On August 26, 2024, the 11th Circuit Court of Appeals issued a stay on a federal district court decision, allowing Florida to enforce laws that ban gender-affirming care for transgender and gender non-conforming (TGNC) minors and restrict it for adults. These laws remain in effect while the court considers Florida’s appeal of a previous ruling that found the state's anti-trans law, FL SB 254, to be unlawful.


Plume vehemently disagrees with this decision. Gender-affirming care is medically necessary, life-saving, and supported by all major professional medical associations in the United States. We are working to ensure patients can continue to access gender-affirming care in Florida.

What Does This Mean for Plume Members?

In-Person Consent Form Signing is Required: All trans adults starting or continuing gender-affirming hormone therapy (GAHT) must sign a Florida Board of Medicine-approved consent form in person with a licensed MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine). RNs, APNs, and PAs are currently not permitted to prescribe gender-affirming care prescriptions or perform gender-affirming procedures.


Continued Virtual Care: If you have already completed an in-person consent form, you can continue to receive virtual care from the specific provider who signed it. If your provider is no longer with Plume, you will need to sign an informed consent in person with a new Plume provider.


Upcoming In-Person Events: Plume is organizing in-person events for individuals who need to sign a consent form. Details on how to sign up will be shared once they are finalized.

How can I get an in-person appointment?

New Patients

After completing your Get Started form:

  • Setup your Plume login and follow the instructions on your Plume Member Dashboard to complete your intake.
  • Schedule your initial consultation (this is not the in-person visit).
  • After your consultation, you'll schedule your required in-person visit.
  • Once your in-person consent is completed, you can begin GAHT care.


Returning Patients (previously used Plume Clinic)

  • Log in to your Spruce account and message us, or email hello@getplume.co.
  • We’ll help reactivate your membership and share details about our next in-person consent signing events.
  • Once your in-person consent is completed, your care can resume virtually.

Yes, Florida law currently requires all trans and gender non-conforming adults on GAHT to provide in-person consent with a licensed MD or DO. If you are an active Florida member and have not yet signed your in-person consent form, please reach out to the Care Team in Spruce or at members@getplume.co.

What if a pharmacy won’t fulfill my order?

If your pharmacy rejects your prescription, your provider can resend it to a different in-person pharmacy. Please provide us with the name and address of your new preferred pharmacy. If you prefer a mail-order pharmacy, options like Amazon or New Era are available, although prices may vary based on your location. If you continue to experience issues, please notify your Care Team, and our Pharmacy Manager will assist you.