Family Law & Gender Affirming Care: Impacts on Child Custody Agreements

For parents of transgender youth in Florida, the debate around access to gender-affirming medical care has become a multilayered legal dilemma that directly impacts child custody agreements.

With the state’s new ban on this care for minors facing ongoing constitutional challenges in court, there is considerable uncertainty around factors like medical decision-making authority and relocating for treatment access.

As an attorney assisting families through custody disputes for decades, I’ve seen firsthand how this issue has complicated things. When parents differ on what is best for their transgender child, custody battles often erupt over who has the final say on medical decisions.

Arguments arise over whether moving out of state briefly to obtain gender-affirming care should impact custody terms. With the ban’s legality still unresolved, it is a complex landscape to navigate.

In this article, I’ll discuss the key challenges the ban on gender-affirming care creates for child custody determinations and provide guidance on strategies families and attorneys can consider as they move forward.

What is Gender-Affirming Care?

Gender-affirming care encompasses a range of medical treatments and social support designed to help transgender and gender-diverse individuals live authentically under their gender identity.

This type of care affirms an individual’s sense of self and who they know themselves to be.

For transgender people diagnosed with gender dysphoria, a conflict between assigned gender at birth and gender identity, gender-affirming care can be critically important for overall health and well-being.

Numerous studies have found that access to appropriate care significantly reduces rates of anxiety, depression, and suicide ideation among transgender populations.

Gender-affirming medical treatments may include:

• Puberty blockers for adolescents, which temporarily suppress pubertal development like voice changes or periods. This provides time to explore gender identity.
• Hormone therapy, like testosterone or estrogen, induces secondary sex characteristics aligned with gender identity. This can give individuals physical attributes more aligned with their gender.
• Gender affirmation surgeries, including top surgery, bottom surgery, facial surgery, and other procedures. These allow individuals to further align physical characteristics with gender identity.
• Other supportive medications and treatments to help align secondary sex characteristics with gender identity.

These interventions are well-studied and endorsed by major medical associations as medically necessary, evidence-based care for those experiencing gender dysphoria.

Ongoing access to gender-affirming medical care is often essential for transgender individuals to improve mental health outcomes and lead fulfilling lives.

In addition to medical treatments, social elements of gender-affirming care may include:

• Using chosen name, pronouns, clothing, and hairstyles aligned with gender identity
• Legally changing the name and gender markers on identity documents
• Accessing psychological and mental health care providers experienced with gender-diverse patients
• Finding community support among other transgender and nonbinary individuals

With many facets spanning the medical, psychological, and social realms, gender-affirming care aims to fully embrace and support transgender individuals seeking to live in their truth.

Where Florida’s Gender-Affirming Care Ban Stands—And The Ongoing Fight Over Its Legality

In 2023, Florida passed legislation making it a felony for doctors to provide treatments such as hormone therapy and puberty blockers to anyone under 18 for the purpose of gender transition.

Almost immediately, a lawsuit was filed by three families challenging the constitutionality of this law.

In February 2023, a federal judge issued a preliminary injunction preventing the state from enforcing the ban against the plaintiffs. However, the scope of protections remains ambiguous as the injunction did not clearly halt enforcement against all families.

Florida is expected to appeal this injunction, so for now, the ultimate legality of the ban remains unsettled. But even with the matter still working through courts, the law’s mere existence has already shaped family court proceedings across the state.

Child Custody Disputes Have Become Key Battlegrounds

Given this climate, child custody cases (called parental responsibility in Florida) involving transgender youth have often become intensely contested battlegrounds between parents who differ over medical decision-making regarding gender-affirming treatments.

What if one parent strongly supports their child starting hormone therapy or puberty blockers, believing it is critically important for their child’s health and well-being? But the other parent opposes this, perhaps citing concerns over long-term impacts or Florida’s ban?

When parents reach such impasses, who should have the final say over whether a transgender minor can access potentially lifesaving care?

What if one parent opts to move out of state for a period solely to obtain gender-affirming treatment for their child that is prohibited in Florida? Should that choice impact custody determinations in any way?

With the ban’s legality ambiguous, there are no easy answers.

Building The Strongest Case For Your Child

For parents who feel certain their transgender child needs access to gender-affirming medical care, having the strongest possible case is crucial, whether negotiating custody agreements outside court or litigating the matter before a judge.

Here are a few key tips:

• Get declarations from your child’s doctors, therapists, and other mental health providers about the treatment’s benefits and medical necessity. Have them testify in court if need be.
• Present credible research demonstrating how gender-affirming care like puberty blockers reduces depression, anxiety, and suicide risk in transgender youth.
• Share details of your child’s personal gender dysphoria experiences and how any treatments so far have helped their social and psychological well-being.

While judges must consider the legal complexities, emphasizing the real-world impacts on your child’s health and happiness can go a long way.

Until the ban’s fate is fully resolved, I recommend closely tracking legal developments around the ban and speaking to an experienced family law attorney about your case. As appeals and decisions unfold, new options may emerge for your child.

Our Commitment to Supporting Florida’s Transgender Youth

At the intersection of family law and transgender rights, few issues strike so intimately at parents’ deepest hopes of protecting their children. As an attorney, I aim to provide both compassionate counsel and vigorous legal advocacy to ensure your child’s needs are prioritized in any custody agreement.

Florida’s vibrant transgender community deserves our state’s full support, and all families should have access to vital care. Though uncertainties lie ahead in the legal realm, there are also many reasons for hope.

If you need assistance navigating your child’s custody agreement in light of the complexities around gender-affirming medical care, please do not hesitate to reach out. My team at Vasquez de Lara Law Group is ready to help and discuss options for your specific situation. Contact us today for a free case evaluation.