Federal Court Sides With Alabama on Transgender Treatment Ban for Minors

A federal appeals court has supported an Alabama law stating that it is a felony to offer transgender treatments—including hormone therapy, puberty blockers, and surgery—to minors.
Federal Court Sides With Alabama on Transgender Treatment Ban for Minors
Transgender affirming childrens books in Irvine, Calif. on Aug. 30, 2022. (John Fredricks/The Epoch Times)
Naveen Athrappully
8/22/2023
Updated:
8/22/2023
0:00

A federal appeals court has reversed a preliminary injunction against an Alabama law that sought to ban transgender procedures for minors, noting states have a “compelling interest” in protecting children from potentially harmful medications.

Alabama’s “Vulnerable Child Compassion and Protection Act,” or SB 184, makes it a felony to provide transgender treatments to minors, including hormone therapy, puberty blockers, and surgery. Passed by the state Legislature in April 2022, medical providers who violate the law could face up to 10 years in prison. A month later in May 2022, U.S. District Judge Liles C. Burke granted a preliminary injunction against the law, blocking it from coming into effect.

On Monday, a three-judge panel of the 11th U.S. Circuit Court of Appeals vacated the May 2022 injunction against SB 184, paving the way for the bill to come into effect.

However, the injunction will continue to remain in place until the court issues an official mandate, which could take several days. Once the injunction is officially lifted, SB 184 can be enforced in Alabama.

“States have a compelling interest in protecting children from drugs, particularly those for which there is uncertainty regarding benefits, recent surges in use, and irreversible effects,” the court opinion said (pdf).

“The record evidence is undisputed that the medications at issue present some risks. As the district court recognized, these medications can cause ‘loss of fertility and sexual function.' The district court also acknowledged testimony that ‘several European countries have restricted treating minors with transitioning medications due to growing concern about the medications’ risks.’”

The appeals court criticized the district court’s rationality while issuing the preliminary injunction.

The district court had held that there was a specific right under the U.S. Constitution which allows parents “to treat [one’s] children with transitioning medications subject to medically accepted standards.”

However, the district court’s judgment on this point is based on “an unprecedented interpretation” of the fundamental rights of parents regarding the upbringing, care, and control of their children, the opinion stated.

“That was error,” it said.

“Neither the record nor any binding authority establishes that the ‘right to treat [one’s] children with transitioning medications subject to medically accepted standards’ is a fundamental right protected by the Constitution.”

No Violation of Equal Protection Clause

The judges in the 11th U.S. Circuit Court of Appeals also dismissed the argument that SB 184 violated the equal protection clause and criticized the district court for judging the law as classifying individuals “on the basis of sex.”

It pointed out that the state of Alabama has argued that the law only “classifies on the bases of age and procedure, not sex or gender nonconformity.” The court agreed that SB 184 is best understood as a law “that targets specific medical interventions for minors” rather than something violating the equal protection clause.

A young girl at the annual New York City Pride March in New York City on June 25, 2023. (Samira Bouaou/The Epoch Times)
A young girl at the annual New York City Pride March in New York City on June 25, 2023. (Samira Bouaou/The Epoch Times)

SB 184 “establishes a rule that applies equally to both sexes,” the appeals court stated, while reasoning that the law only refers to sex because it regulates medical procedures that are “themselves sex-based.”

“The regulation of a course of treatment that, by the nature of things, only transgender individuals would want to undergo would not trigger heightened scrutiny unless the regulation is a pretext for invidious discrimination against such individuals, and, here, the district court made no findings of such a pretext,” the opinion stated.

In addition to banning transgender treatment for minors, SB 184 prohibits school staff from withholding information from parents or legal guardians if a minor’s perception of his or her gender is “inconsistent with the minor’s sex.”

The bill states that individuals who undergo transgender procedures have been found to suffer from elevated mortality rates and higher rates of substance abuse, depression, and psychiatric hospitalizations compared to the general population.

It argues that minors are “unable to comprehend and fully appreciate the risk and life implications” resulting from such procedures.

While introducing the bill, Republican state Rep. Wes Allen pointed out that “we make decisions in this body all the time that are to protect children from making decisions that could permanently harm them.” He gave the example of how minors are prohibited from getting tattoos or buying nicotine products.

Responses

Critics of the bill slammed the latest ruling.

In an Aug. 21 statement, the Southern Poverty Law Center, which represents the plaintiffs challenging the law, called the ruling “a deeply disappointing decision.”

“Our clients are devastated by this decision, which leaves them vulnerable to what the district court—after hearing several days of testimony from parents, doctors, and experts—found to be irreparable harm as a result of losing the medical care they have been receiving and that has enabled them to thrive,” it said.

However, Alabama Attorney General Steve Marshall welcomed the decision in an Aug. 21 statement, calling it “a significant victory for our country, for children, and for common sense.”

“The Eleventh Circuit reinforced that the State has the authority to safeguard the physical and psychological wellbeing of minors, even if the United States Attorney General and radical interest groups disapprove,” Mr. Marshall said.

The 11th Circuit’s decision comes as a federal judge in Atlanta recently put a temporary freeze on the implementation of a Georgia law prohibiting the use of cross-sex hormones to treat minors identifying as transgender.