In a second win against anti-trans legislation in only one week, a rule that banned Medicaid coverage for gender-affirming care in Florida was struck down by a federal judge on Wednesday, June 21. 

“The elephant in the room should be noted at the outset,” said US District Judge Robert Hinkle in his ruling. “Gender identity is real. The record makes this clear.” 

Judge Hinkle ruled that the ban on coverage of gender-affirming healthcare, which was adopted in the form of a rule by the Florida Agency for Health Care Administration (AHCA) in August 2022, was in violation of federal law governing Medicaid, as well as the US Constitution’s equal protection guarantee and the Affordable Care Act’s ban on sex discrimination. 

Medicaid is a joint federal-state program designed to provide healthcare to low-income individuals. Under the ban, Medicaid could deny coverage for hormone treatment, puberty blockers, and surgery, as well as other procedures relating to gender-affirming care, even though these procedures were still covered for treatments not related to trans healthcare.

Judge Hinkle’s decision in the case Dekker v. Weida, which was brought to the Florida courts by two trans adults and two trans minors, contained an opinionated response to those who continue to oppose trans rights. “There are those who believe that cisgender individuals properly adhere to their natal sex and that transgender individuals have inappropriately chosen a contrary gender identity, male or female, just as one might choose whether to read Shakespeare or Grisham,” the ruling stated.

“Many people with this view tend to disapprove all things transgender and so oppose medical care that supports a person’s transgender existence. In this litigation, the defendants have explicitly acknowledged that this view is wrong and that pushing individuals away from their transgender identity is not a legitimate state interest,” Hinkle said, adding that the ban was adopted for “political reasons”.

Win for transgender Medicaid beneficiaries in Florida! ?️‍⚧️? In today’s victory, the Court ruled that Florida’s anti-transgender health care rule prohibiting coverage for treatment of gender dysphoria for transgender Floridians is unlawful and unconstitutional. pic.twitter.com/6stcVC1zSe

— Lambda Legal (@LambdaLegal) June 22, 2023

In addition to invalidating the previous rule, Judge Hinkle’s decision similarly ordered Medicaid to pay for all of the medical care that the plaintiffs receive relating to their gender affirmation in the future. Hinkle also prevented the AHCA, including its head, Jason Weida, from blocking the plaintiffs’ access to care. 

Hinkle’s decision comes only one day after US District Judge James M. Moody Jr. struck down a similar Arkansas ban on gender-affirming care for trans minors, marking a powerful week for pro-trans decisions in the nation. However, both Arkansas and Florida are likely to appeal their cases. 

Commenting on the ruling, 29-year-old plaintiff August Dekker 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. I am also happy for other transgender Floridians that get care through Medicaid, as now access to that lifesaving, critical care can continue.”

Lambda Legal counsel and health care strategist Omar Gonzalez-Pagan also welcomed the ruling, saying: ​​“Gender-affirming medical care is evidence-based care. In court what matters are the facts and the law, not fearmongering and heated rhetoric.”

“We are gratified by today’s result which protects access to care for some of the most vulnerable Floridians, transgender Medicaid beneficiaries,” Gonzalez-Pagan added. “It is unfortunate that Florida politicians like [Gov.] 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.”

Alejandro Caballo, a trans advocate and academic, tweeted in response to Judge Hinkle’s decision, writing: “Florida has lost their case denying trans people Medicaid coverage for gender-affirming care. This is another final judgment. The precedent could be used to challenge restrictions on adult care in Florida. The wins keep coming!”