Judge limits Florida’s investigation of treatment standards in American medicine


A legal battle over Florida’s ban on Medicaid spending for gender-affirming Medicare spilled into Washington Thursday as a federal judge partially approved an urgent request from 18 American mental health and medical groups to overturn subpoenas the state then sent them. Ban viewer.

Professional associations have accused Florida of targeting members like the American Academy of Pediatrics, the American Psychological Association and the Endocrine Society after they expressed a widely accepted medical view that care such as puberty blockers, hormones and reassignment surgery could be an appropriate treatment for transgender people. Young and old.

The groups spoke out last fall in support of a lawsuit filed by four transgender patients and their parents to overturn the ban in federal court in Tallahassee. But the organizations said government officials responded with a “highly inappropriate and invasive” hunting campaign for documents and internal communications about their political positions. They accused the state of looking for a “presumed internal opposition” and being biased in the service of attacking the groups’ guiding principles and credibility “from the inside out”.

The state’s search for internal voting results and deliberations may have a chilling effect on the First Amendment rights of American and international medical practitioners and researchers, and the “frank, unfettered dialogue” vital to their missions and the scientific process, Attorney Cortlin H. Lanin said.

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

Florida lead attorney Muhammad W. Much to the court: “Openness and transparency are hallmarks of the scientific method.” Societies now seek to protect from any scrutiny how they arrived at this opinion and whether it was the result of careful study and discussion among memberships or the result of a handful of people dictating a conclusion.”

After an hour-long hearing Thursday, US District Judge Carl J. Nichols sharply narrowed Florida’s request ahead of the approaching Feb. 2 deadline in the Tallahassee primary lawsuit.

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But Nichols agreed that at least some of the information the groups hold is needed because it can answer the central question posed by the Florida judge about whether it is reasonable for the state’s Medicaid agency to find gender confirmation treatments “experimental” given the situation. Present. Medical knowledge.

The court fight and Thursday’s ruling underscore how forcefully Florida Gov. Ron DeSantis (R) and his administration have pressed the state’s assault on medical treatment for transgender people, a wedge issue that conservative politicians have picked up in the country’s culture wars, and not just transgender patients and their families in the crosshairs. Fires, as well as doctors and increasingly the medical establishment.

the lawsuit It was introduced in Florida after the state’s Medicaid agency Funding for gender transition has ended care in August, Joining Texas and AlabamaOnly treatments that have been shown to be safe and effective and meet the criteria for medical necessity may be covered. Since then, the state’s politically appointed Board of Medicine has become the first to try to ban health care professionals who are licensed to provide such treatment to minors, threatening with offenders Penalties, including loss of medical license.

Since 2020, hundreds of bills have been introduced in about half of the 50 states targeting transgender people and especially youth, with sponsors saying the policies are meant to protect children and families from harmful actions they may later regret. But many medical professional organizations say treatment is possible Reduce emotional distress For transgender youth and Reducing the risk of suicide. This finding is supported by the largest US study to date, Posted last week in the New England Journal of Medicine, and add to a growing body of evidence that children’s mental health is improved by gender confirmation therapy.

On Thursday, Nichols said the patients who filed the lawsuit and their families rely heavily on the public and widespread acceptance of the standards of care established and approved “by every major medical organization in the United States” as evidence that such treatments are not experimental.

“I think the question of how exactly the guidelines or policy statements are adopted and if [they] So it really reflects the medical consensus here,” Nichols said.

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Nichols said he was not oblivious to Lannin’s clients’ concerns about possible “harassment or interference” with their First Amendment rights. But he said his order was designed to prevent this and that he was outweighed by the information he might have just to resolve a dispute over the best available scientific and medical expertise.

“A state can provide its own scientific evidence and certification, but I don’t think it can figure out the question of how exactly the guidelines were accessed here without having the required information,” Nichols said.

He added that US District Judge Robert Hinkle in Tallahassee had blessed “a free investigation based on everything each side can muster” on this question.

However, Nichols severely narrowed the scope of the state’s requests for information. The judge ordered the AHAs to turn over records “sufficient to prove” their total membership; how they establish policy guidelines and positions, including nurturing gender affirmation from gender confusion; and any “official communication” with all of their members relating specifically to the latter.

He denied the Florida agency’s request for “any” such records and “any documents and communications” such as internal emails that show who was involved in shaping the policy, adding that members’ individually identifying information could be redacted and prevented from being released to the public.

Nichols also denied the state’s request for records detailing any contact with the plaintiffs or any consideration of the risks and side effects of gender dysphoria treatment, saying that information had already been turned over. He blocked Florida’s early request for an interview under oath with representatives from the Academy of Pediatrics, the Endocrine Society and the World Professional Association for Transgender Health, the latter two of which outlined the clinical guidelines involved.

Anne Branigen contributed to this report.

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