Alabama Law Criminalizing Gender-Affirming Care for Youth Takes Effect

Above: Protesters rally against anti-transgender legislation in Alabama

Alabama's law criminalizing the provision of gender-affirming care to minors went into effect Sunday, and health care professionals, parents, and others are worried.

Gov. Kay Ivey signed a bill into law April 8 making it a felony to provide such care, with punishment for violation of up to 10 years in prison and a fine of up to $15,000. It is the most extreme law on the matter in any state.

In a lawsuit brought by parents of transgender children, a physician, a psychologist, and minister, U.S. District Judge Liles Burke heard testimony last week from both plaintiffs and defendants. The plaintiffs want Burke to issue an injunction temporarily blocking the law while the suit proceeds. He issued an order Monday "on secondary issues in the case," AL.com reports, but he did not block it. He said he would issue a more detailed order this week.

"This is a complicated case that raises complex and important issues and consists of many hundreds of pages of briefing and exhibits," Burke wrote, according to AL.com. "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."

Doctors who treat trans youth were deeply concerned about the law and were rushing last week to supply their patients with enough hormones and puberty blockers to last several months before it became illegal to prescribe them. In the past couple of weeks, doctors at the University of Alabama at Birmingham's Gender Clinic "have contacted about 100 recent patients to make sure they have prescriptions they need to maintain treatment in the next year," AL.com reports. Dr. Hussein Abdul-Latif, a physician at the clinic, told the site he was working 14-hour days. Other staffers and patients were panicking, he said.

To the Associated Press, he added, "The state is not only saying I am criminal for prescribing those medications, but it's saying that my organization of thousands of physicians, pediatricians, and pediatric endocrinologists are maybe partners in that criminal enterprise."

Dr. Morissa Ladinsky, another physician at the clinic, told the AP the passage of the law made her feel she was "walking in a nightmare." She continued, "This is the first time ever that I can remember, at least for pediatricians, that we are literally forced to choose between the Hippocratic Oath we took to 'do no harm' and never abandon our patients versus the facing of a potential felony conviction."

The Alabama law is the first to criminalize gender-affirming care for minors, including prescription of hormones and puberty blockers as well as genital surgery, which is not recommended for minors anyway. Some other states have considered such legislation but not passed it. Arkansas passed a ban on such care last year, but it provides for professional discipline for violations, not criminal penalties. The Arkansas law is temporarily blocked by a court while a lawsuit against it is heard.

In Texas, Gov. Greg Abbott ordered that parents who allow their minor children to receive gender-affirming care be investigated for child abuse. He based the order on an opinion issued by the state's attorney general, Ken Paxton. Abbott's directive is likewise blocked due to court action.

A recently published study by scientists and professors, including doctors at the Yale School of Medicine, concluded that both Paxton's opinion and the Alabama law are based on political bias and not science.

The U.S. Department of Justice has filed a motion to intervene in the case being heard by Judge Burke, saying the Alabama law is unconstitutional. The case is one of multiple suits against the statute.