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Florida: What 254 Does and Does Not Do From a Legal Expert

  • May 9, 2023

Florida Senate Bill 254 has been sent to Governor Ron DeSantis for his signature, and he is expected to sign it. The law does not have a waiting period: it will be in effect as soon as it is signed. It will also be challenged immediately. We owe our understanding of what 254 does and does not do to the outstanding communications we’ve received from Southern Legal Counsel. SLC is a partner in several lawsuits challenging Florida’s transphobic and hateful policies. This blog may not have entirely correct information and should not be considered legal advice. We will do our best to update as more details are available

SLC, GLAD, NCLR, and HRC will request that federal courts block 254 from going into effect as soon as it is signed. A block may apply to the entire law or to select portions of the law.

SO HERE’S WHAT 254 DOES AND DOES NOT DO:

New Restrictions on Gender Affirming Care in Florida:

For YOUTH:

  • Adolescents who had prescriptions for gender affirming care treatment before the law goes into effect can continue receiving care. They may not “move on” to next-step treatments in Florida, such as beginning hormones if they are on blockers or getting surgery before age 18.
  • 254 turns the rules adopted by the Board of Medicine and the Osteopathic Medical Board into law.
  • It also creates a felony penalty for providers who prescribe blockers or hormones to youth who have not previously had a prescription for them.

About CUSTODY:

  • 254 allows Florida courts to change custody agreements that originated in another state if one parent (in Florida) requests interference.
  • This only applies to legal custody agreements created during divorce proceedings or the dissolution of a marriage.
    • This does not allow Florida to remove children from affirming parents.

For ALL INDIVIDUALS Seeking Gender Affirming Care:

For ADULTS:

  • New prescriptions may only be written by a doctor – an MD or a DO. Nurses with prescribing authority, such as advanced practice registered nurses (APRNs) and nurse practitioners (NPs), or mid-level providers, such as Physician Assistants (PAs) may not prescribe gender affirming medications.
  • The first prescription may only be written at a physical appointment where the doctor is in the room with the patient if it is prescribed for a gender diagnosis. There may be alternative, appropriate diagnoses that allow prescriptions via telehealth. Subsequent prescriptions of the same medicine may be done in telehealth appointments. For our patients currently receiving care, you can continue to receive care from us via telehealth.
  • Informed consent is required for all new treatments. (We already practice informed consent!)

For YOUTH and ADULTS:

  • Private insurance is not prohibited from covering gender affirming care.
  • Physicians can refer patients out of state.

About GENDER MARKER CHANGES:

  • The final bill does not restrict changes to gender markers on legal documents.
  • For more information on updating legal documents in Florida, we recommend Florida Name Change.

What’s Going On Legally?

  • Medicaid payments for gender affirming care were restricted last year. This case goes to trial next week.
  • A request to block the Board of Medicine and Osteopathic Medicine Board rules prohibiting minors from starting care after March 23rd, 2023, was filed in late April. A decision is expected in the next couple of weeks.
  • When 254 is signed, a request to block the law will be filed immediately in federal court.

QueerDoc and Florida

We are accepting new patients in Florida: both youth and adults.

If you need to travel for care after 254 goes into effect, we partner with organizations that can get you–free of charge–from Point A in Florida to Point B in a safe state for your telehealth appointment. Please see Getting Care At QueerDoc: Appointments for more information about our intake process.

what 254 does | Purple glowy background with "Florida" in black letters with white outlines placed in the shape of the state.  Text in white all caps is "QUEER AND GENDER AFFIRMING HEALTHCARE FOR PEOPLE IN". A pride progress flag and @QUEERDOC are at the bottom of the image.

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*** Disclaimer

This blog is for entertainment, informational, and general educational purposes only and should not be considered to be healthcare advice or medical diagnosis, treatment or prescribing. The Content is not intended to be a substitute for professional medical care. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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