Transgender youth in Alabama can get gender-affirming medical care, judge rules

On Friday, a federal judge blocked part of an Alabama law that made it a crime to prescribe puberty blockers and gender-affirming hormones to transgender minors.

US District Judge Liles Burke issued an injunction to stop the state from enforcing the drug ban, which took effect on May 8, as a court challenge progresses.

The judge passed other parts of the law that prohibited gender-affirming surgeries for transgender minors, which doctors testified are not performed on minors in Alabama. He also put in place a provision that requires counselors and other school officials to tell parents if a minor reveals he or she thinks he or she is transgender.

The Vulnerable Child Compassion and Protection Act makes it a crime, punishable by up to 10 years in prison, to prescribe or administer gender-affirming medication to transgender minors to help assert their new gender identity.

Burke ruled that Alabama had produced no credible evidence to show that transitional drugs are “experimental”, while “the undisputed registry evidence is that at least twenty-two major medical associations in the United States endorse transitional drugs as well-established and evidence-based treatments for gender dysphoria in minors.”

“Law enforcement upholds and reaffirms the ‘enduring American tradition’ that parents – not states or federal courts – play the primary role in nurturing and caring for their children,” Burke wrote in the opinion.

Similar law blocked in Arkansas

The legislation was part of a wave of bills in Republican-controlled states on transgender minors, but it was the first to impose criminal penalties against doctors who provide the drugs. In Arkansas, a judge blocked a similar law before it took effect.

The US Department of Justice and four families with transgender children challenged the Alabama law as discriminatory, an unconstitutional violation of equal protection and free speech rights, and an intrusion into the family’s medical decisions.

“This is a huge relief for transgender children and their families,” Morissa Ladinsky, a pediatrician who founded a Birmingham medical team that treats children with gender dysphoria, said on Friday.

“The court ruling recognizes that this is a well-established care that has been endorsed by 22 major medical associations.

Protesters in support of transgender rights march around the Alabama State House on March 2, 2021. (Jake Crandall//The Montgomery Advertiser/The Associated Press)

Representatives for Alabama Governor Kay Ivey and Attorney General Steve Marshall could not immediately be reached for comment Friday night.

The state attorney general’s office argued that the use of the drugs is an uncertain science and therefore the state has a regulatory role to protect children. During a hearing before Burke, state prosecutors argued that European countries take a more conservative approach to drugs.

Alabama lawmakers, who passed the bill this spring, said drug decisions must wait until adulthood. “I firmly believe that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl,” Ivey said when he signed the legislation last month.

The judge said Alabama’s evidence was unconvincing. He observed a psychologist who testified that most children growing up out of gender dysphoria have never cared for a transgender minor under the age of sixteen. The other state witness was a woman who testified that she regretted taking testosterone at age 19.

The American Academy of Pediatrics and the Society for Pediatric Endocrinology endorse the treatments that clinics here and in other states are offering to transgender youth. More than 20 medical and mental health organizations asked Burke to block the law.

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