A federal judge on Tuesday ruled that key aspects of Florida’s ban on gender-affirming care for minors and the state’s restrictions on similar care for adults are discriminatory and unconstitutional.

The 105-page opinion in the case Doe v. Ladapo, issued by U.S. District Judge Robert Hinkle of the Northern District of Florida, permanently blocks Florida’s adult and minor gender-affirming care restrictions under a 2023 Florida law that prohibits gender-affirming care for anyone under age 18.

That law also allows the state to take temporary custody of children who may be receiving gender-affirming care in the future and places some restrictions on adult care.

“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 state’s full approval so long as the purpose is not to support the patient’s transgender identity,” Hinkle wrote in the ruling. 

The judge declared that the state is allowed to regulate but cannot deny care. 

Hinkle said the state cannot exclude professionals other than physicians from participating in gender-affirming care, even under the supervision of a physician. Florida’s law prevents registered nurses from providing gender-affirming care and also prohibits telemedicine for gender-affirming care. The judge struck down these two policies.

The ruling also blocks Florida’s requirement for annual X-rays and other assessments more frequently than medically indicated and the state’s requirement for patients to sign informed consent forms for procedures they may never receive, among other things.  

Last June, Hinkle had temporarily blocked enforcement of Florida’s ban on care for transgender minors for the three families who filed the lawsuit, pending the outcome of the case. Florida Gov. Ron DeSantis signed the 2023 law just as he was launching his campaign for the 2024 Republican presidential nomination. He has since dropped out.

A spokesperson for DeSantis said the state plans to appeal the ruling and said that the governor’s office “disagree[s] with the Court’s erroneous rulings on the law, on the facts, and on the science.”

Twenty-five conservative-led states have passed laws or policies banning gender-affirming care for minors, according to the Human Rights Campaign. Courts have had mixed rulings in lawsuits challenging these policies, winning in cases in federal courts in Arkansas but losing in Texas. 

In November, families and advocates in Tennessee asked the U.S. Supreme Court to block the state’s ban on gender-affirming care for minors.

The outcome of the Florida case has the potential to set precedent if the high court takes up the case.

“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 Florida opinion. 

“In time, discrimination against transgender individuals will diminish, just as racism and misogyny have diminished,” he wrote.