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Transgender medication law in Alabama blocked by judge

Alabama Gov. Kay Ivey sits at a desk.
Alabama Gov. Kay Ivey, shown in 2021, reiterated her defense of a transgender medication law after a federal judge partially blocked it Friday.
(Jake Crandall / Associated Press)
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A federal judge on Friday blocked part of an Alabama law that made it a felony to prescribe gender-affirming puberty blockers and hormones to transgender minors.

U.S. District Judge Liles Burke issued a preliminary injunction to stop the state from enforcing the medication ban, which took effect May 8, while a lawsuit goes forward. The ruling was a victory for families and advocacy groups that challenged the first-of-its-kind law as an illegal intrusion into family and medical decisions.

Alabama Gov. Kay Ivey referred to the ruling as a “temporary legal roadblock.” Alabama’s state attorney general has indicated that he will appeal.

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“This ruling means that parents of transgender children in Alabama will continue to be able to make the healthcare decisions that are best for their families. It is an extraordinary relief. Parents should not be punished for wanting to do what’s best for their kids,” said Jennifer Levi, director of the Transgender Rights Project for GLBTQ Legal Advocates & Defenders.

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The Vulnerable Child Compassion and Protection Act made it a felony, punishable by up to 10 years in prison, to prescribe or administer to transgender minors medication to help affirm a new gender identity. The judge left in place another part of the law that banned gender-affirming surgeries for transgender minors, which doctors had testified are not conducted on minors in Alabama. He also left in place a provision that requires counselors and other school officials to tell parents if minors disclose that they think they are transgender.

“We will continue fighting to protect Alabama’s children from these radical, unproven, life-altering drugs, despite this temporary legal road block,” Ivey said in a statement Saturday morning. “It is especially important while they are at such a vulnerable stage in life. We will continue to uphold our duty to ensure that children are free to grow up into the adults God intended them to be, even with today’s societal pressures and modern culture.”

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A spokesman said Alabama Atty. Gen. Steve Marshall is disappointed in the court’s decision “and is already working on filing an appeal in defense of the law.”

Four families with transgender children ranging in age from 12 to 17 had filed a lawsuit challenging the Alabama law as discriminatory, an unconstitutional violation of equal protection and free speech rights and an intrusion into family medical decisions. The U.S. Department of Justice joined the lawsuit seeking to overturn the law.

Burke, nominated to the court in 2017 by President Trump, ruled that Alabama had produced no credible evidence to show that transitioning medications are “experimental.”

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He added in the ruling that “the uncontradicted record evidence is that at least twenty-two major medical associations in the United States endorse transitioning medications as well-established, evidence-based treatments for gender dysphoria in minors.” He noted testimony from a mother who said she feared her child would commit suicide if she lost access to the medications.

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

Jeff Walker of Auburn, Ala., told the Associated Press the ruling “took a lot of weight off our shoulders.” His family is not a plaintiff in the case but had been scrambling to figure out how to continue to care for their daughter, Harleigh, 15. Harleigh said the decision was a “huge stress relief.”

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

Dr. Morissa Ladinsky, a pediatrician who founded a Birmingham medical team that treats children with gender dysphoria, said the decision was a “huge relief for transgender children and their families.”

“The court’s decision recognizes that this is well-established care that has been endorsed by 22 major medical associations. This decision will ensure transgender children in Alabama and
beyond can continue to receive this evidence-based, well-known, life-saving care,” she said.

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More than 20 medical and mental health organizations urged Burke to block the law. Fifteen states filed briefs in the case in support of Alabama’s law.

The Alabama attorney general’s office argued that the use of the medications is unsettled science, and thus the state has a role in regulation to protect children. During a court hearing
before Burke, state attorneys argued that European countries take a more conservative approach to the medications. Alabama lawmakers, who approved the bill this spring, said decisions on the medications should wait until the patient enters adulthood.

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