Judge curbs Florida probe into U.S. medicine’s trans treatment standards


A legal battle over Florida’s ban on Medicaid spending for gender-affirming care spread to Washington on Thursday, with a federal judge partially granting an urgent request by 18 U.S. medical and mental health groups to drop the state’s opposition to Subpoenas issued to them after gender-affirming medical treatment. prohibit.

Professional societies accuse Florida of targeting members such as the American Academy of Pediatrics, the American Psychological Association and the Endocrine Society for expressing the widely accepted medical view that care such as puberty blockers, hormones and sex reassignment surgery may be appropriate treatments for transgender youth and adults .

Last fall, the groups spoke out in support of a lawsuit brought by four trans patients and their parents to overturn the injunction in Tallahassee federal court. But state officials responded in a “highly inappropriate and aggressive” way to obtain internal documents and communications about their policy positions, the groups said. They accused the government of seeking out “so-called internal dissent” and bias in order to attack the group’s guidelines and credibility “from the inside out”.

The state seeks internal vote results and deliberations that could chill the First Amendment rights of U.S. and international medical practitioners and researchers to associate and “candid, uninhibited dialogue” that is critical to their missions and the scientific process effect, said attorney Cortlin H. Lanning.

Lawyers for the Florida Health Care Authority, however, questioned the authority and basis of the groups’ treatment guidelines.

“Openness and transparency are hallmarks of the scientific method,” Florida Attorney General Mohammad O. Jazil wrote in a letter to the court. “Bearing themselves in potential cases as the standard-bearers of mainstream scientific opinion on the treatment of gender dysphoria,” the associations are now trying to shield from any scrutiny how they arrived at that opinion, and whether it “was a matter of careful research and The outcome of a debate” membership or the outcome of a minority decision. “

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After an hour-long hearing Thursday, U.S. District Judge Carl J. Nichols sharply narrowed Florida’s case ahead of the looming Feb. 2 deadline for the Tallahassee lawsuit. request scope.

Transgender residents sue Florida over ban on gender-affirming Medicaid program

But Nichols agrees that at least some of the information held by these groups is needed because it could answer the central question posed by a Florida judge about whether the state Medicaid agency reasonably determined gender-affirming treatments to be “experimental,” given the current medical knowledge of the situation.

The court battle and Thursday’s ruling underscore how aggressively Florida Gov. Ron DeSantis (R) and his administration are pushing a national assault on transgender healthcare, a choice conservative politicians have made in the nation’s culture wars. Wedge issues, not only are trans patients and their families being targeted, but increasingly doctors and healthcare providers as well.

The state’s Medicaid agency ended funding for gender transition care in August, joining Texas and Alabama in saying “only treatments that have been found to be safe, effective and meet criteria for medical necessity to be covered,” the lawsuit was filed in Florida.The state’s politically appointed medical board has become the first to seek to ban its licensed health care professionals from providing such treatment to minors, threatening Violators will face penalties, including the suspension of their medical licenses.

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Since 2020, hundreds of bills targeting transgender people, especially transgender youth, have been rolled out in about half of the 50 states, policies that sponsors say are designed to protect children and families from what they may regret Harmful surgery. But several professional medical institutions say that treatment can reduce the emotional distress of transgender youth and reduce the risk of suicide. The findings are backed up by the largest U.S. study to date, published last week in the New England Journal of Medicine, and add to growing evidence that children’s mental health is positively correlated with sex. improved with treatment.

On Thursday, Nichols said that suing patients and their families relies heavily on public and widely accepted standards of care, developed and endorsed by “every major medical organization in the United States,” as evidence that such treatments are not experimental.

“I think it’s a question of how exactly a guideline or a policy statement is passed, and whether [they] So really reflecting the medical consensus is relevant here,” Nichols said.

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Nichols said he wasn’t blind to concerns among Lannin’s clients that their First Amendment rights could be “harassed or interfered with.” But he said his order was tailored to prevent that, and that disputes about the best available scientific and medical expertise outweighed its importance only by the relevance of the information they might have .

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“The state can provide its own scientific evidence and testimony, but I don’t think it can uncover issues about how exactly the guidelines were arrived at without having the requested information,” Nichols said.

U.S. District Judge Robert Hinkle of Tallahassee upheld a “liberal inquiry based on whatever the parties can gather” on the issue, he added.

Still, Nichols has significantly narrowed the scope of the state’s information request. The judge ordered the American Health Association to turn over records “sufficient to show” its membership totals; how they developed guidelines and policy positions, including gender-affirming care for gender dysphoria; and any “official communications” with their membership specifically concerning post- By.

He rejected the Florida agency’s request for “any” such records and “any documents and communications,” such as internal emails showing who was involved in policymaking, adding that members’ personally identifiable information could be redacted and made public disclosure.

Nichols also denied the state’s request for records detailing any contact with the plaintiff or any consideration of the risks and side effects of gender dysphoria treatment, saying such information had been turned over. He also barred Florida from requesting interviews with sworn representatives of the Academy of Pediatrics, the Endocrine Society and the World Professional Association for Transgender Health, whose clinical guidelines have been called into question.

Anne Branigin contributed to this report.


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