Court Rules Alabama Can Enforce Ban on Transgender Medical Treatments for Minors

A three-judge panel of the U.S. Court of Appeals for the 11th Circuit unanimously reversed a district court’s temporary halt to enforcement of an Alabama law that prohibits minors from obtaining puberty blockers, cross-sex hormones, and transgender surgeries for treating gender dysphoria.

In Eknes-Tucker v. Marshall, the appeals court on Monday rejected the plaintiffs’ arguments, described in the opinion as “a group of transgender minors, their parents, and other concerned individuals” who challenged the constitutionality of Alabama’s Vulnerable Child Compassion and Protection Act.

The opinion describes the law:

Section 4(a)(1)–(3) of the Act states that “no person shall engage in or cause” the prescription or administration of puberty blocking medication or cross-sex hormone treatment to a minor “for the purpose of attempting to alter the appearance of or affirm the minor’s perception of his or her gender or sex, if that appearance or perception is inconsistent with the minor’s sex.” Thus, section 4(a)(1)–(3) makes it a crime in the State of Alabama to take part in providing puberty blockers or cross-sex hormone treatment to a minor for purposes of treating a discordance between the minor’s biological sex and sense of gender identity.

The appeals court rejected the arguments of the plaintiffs that the law violates the Due Process and Equal Protection Clauses of the Fourteenth Amendment:

Specifically, as to the due process claim, the district court held that there is a constitutional right to “treat [one’s] children with transitioning medications subject to medically accepted standards” and that the restrictions of section 4(a)(1)–(3) likely impermissibly infringe upon that constitutional right. As to the equal protection claim, the district court held that section 4(a)(1)–(3) classifies on the basis of sex by classifying on the basis of gender nonconformity and likely amounts to unlawful discrimination under the intermediate scrutiny standard applicable to sexbased classifications.

The court ruled that the district court “abused its discretion in issuing this preliminary injunction because it applied the wrong standard of scrutiny”:

The plaintiffs have not presented any authority that supports the existence of a constitutional right to “treat [one’s] children with transitioning medications subject to medically accepted standards.” Nor have they shown that section 4(a)(1)–(3) classifies on the basis of sex or any other protected characteristic. Accordingly, section 4(a)(1)–(3) is subject only to rational basis review. Because the district court erred by reviewing the statute under a heightened standard of scrutiny, its determination that the plaintiffs have established a substantial likelihood of success on the merits cannot stand. We therefore vacate the preliminary injunction.

“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,” said Alabama Attorney General Steve Marshall (R) in a statement Tuesday.

Meanwhile, transgender activists lamented the ruling.

Dr. Morissa Ladinsky, a transgender industry pediatrician and co-leader of the University of Alabama Youth Multidisciplinary Gender Health Team, said in a statement to The Associated Press (AP) Monday that she is hopeful “today’s decision is just a temporary setback.”

“As a doctor who has treated hundreds of transgender adolescents, I know firsthand the challenges these young people and their families face and the benefits these treatments provide to youth who need them,” Ladinsky added. “This is safe, effective, and established medical care. There is no valid reason to ban this care.”

The discredited Southern Poverty Law Center, the National Center for Lesbian Rights, GLBTQ Legal Advocates & Defenders, and the Human Rights Campaign also reacted to the court’s ruling with the joint statement their 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.”

After Governor Kay Ivey (R) signed the legislation into law in April 2022, the Biden Department of Justice filed a lawsuit challenging the new law, marking the first time the DOJ has sued an individual state over a law protecting minors from an activist transgender medical industry.

The leftist American Civil Liberties Union (ACLU) also promptly vowed to sue the state.

In May 2022, the federal district court issued its preliminary injunction blocking the law from being enforced.

“Alabama takes this responsibility seriously by forbidding doctors from prescribing minors sex-modification procedures that have permanent and often irreversible effects,” Marshall said about the ruling. “This is a significant victory for our country, for children, and for common sense.”

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Susan Berry, PhD is national education editor at The Star News Network. Email tips to [email protected]




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