Florida Lawsuit Targets Major Medical Groups Over Gender-Affirming Care Guidelines

Florida Attorney General James Uthmeier has filed a civil lawsuit accusing three major medical organizations of racketeering for their role in developing and promoting clinical guidelines that support gender-affirming health care for transgender adolescents. The complaint, filed in a Florida state court, names the World Professional Association for Transgender Health , the Endocrine Society, and the American Academy of Pediatrics as defendants.

According to the official news release from the Office of the Florida Attorney General , Uthmeier alleges that these medical organizations engaged in a scheme to promote gender-affirming medical interventions for minors while downplaying or ignoring risks, framing the case as a violation of Florida’s civil racketeering and consumer protection laws. The complaint challenges the organizations’ clinical practice guidelines and position statements that recognize gender-affirming care as a medically appropriate option for some transgender youth.

In announcing the lawsuit, Uthmeier claimed that the groups “misled” families and policymakers and described gender-affirming interventions with inflammatory language, referencing “castrations” and “double mastectomies” in remarks reported by multiple outlets. He also asserted that the medical guidance supporting gender-affirming care is based on what he called a “sham consensus,” and he invoked the Cass Review from the United Kingdom as evidence that such care is unsafe, despite ongoing debate about that report’s interpretation and use in U.S. policy debates.

The three organizations named in the lawsuit have for years maintained clinical guidelines that recognize gender-affirming treatments—such as puberty blockers and hormone therapy—as evidence-based and appropriate for some transgender adolescents when provided under specialist supervision and after careful assessment. The Endocrine Society’s clinical practice guideline on gender dysphoria and gender incongruence states that gender-affirming hormone therapy can improve psychological functioning and quality of life for transgender people when used according to established protocols.

The American Academy of Pediatrics has adopted policy positions supporting access to gender-affirming care, emphasizing that such care should be individualized, developmentally appropriate, and delivered in a multidisciplinary setting that includes mental health support. WPATH’s Standards of Care set out international guidelines for transgender health, including criteria for medical and surgical interventions and a focus on reducing discrimination and barriers to care for transgender people.

These guidelines align with positions from numerous other professional bodies, including the American Medical Association and the American Psychological Association, which have stated that gender-affirming care, when provided according to established standards, is an important component of health care for many transgender people.

The lawsuit is the latest in a series of actions by Florida officials aimed at restricting gender-affirming care and limiting protections for transgender people. In recent years, Florida lawmakers and agencies have moved to ban or severely limit access to gender-affirming care for minors and, in some cases, adults, through legislation and regulatory actions affecting Medicaid coverage and clinical practice.

Civil rights groups and LGBTQ+ organizations have already challenged several of those measures in federal court, arguing that the restrictions discriminate against transgender people and violate constitutional protections. The new lawsuit targeting national and international medical groups adds another front in ongoing legal and political conflicts over transgender health care in the United States.

Advocates for LGBTQ+ equality and many medical professionals have criticized the Florida lawsuit as an attack on both transgender people and the independence of evidence-based medicine. Organizations such as Lambda Legal and the American Civil Liberties Union have previously argued, in related litigation, that efforts to ban gender-affirming care ignore the prevailing medical consensus and place transgender youth at increased risk of mental health challenges by cutting off affirming treatment options.

Medical experts cited by national outlets have emphasized that major professional associations base their guidelines on systematic reviews of available evidence and on clinical experience that considers both potential benefits and risks. Some have warned that treating these organizations’ guideline development processes as potential “racketeering” could have a chilling effect on the creation of clinical standards in other areas of medicine, with possible consequences for patient care beyond transgender health.

LGBTQ+ advocacy groups note that transgender people already face significant barriers to health care, including discrimination, lack of knowledgeable providers, and insurance exclusions. They argue that lawsuits and legislative measures targeting gender-affirming care further stigmatize transgender people and may discourage families and youth from seeking support, even when care is legal and medically indicated.

As the case moves forward in Florida’s courts, legal observers expect extensive disputes over scientific evidence, the scope of state racketeering laws, and the boundaries between government regulation and the professional autonomy of medical organizations. The outcome could influence not only access to gender-affirming care in Florida but also future efforts by other states to target medical guidelines and professional associations involved in transgender health.