transgender people in Florida who were pre-treatment when the law was passed, their transition journey is seemingly over before it can start.

Tristan Pyles, an eighteen-year-old student at the University of Florida, was intending to start their medical transition in the coming months, but is currently unable to even get an appointment. Pyles, who is nonbinary, says that what they’re most worried about is not their inability to start hormones, but instead feeling unwelcome in the state they grew up in.

“I don't feel safe here. And this bill, and everything else going with it, it only proves to me that things are actively getting worse. A lot of people are saying it's just a cycle. It's a cycle of things and things are gonna get better eventually. I'm scared for my safety, and for how far it’s going to get before it cycles back. And for that reason, I'm going to leave as soon as possible.”

Saenz feels similarly.

After Gov. Ron DeSantis signed a new law preventing nurse practitioners from providing gender affirming care, thousands of trans adults in Florida lost access to their providers and medications without warning. (AP Photo/Laura Bargfeld)
Laura Bargfeld/AP
/
AP
After Gov. Ron DeSantis signed a new law preventing nurse practitioners from providing gender affirming care, thousands of trans adults in Florida lost access to their providers and medications without warning. (AP Photo/Laura Bargfeld)

“It's a very interesting feeling to feel like your existence- your humanity- is something that is political, something that's up for debate, I guess. It's been hard to focus, like in school and at work, when you have your ability to live and go about the day as you please questioned and challenged, and even having decisions made for you.”

Planned Parenthood of Southwest and Central Florida is a major provider of gender-affirming care in the southwest Florida area. The Director of Patient Experience for the organization, Luz –- who isn’t using their last name for confidentiality reasons –- says that patients aren’t the only ones struggling with the uncertainty this law creates.

“Providers are frustrated," Luz said. "These laws are tying their hands with bad policies. And it's putting them in a position where they can't treat their patients in a way that follows science and centers at the health care the individual patient needs.”

For Kait Thomson, the Director of Government Relations and Community Engagement at the organization, the frustration is both personal and professional. Thomson, who is nonbinary and uses they/them pronouns, has been active in advocating against this law during the legislative session, and says that while SB 254 is uniquely restrictive, it’s nothing new.

“Transgender, non-binary and gender-diverse people, like everyone else, have a fundamental need for quality health care and deserve to be treated with dignity and respect. You know, at the end of the day, the hate being shown to these communities of trans and gender nonconforming individuals by Florida's legislature is shameful and disturbing. But it's nothing new. We’ve fought for patients bodily autonomy at Planned Parenthood for over 100 years. And we're not backing down from the fight. We'll be here to provide care for our patients no matter what.”

Medical professionals and transgender individuals alike have taken issue with the wording of the newly issued informed consent form, which states that gender-affirming care is “purely speculative” and “based on very limited, poor-quality research.”

Since its signing, the law has experienced multiple legal challenges to its enforcement. Following the filing of Doe v. Ladapo, a challenge to the SB 254’s provision banning all gender-affirming care for minors, U.S. District Judge Robert Hinkle has issued two rulings protecting the rights of trans Floridians to receive care while the case is decided.

The State of Florida announced its intent to appeal both rulings on Tuesday.

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