Floridas restrictions on gender-affirming care for minors and adults are unconstitutional, a federal judge ruled Tuesday.

The decision overturns the law banning gender-affirming care for minors, including puberty blockers and hormone therapy, that Republican Gov. Ron DeSantis signed last year.

It also relieves transgender adults of the requirement that patients see a physician in person for any transition-related care, a rule that was particularly burdensome given that most people received care from nurse practitioners and use telehealth appointments.

U.S. District Judge Robert Hinkle in Tallahassee sided with the 11 plaintiffs, including four transgender adults and seven parents of transgender children.

The State of Florida can regulate as needed but cannot flatly deny transgender individuals safe and effective medical treatment treatment with medications routinely provided to others with the states full approval so long as the purpose is not to support the patients transgender identity, Hinkle wrote.

The 105-page order in Doe v. Lapado is the first time a federal court has weighed in on the constitutionality of restrictions on gender-affirming care for adults. Last year a federal judge struck down Arkansas ban for minors as unconstitutional.

Gender identity is real. Those whose gender identity does not match their natal sex often suffer gender dysphoria, wrote Hinkle, a 72-year-old who was nominated by Democratic President Bill Clinton. Florida has adopted a statute and rules that ban gender-affirming care for minors even when medically appropriate. The ban is unconstitutional.

The plaintiffs challenge, however, did not include the states restrictions on gender-affirming surgery, and the state still prohibits those procedures for minors and has some restrictions for adults.

In the order, Hinkle criticized DeSantis and some state legislators who plainly acted from old-fashioned discriminatory animus and described the frenzied rhetoric of legislators who mischaracterized the kinds of care that transgender people seek as castration and mutilation.

Hinkle quoted an unnamed state House member who ranted about the dangers of gender-affirming care and falsely described it as doctors taking little children and they put them to sleep on a gurney. They cut off their breasts. They sever their genitalia. They throw them in the trash.

Hinkle blasted the state legislators and wrote that this statement is probably about as far removed from reality as any statement by any legislator ever.

He instead cited the nearly two dozen American medical associations that support gender-affirming care for minors and adults and wrote that not a single reputable medical association has taken a contrary position.

Transgender opponents are of course free to hold their beliefs. But they are not free to discriminate against transgender individuals just for being transgender, Hinkle wrote in the ruling. In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished. To paraphrase a civil-rights advocate from an earlier time, the arc of the moral universe is long, but it bends toward justice.

DeSantis signed the ban after the state medical boards filled with DeSantis political appointees first passed its own rules to ban that care in late 2022. Florida became the first state in the nation to pass such a ban.