Identity documents In January 2022, it was reported that for the first time within Florida's history a
birth certificate has "sex-unknown" listed for an individual, instead of either just male or female. In January 2024, the Florida Department of Highway Services and Motor Vehicles unilaterally implemented regulations banning the issuing of any drivers license with a gender marker different from the holder's assigned sex at birth. Those who currently hold/use such licenses, or those who attempt to obtain them, are considered criminally guilty of fraud, with the license in question subject to suspension and revocation.
History In July 2024, it was widely reported by the media that transgender individuals born within Florida could not get to “update or make changes” to the sex on their own personal
birth certificate - despite explicit Florida legislation for years allowing and permitting it. Transgender people in Florida were previously allowed to change their legal gender on their birth certificates, but not their driver's licenses and other state IDs. The Bureau of Vital Statistics could issue an amended birth certificate with a corrected gender marker upon receipt of an "Application to Amend a Florida Birth Record", an "Affidavit of Amendment of Certificate of Live Birth" signed in front of a notary, a letter from a physician confirming "appropriate clinical treatment for gender transition", and the payment of the amendment fee. "Appropriate clinical treatment for gender transition" does not include the need to undergo
sex reassignment surgery or sterilization. The Department of Highway Services and Motor Vehicles once required evidence of sex reassignment surgery in order to change the gender marker on a Florida ID and driver's license. In 2011, the Department changed its requirements. In order to update a name and/or gender on a Florida ID or driver's license, the applicant must submit a court order for a name change and/or a signed original statement on office letterhead from the attending physician stating that the applicant is undergoing "appropriate clinical treatment for gender transition".
Facility Requirements Based on Sex Act Since July 1, 2023, it is illegal for a trans person at any state school, state university, or government building (e.g., at a beach or airport), to use any bathroom or changing facility consistent with their gender identity. Each institution must place gender labels on its bathrooms and establish internal "disciplinary procedures" for its own members (faculty, staff, students, inmates, etc.) who enter the bathroom forbidden to them. On August 23, for
Florida's 28 public community and state colleges, the Florida Board of Education approved a disciplinary procedure: employees who enter the bathroom forbidden to them can be fired. (This procedure does not affect Florida's state universities, which are in a different system.) On October 18, 2023, the Florida Board of Education voted to apply a similar restriction on bathroom use at private college and university buildings, including at any student housing run by those schools. The schools must prove their compliance by April 1, 2024. In October 2022, the
Florida Board of Education unanimously approved restrictions on how transgender people can use school bathrooms, aligned with the Parental Rights in Education Act ("Don't Say Gay"). In January 2023, the
United States Court of Appeals for the Eleventh Circuit sided with the Ponte Vedra Beach school district and formally upheld the ban on transgender individuals within bathrooms in Florida. On May 17, 2023, DeSantis signed a bathroom bill into law, from participating in sports designated for female students. In April, the bill had been passed by the
Florida House of Representatives, then shelved by the
Florida Senate before being taken up again with last-minute legislative "procedural maneuvers". Immediately after DeSantis signed the bill, a lawsuit was filed in state and federal courts. Additionally, the
Human Rights Campaign kicked off the campaign to try and stop the law from going into effect (called "nullification") on midnight July 1. In early 2023, the
Florida High School Athletics Association recommended that all female athletes be mandated to supply up to date information on their menstrual cycles to a database accessible by their school's administrators. This was speculated by many to be a method of both enforcing abortion restrictions, and detecting any female athletes who might be trans women in violation of the state's ban.
Healthcare In August 2022, Florida, citing state-issued guidance against gender affirming care ("widely debunked", according to the UK's
Independent), began a rule change process to institute bans on social transition and gender-affirming healthcare for trans youth and a requirement for any adult seeking gender-affirming care to receive approval from the Florida Board of Medicine at least 24 hours in advance. On November 4, 2022, the new rule was approved by the Florida Board of Medicine. All 14 board members had been appointed to the position by Governor DeSantis, and eight of them had contributed financially to DeSantis' election campaign. On the same day, the state Board of Osteopathic Medicine approved a similar rule, but theirs contained an exemption to allow gender-affirming care for children enrolled in research studies. The Board of Medicine rule took effect on March 16, 2023. On May 17, 2023, DeSantis signed a law to codify these changes. but a year later, on August 26, 2024, the U.S. Court of Appeals for the 11th Circuit sided with the state of Florida and stayed the injunction.
Youth State board rules As a result of the Board of Medicine rule, minors (under 18) cannot receive any gender-affirming healthcare in Florida, even to participate in clinical trials. This means they cannot receive puberty blockers, hormone therapy, or gender confirming surgeries (though surgery was already generally not provided to minors), unless they are
intersex. Furthermore, a memo stated that
social transition "should not be a treatment option for children or adolescents", contradicting the global medical consensus as reflected in the
WPATH Standards of Care. Most major medical organizations, including the
U.S Department of Health and Human Services (HHS), and international bodies such as
The Endocrine Society, opposed Florida's proposal.
