Alabama doctors now face 10 years in prison if they allow puberty suppressants or hormones to transgender children, after an appeals court upheld the state’s ban.
A lower court judge had suspended the ban after four families with transgender children aged 12 to 17 challenged it as unconstitutional.
But the 11th U.S. Circuit Court of Appeals said the ban could go ahead, stressing that doubts still remain about the drugs’ safety.
It comes as more than 20 Republican-led states are facing looming lawsuits over the restrictions they’ve placed on doctors who help transgender children over the past three years.
Alabama Attorney General Steve Marshall called the ruling a “major victory for our country, for children and for common sense.”
Alabama Attorney General Steve Marshall can now threaten doctors in his state with long prison terms
Protesters lobby for trans rights outside the Alabama Statehouse in Montgomery, Alabama on March 31, 2023
Birmingham pediatrician Dr Morissa Ladinsky stressed in an April 2022 interview that the drugs were ‘safe, effective and established medical care’ for transgender teens
“The Eleventh Circuit has emphasized that the state has the authority to protect the physical and psychological well-being of minors,” he added.
Gender-affirming care for minors has been at the center of political debate in recent years, due to concerns that patients receiving this care are vulnerable and not fully aware of the risks.
The ban was imposed last year by Alabama’s Vulnerable Child Compassion and Protection Act, but was challenged by families as an unconstitutional violation of equal protection and the right to free speech, as well as an infringement on families’ medical decisions.
U.S. District Judge Liles Burke suspended the ban, concluding that Alabama had not provided credible evidence to show that the menopause medication is “experimental.”
Puberty blockers have been used for thirty years to treat children in early puberty, with Food and Drug Administration (FDA) approval, and sex steroids have been used for decades for hormonal disorders.
They have long been used to treat youth who raise gender questions, but have not been federally approved for that purpose, and the appeals court ruled that “there is uncertainty about benefits, recent increases in use, and irreversible effects.”
The wave of bans has left thousands of families with transgender children facing grueling travel across the country in search of clinics that are still allowed to serve them.
About 89,100 transgender teens ages 13 to 17 live in states with disabilities, representing 30 percent of all transgender minors in the U.S., according to research published in the Journal of the American Medical Association.
Their average trip to an appointment has increased from less than 50 minutes to 5.3 hours since the bans went into effect.
Maps published in the Journal of the American Medical Association show how average travel time to the nearest gender-affirming clinic has skyrocketed since the wave of restrictions came into effect
The American Medical Association and the American Academy of Pediatrics oppose the bans, and experts say treatments are safe when applied properly, and bans have also been temporarily blocked by federal judges in Florida, Indiana, and Kentucky.
But an appeals court also upheld Tennessee’s ban, and the issue appears destined to go to the Supreme Court.
There are concerns among Republican lawmakers about the lack of long-term safety data on puberty blockers and hormone drugs, which has led other countries such as Britain and Scandinavia to restrict access for minors.
But pediatrician Dr. Morissa Ladinsky of Birmingham said she hopes Alabama’s reinstatement of prohibition is just a “temporary setback.”
“As a physician who has treated hundreds of transgender adolescents, I know firsthand the challenges these young people and their families face and the benefits these treatments bring to youth who need them.
Alabama Governor Kay Ivey (right) signed the state’s Vulnerable Child Compassion and Protection Act last year, but campaigners have warned that the fight for transgender rights has only just begun
“This is safe, effective, and established medical care. There is no valid reason to prohibit this care.’
Advocacy groups representing families who have challenged the Alabama law pledged to continue the fight, saying that “parents, not the government, are best placed to make these medical decisions for their children.”
The Southern Poverty Law Center, the National Center for Lesbian Rights, GLBTQ Legal Advocates and Defenders and the Human Rights Campaign released a joint statement.
“Our clients are devastated by this decision, which leaves them vulnerable to what the court – after hearing several days of testimony from parents, doctors and experts – deemed irreparable harm from the loss of the medical care they received. and that has enabled them to thrive,” they said.