State of play: Accessing gender-affirming care in Orlando

Credit: J.D. Casto

It’s been three years since the Republican-controlled Florida Legislature joined other red states in passing a law (SB 254) that banned gender-affirming healthcare for transgender minors in Florida and restricted access to care for adults.

Since then, the political appetite for attacks on trans rights in Florida has somewhat ebbed — meaning fewer anti-trans laws have actually passed — though not completely disappeared.

A couple of state Republicans, for instance, tried to criminalize helping youth access gender-affirming care this year, at the behest of a national anti-LGBTQ group. But their proposal to do so (HB 743/SB 1010) failed to pass.

Still, the legal landscape for access to this life-saving care may be a shock to Orlando newcomers. Whether you’re moving to Orlando for a new job, for school, or if you’re the parent of a trans child who wants to know about available options in the City Beautiful, we’re here to answer questions.

For this guide, Orlando Weekly spoke to Equality Florida public policy manager Quinn Diaz, Hope CommUnity Center LGBTQ+ services manager Zafia Gómez, and consulted the ACLU of Florida’s 2026 resource guide to help ensure the following information is accurate and current as of publication. This guide should not be construed as legal or medical advice.

Access for adults

Is gender-affirming care banned for adults in Florida?

No. Adults age 18 and older can legally access medical forms of gender-affirming care, such as hormone replacement therapy and surgical procedures. But there are restrictions on how adults can do so under the 2023 law (SB 254) mentioned above.

OK, so how can I get gender-affirming care?

Adults in Florida can receive gender-affirming healthcare through a licensed physician. This means you can access this care through a primary care doctor (M.D.), doctor of osteopathic medicine (D.O.), endocrinologist, or an OB/GYN. Nurse practitioners and physician assistants, however, can no longer provide gender-affirming medical care under the 2023 law, even to informed and consenting adults.

Can I get gender-affirming care via telehealth?

Yes and no. You cannot initiate gender-affirming healthcare treatments through a telehealth appointment. That has to be done in-person. However, once you’ve started treatment, you can get prescription refills or continue your treatment through telehealth.

What’s up with that?

Under the 2023 law, adults in Florida must sign an informed consent form to initiate gender-affirming care, and you must be in the presence of the treating physician to do so. A witness and the physician themselves must also sign this form.

Can adults get gender-affirming surgery in Florida?

Yes, adults in Florida above age 18 can legally undergo gender-affirming surgical procedures. If you plan on using health insurance to help pay for it, however, you may have to meet certain eligibility requirements. This varies according to the insurance provider and the specific health plan.

Does insurance cover gender-affirming care in Florida?

Private insurance plans may cover gender-affirming medical interventions in Florida for adults, but it will depend on your specific health plan. Some plans may have preauthorization requirements, exclusions, or other eligibility requirements for coverage.

What about Medicaid?

That’s complicated. Currently, Florida Medicaid should cover certain gender-affirming medical interventions for adults, such as hormones. But according to the ACLU, the state Medicaid program has continued to deny coverage, pending an ongoing court case on the issue.

“It is allowed to cover,” Diaz told Orlando Weekly. “But it’s just really hard if you’re a Medicaid recipient to access that information … and like, even find a willing provider.”

Can public colleges/universities offer gender-affirming care services?

Broadly, no. Florida law now prevents public higher education institutions in Florida from spending state funds on gender-affirming medical care, even for adults. This, at the very least, applies to medical interventions such as prescriptions.

The University of Florida only recently stopped providing gender-affirming care, according to the Independent Florida Alligator, a student newspaper. The University of Central Florida did not respond to our inquiry about gender-affirming care services.

Access for minors

Is gender-affirming care banned for minors in Florida?

Yes. All medical forms of gender-affirming care are banned for minors under age 18 in Florida.

This doesn’t affect access to mental health counseling or social interventions, however, such as using a minor’s chosen name, using pronouns that align with their gender identity, and allowing them to wear clothes that feel comfortable to them that may not align with their sex assigned at birth.

Are there exceptions to this ban?

Yes. Minors in Florida who initiated their gender-affirming medical treatment through a licensed Florida provider prior to May 17, 2023, may continue their treatment in Florida. The ban also doesn’t affect mental health counseling — just medical interventions.

What if the minor has parental consent?

Doesn’t matter. Even with parental consent, Florida law bans gender-affirming medical care in Florida for patients under 18.

Can minors get gender-affirming surgical procedures in Florida?

No. Gender-affirming surgical procedures are only permitted for people 18 and older.

As a parent, what if my child/teen began gender-affirming treatment in another state before moving to Florida? Would they be able to continue their care here?

Likely not. According to Gómez, state law restricts providers from providing gender-affirming medical care, such as puberty blockers, to minors “even if that care was safely initiated in another state.”

This is the understanding of Diaz, from Equality Florida, as well. “That said, a minor may still be able to maintain continuity of care if they continue seeing an out-of-state provider and receive care outside of Florida, subject to the laws and regulations of the state where that care is being provided,” Diaz told the Weekly. “The key issue is that Florida law does not appear to provide a grandfathering or continuation-of-care exception for minors if treatment began elsewhere.”

Can Florida minors travel out of state for gender-affirming care?

Yes. Although lawmakers tried to restrict that earlier this year, that proposal didn’t pass. As of publication, there is no law in Florida that prohibits minors and their parents from traveling out of Florida to get gender-affirming care in a state where it is legal for them to do so.