Background of state board rules Surgeon General
Joseph Ladapo's April 2022 press release stated that the federal government's guidance "was never about health care, it was about injecting political ideology into the health of our children. Children experiencing gender dysphoria should be supported by family and seek counseling, not pushed into an irreversible decision before they reach 18." He cited a study that claimed high rates of
desistance among transgender youth but that has been widely criticized by the psychiatric community for using "a large cohort of children who did not actually meet the criteria for gender dysphoria, meaning they were not transgender". The motion mandates all transgender youth to detransition until they turn 18. At one point during the hearing, in response to one protester yelling that trans children would be harmed as a result, board member Dr. Zachariah P. Zachariah answered "That's okay", before voting on the issue. Some who had been at the meeting said that the board had put all the speakers in favor of the ban, many of whom were from outside of the state or outside of the country, first in line to speak, before cutting off public comment once they ran out and pro-trans Floridians began speaking at the meeting. Some protesters staged a
die-in where the meeting was held.
Legislation In April 2023, both houses of the Florida state legislature passed
a bill codifying the ban on gender affirming care for minors, and allowing the state to modify or nullify parental custody agreements from other states if the child involved is allowed access to or is “threatened with” being allowed access to gender affirming care. Opponents of the bill said that it would effectively allow kidnapping of trans kids across state lines. During protests against the bill, several trans children were reportedly detained by the legislature and illegally withheld from their parents. All but one were eventually released, with the remaining one being arrested and criminally charged with disturbing the peace. Less than a week later, the Florida House issued subpoenas to the
American Psychological Association and
American Academy of Pediatrics over their advocacy in favor of gender affirming care. Florida House Speaker Paul Renner stated that the purpose of the subpoenas was to see whether the organizations in question had been captured by "radical gender ideology". In June 2024, a federal judge permanently blocked the law from taking effect, striking down provisions that banned gender affirming care for minors and adults.
Commentary DeSantis and other Republicans have characterized gender-affirming care "as medically unproven and potentially dangerous in the long term, [and] as another political battle against liberal ideologies." Many medical groups, doctors, and mental health specialists have said that treatment for transgender youth is safe and effective, although there is a lack of long-term research on gender-affirming care. Ladapo's guidelines were also heavily criticized by organizations such as
GLAAD,
The Trevor Project, the
Human Rights Campaign, and the
ACLU. The LGBT media advocacy organization GLAAD argued that the memo was "playing politics with [transgender children's] lives", stating that "All major medical associations support gender-affirming care for trans youth. Denying kids live-saving, medically necessary, gender-affirming care is downright dangerous." In May 2023, this rule was codified into law. The law, "Treatments for Sex Reassignment," says that "consent must be voluntary, informed, and in writing on forms adopted in rule by the Board of Medicine and the Board of Osteopathic Medicine." In January 2023, the DeSantis administration issued an executive memorandum requiring all of Florida's public universities to provide numbers on how many adults they provided with gender affirming medical care, the types of care provided, the names of facilities used, and the number and ages of individuals prescribed various specific treatments. On May 17, 2023, DeSantis signed a law, "Treatments for Sex Reassignment" (often referred to as SB 254) The bill also included a mandatory pause on all gender affirming healthcare for trans adults in the state of Florida, due to a requirement for all adult patients to sign a form which had yet to be drafted by the Florida Board of Medicine. SB 254 was eventually struck down as unconstitutional in June 2024, including its provisions on adult gender-affirming care.
State Medicaid In June 2022, the Florida Agency for Healthcare Administration (AHCA), the agency responsible for overseeing the state's
Medicaid service, released a report declaring transgender hormone therapy "experimental and investigational". The AHCA did not reveal its communications with health experts that led to its report. The report was criticized by a group of scientists, including four from
Yale University, who called the report unscientific, flawed, and politically motivated, finding that the report ignored accepted scientific studies and consensus regarding gender dysphoria, had its writers chosen from those with ties to anti-LGBTQ groups specifically for their bias, cited sources with no scientific merit - including a student blog post and a letter to the editor, and that if the state used the same standard it used in the report to evaluate other treatments, it would no longer allow Medicaid to pay for drugs that lower cholesterol. Effective from August 21, 2022, state Medicaid regulations ban coverage of sexual reassignment surgery, hormone replacement therapy, puberty blockers and "any other transgender healthcare initiatives" for all individuals, regardless of age. This rule affects an estimated 9,000 transgender Floridians. The judge ordered the AHCA to turn over its communications with health experts by February 14, 2023. The decision was appealed. On October 13, 2023, legal representatives from 19 states—principally Attorneys General
Steve Marshall of Alabama,
Tim Griffin of Arkansas, and
Jonathan Skrmetti of Tennessee—submitted an amicus brief arguing that the court should reverse its decision and forbid Medicaid coverage of all gender-affirming care, including care for adults. The amicus brief cited the
Dobbs decision. On November 22, 2024, the
11th U.S. Circuit Court of Appeals heard arguments appealing the case.
Prison Under Florida law, trans people are sent to prisons based on their assigned gender at birth. In men's prisons, trans women frequently have their heads forcibly shaved and - due to “anti-woke” restrictions implemented in 2023 - are forcibly taken off hormone therapy, and instead put through psychiatric
conversion therapy. == Education ==