Alabama’s ban on medical treatments for transgender minors starts today

Protest in Montgomery

Protestors in support of transgender rights rally outside the Alabama State House in Montgomery, Ala., on Tuesday, March 30, 2021. (Jake Crandall/The Montgomery Advertiser via AP)AP

A new Alabama law banning certain medical treatments for minors with gender dysphoria takes effect today unless a federal judge grants a request to put a temporary hold on it while a lawsuit is pending.

U.S. District Judge Liles Burke said Friday he and his staff were devoting all their time to prepare an order but did not say how or when he would rule.

Today, Burke issued an order on secondary issues in the case and said he expected to file an opinion this week.

“This is a complicated case that raises complex and important issues and consists of many hundreds of pages of briefing and exhibits,” the judge wrote. “The Court has made very substantial progress toward crafting an opinion in this matter and expects to file the opinion by the end of this week, if not sooner.”

Alabama’s law is the first in the country to actually take effect. The Alabama Vulnerable Child Compassion and Protection Act makes it a felony to provide puberty blockers, hormones and surgeries for the purpose of helping transgender minors, people under 19, transition to the gender they identify with. Violators of the law would face a penalty of up to 10 years in prison.

Gov. Kay Ivey signed the bill on April 8, a day after it passed the Alabama Legislature. It takes effect 30 days after it was signed, meaning May 8.

Parents of four transgender youth ages 12 to 17 filed a lawsuit saying the law would deprive their children of access to established medical care that is safe, effective, and necessary. They say it violates federal law and the Constitution. They are joined in the case by a child psychologist who counsels transgender youth at UAB Hospital, a pediatrician, and a pastor. The U.S. Department of Justice opposes the law and joined the case.

The plaintiffs asked the court to issue a preliminary injunction to stop enforcement of the law while the case is pending with the goal of permanently blocking it.

Judge Burke held a three-day hearing last week, listening to testimony from witnesses for the plaintiffs, the state, and the DOJ. The parties have filed briefs and declarations from witnesses to support their positions.

Alabama Attorney General Steve Marshall and his attorneys are defending the law. The state and its expert witnesses acknowledge that youth with gender dysphoria face severe stress and higher risk of depression and suicides. But they say the medical interventions should be available only to adults because of the risks and uncertainty about the long-term consequences of treatments, such as loss of sexual function and sterility, that minors might regret as adults. They say a watchful and waiting approach with mental health counseling is the best course for minors.

At the conclusion of the hearing on Friday, Burke told lawyers from all sides to begin preparing for trial. The judge said he expected an expedited case, which he said meant in about six months.

Last year, Arkansas became the first state to ban the medical treatments for transgender youth. A federal judge temporarily blocked the law in July, a week before it was to take effect.

Jeffrey Doss, an attorney for plaintiffs in the Alabama case, said they are not challenging the ban on surgeries done for the purpose of helping transgender minors transition. During discussions of the bill in the Legislature, Alabama doctors said no such surgeries are done in the state.

Alabama lawmakers passed the bill on the last day of the legislative session this year. It was the third year for the bill to be introduced and debated with public hearings that filled committee rooms with both opponents and advocates of the law and rallies at the State House by opponents of the law.

Read more: Alabama doctors race to squeeze in appointments, prescriptions for trans children before ban takes effect.

Read more: Alabama clergy sign letter of support for transgender children.

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