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 medical care spilled over into Washington on Thursday after a federal judge rejected a state subpoena from 18 U.S. medical and mental health groups. Granted the instant application for cancellation of the letters in part. Prohibition.

Professional associations accused Florida of targeting members such as the American Academy of Pediatrics, the American Psychiatric Association and the Endocrine Society when they expressed the widely accepted medical view that puberty blockers, hormones and gender reassignment Surgery may be an appropriate treatment for transgender people. youth and adults.

The groups spoke out last fall in support of a lawsuit filed by four transgender patients and their parents in federal court in Tallahassee to overturn the ban. But the organizations said state officials responded with a “grossly inappropriate and offensive” fishing campaign for internal documents and communications about their policy positions. He accused the state of preying on “internal dissension” and bias “from the inside out” in the service of attacks on the groups’ guidelines and reputation.

The State’s search for internal voting results and First Amendment rights for American and international associations of medical professionals and researchers, and “clear, unfettered dialogue” essential to their mission and scientific practice. , Attorney Cortlin H. Lenin said.

However, attorneys for Florida’s Agency for Health Care Administration challenged the groups’ authority and basis for setting treatment guidelines.

“Openness and transparency are hallmarks of the scientific method,” Florida lead attorney Muhammad O’Jazzal wrote to the court. “Putting themselves in the mainstream as the standard bearers of the prevailing scientific approach to the treatment of sexual dysphoria,” the associations now seek to shield how they arrived at that approach from any scrutiny. And is it “the result of careful study and discussion among them. The membership or a handful of people who dictate a conclusion.”

After an hour-long hearing Thursday, U.S. District Judge Carl J. Nichols narrowly narrowed Florida’s request ahead of a fast-approaching Feb. 2 deadline in the Tallahassee case.

Trans residents sue Florida over ban on gender-affirming Medicaid care.

But Nichols agreed that the groups need at least some of the information because it could answer a central question posed by a judge in Florida about whether it’s appropriate for the state Medicaid agency to find out Gender-affirming therapies are “experimental.” Medical knowledge.

The court battle and Thursday’s decision underscored how aggressively Florida Gov. Ron DeSantis (R) and his administration are pushing the state’s attack on transgender medical treatment, an issue that conservatives Favored politicians have opted into the nation’s culture wars, not only with transgender patients and their families, but increasingly with doctors and the medical establishment as well.

The lawsuit was filed in Florida after the state’s Medicaid agency ended funding for gender transition care in August, joining Texas and Alabama, saying “only treatments that are safe, effective found, and which meet the criteria of medical necessity, may be covered.” The state’s politically appointed Board of Medicine has since become the first to try to ban health care professionals from licensing such treatment to minors. Violators face fines, including the loss of their medical licenses.

Since 2020, nearly half of the 50 states have introduced hundreds of bills targeting trans people, and especially trans youth, with policies sponsors say protect children and families from harmful practices. for which they may regret later. But several professional medical organizations say treatment can ease emotional distress and reduce the risk of suicide for transgender youth. The finding is supported by the largest US study to date, published last week in the New England Journal of Medicine, and adds to a growing body of evidence that children’s mental health is affected by gender. Affirmative action improves.

On Thursday, Nichols said the patients and their families who are suing have a lot of reliance on public and widely accepted standards of care and evidence that such treatments are not experimental.

“I think it’s a question of how the guidelines or policy statements were adopted and arrived at [they] So truly reflecting the clinical consensus is relevant here,” Nichols said.

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Nichols said she is not blind to potential “harassment or interference” with the First Amendment rights of Lennon’s clients. But he said his order was designed to prevent that and that it was too weighted by the relevance of the information to resolve the dispute on the best science and medical expertise he had. May be.

Nichols said, “The state can provide its scientific evidence and testimony, but I don’t think it can explore the question of how the guidelines got there without getting the information it needs.”

He added that U.S. District Judge Robert Hinkle in Tallahassee has given his blessing to an “independent investigation based on whatever each side can submit” on the question.

Still, Nichols quickly narrowed the scope of the state’s information requests. The judge ordered the American health associations to turn over records “sufficient to show” their total membership. how they establish guidelines and policy positions, including gender-affirming care for gender dysphoria; and in particular any “official communication” with their entire membership relating to the latter.

He rejected the Florida agency’s demand for “any” records and “any documents and communications” such as internal emails that would reveal who was involved in policy-making, adding that members Personally Identifiable Information may be redacted and prevented from public disclosure.

Nichols also denied the state’s request for records of any communication with the plaintiff or any consideration of the risks and side effects of gender dysphoria treatment, saying such information was already being handed over. are And it prematurely blocked a call to interview sworn representatives of the Florida Academy of Pediatrics, the Endocrinology Society and the World Professional Association for Transgender Health, the latter two of which set the medical guidelines in question. are

Ann Braggin contributed to this report.


An earlier version of this article stated that one of the groups involved was the American Psychological Association. This is the American Psychiatric Association. This article has been corrected.

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