Florida Senate Bill 254 is a state law that impacts gender-affirming care (including gender-affirming hormone therapy, sometimes called HRT) in Florida. It was signed into law on May 17, 2023 and became effective immediately.

This bill creates new requirements for receiving gender-affirming care in Florida. The requirements have changed several times since May 17, 2023. FOLX is open in Florida for care, and we will help ensure you can meet the requirements!

What does the bill actually say?

The overview language of the bill regarding adult gender affirming care states:

• Requiring that such prescriptions and procedures for patients older than 18 years of age be prescribed, administered, or performed only with the voluntary and informed consent of the patient
• Providing criteria for what constitutes voluntary and informed consent
• Providing that only a physician may prescribe, administer, or perform such prescriptions and procedures
• Defining the term “physician”
• Providing applicability; providing for disciplinary action; providing criminal penalties [for clinicians]
• Requiring the Board of Medicine and the Board of Osteopathic Medicine to adopt certain emergency rules
• Providing that such emergency rules remain in effect until they are replaced by nonemergency rules

The full text of the informed consent section reads:

(2) If sex-reassignment prescriptions or procedures are prescribed for or administered or performed on patients 18 years of age or older, consent must be voluntary, informed, and in writing on forms adopted in rule by the Board of Medicine and the Board of Osteopathic Medicine. Consent to sex reassignment prescriptions or procedures is voluntary and informed only if the physician who is to prescribe or administer the pharmaceutical product or perform the procedure has, at a minimum, while physically present in the same room: 

• (a) Informed the patient of the nature and risks of the prescription or procedure in order for the patient to make a prudent decision; 
• (b) Provided the informed consent form, as adopted in rule by the Board of Medicine and the Board of Osteopathic Medicine, to the patient; and 
• (c) Received the patient’s written acknowledgment, before the prescription or procedure is prescribed, administered, or performed, that the information required to be provided under this subsection has been provided. 

(3) Sex-reassignment prescriptions or procedures may not be prescribed, administered, or performed except by a physician. For the purposes of this section, the term “physician” is defined as a physician licensed under chapter 458 or chapter 459 or a physician practicing medicine or osteopathic medicine in the employment of the Federal Government. 

(4) Consent required under subsection (2) does not apply to renewals of prescriptions consistent with those referenced under s. 456.001(9)(a)1. and 2. if a physician and his or her patient have met the requirements for consent for the initial prescription or renewal. However, separate consent is required for any new prescription for a pharmaceutical product not previously prescribed to the patient.