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Federal judge blocks Alabama law criminalizing medical care for transgender youth

Trump-appointed U.S. District Judge Liles Burke found that the plaintiffs are substantially likely to win their case on multiple grounds.


Transgender youth in Alabama can once again receive medical treatment for gender dysphoria as a federal judge has issued an injunction against the Alabama law seeking to criminalize the care.

U.S. District Judge Liles Burke, who was appointed by former President Donald Trump, allowed the law to go into effect last Sunday while he crafted his decision, which he released Friday night.

Burke found that the plaintiffs are substantially likely to win their case on multiple grounds.

“Parent Plaintiffs are substantially likely to show that they have a fundamental right to treat their children with transitioning medications subject to medically accepted standards and that the Act infringes on that right,” Burke wrote in the ruling. “The Act prevents Parent Plaintiffs from choosing that course of treatment for their children by criminalizing the use of transitioning medications to treat gender dysphoria in minors, even at the independent recommendation of a licensed pediatrician.”

Burke said the state failed in its attempt to show that the medications are “experimental” and harmful.

“Defendants produce no credible evidence to show that transitioning medications are ‘experimental,’” The ruling states. “While Defendants offer some evidence that transitioning medications pose certain risks, 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.”

In addition to the parents’ rights to decide their children’s medical treatments, Burke also found the law likely to discriminate against the minors on the basis of sex.

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The State argued that the bill is not discriminatory on sex, but argued that the law “creates two categories of people: (1) minors who seek transitioning medications ‘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’; and (2) ‘all other minors.’

“Because transgender minors fall into both categories, the State reasons, the Act is not a sex-based classification.

“The fundamental flaw in this argument is that the first category consists entirely of transgender minors,” Burke wrote. “The Act categorically prohibits transgender minors from taking transitioning medications due to their gender nonconformity. In this way, the Act places a special burden on transgender minors because their gender identity does not match their birth sex.”

In addition to the likelihood of succeeding on these merits, the court had to find that the plaintiffs would suffer irreparable harm before it could issue an injunction.

“The record shows that, without transitioning medications, Minor Plaintiffs will suffer severe medical harm, including anxiety, depression, eating disorders, substance abuse, self-harm, and suicidality,” Burke wrote. “Additionally, the evidence shows that Minor Plaintiffs will suffer significant deterioration in their familial relationships and educational performance.”

With the injunction now in place, the trial will continue on the merits of the case, which both sides said they expected to take at least six months.

Attorney General Steve Marshall on Saturday released a statement expressing his “disappointment” in the ruling and announcing the state is working on an appeal.

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Gov. Kay Ivey said she would “continue fighting to protect Alabama’s children from these radical, unproven, life-altering drugs, despite this temporary legal road block.”

Jacob Holmes is a reporter at the Alabama Political Reporter. You can reach him at [email protected]

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