Trans kids in Alabama face 'agonizing' future under new health care law

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The law is part of a tidal wave of bills targeting transgender youth across the country.

Transgender youth in Alabama are set to lose access to medications and treatments they were already taking or were set to take later this year, thanks to a new law banning gender-affirming care in the state.

Alabama Gov. Kay Ivey (R) signed the bill into law on Friday. It will go into effect next month, barring any legal intervention.

Under the new law, puberty blockers, hormone treatments, and gender-affirming surgeries would be banned for anyone under age 19, which is Alabama's age of majority. The law would also make it a felony punishable by up to 10 years in prison for physicians to provide gender-affirming care to transgender youth. Another section of the law says teachers, nurses, administrators, and counselors can't "encourage or coerce" a child to keep their gender identity from their family or withhold information they have on their gender identity.

Parents of trans youth in Alabama who are working with LGBTQ groups and civil rights organizations to oppose the law told the American Independent Foundation that this ban would be incredibly harmful to their children.

On Monday, the American Civil Liberties Union, Lambda Legal, and the Transgender Law Center filed a lawsuit against the state challenging its new medical care ban. The pro-LGBTQ rights groups argue in their lawsuit that the law violates the nondiscrimination protections enshrined in Section 1557 of the Affordable Care Act.

The Human Rights Campaign, GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, and the Southern Poverty Law Center filed a separate lawsuit on Monday on behalf of families of trans minors and two physicians who provide gender-affirming care.

The ACLU's lawsuit centers on two families of trans young people who would lose gender-affirming care under the Alabama law.

One of the transgender girls in the lawsuit, who is referred to as H.W., is 15 years old and began taking puberty blockers at 12. A doctor has also recommended that she begin hormone treatments in addition to the puberty blockers. H.W. is supposed to start taking estrogen in the fall, but her continuing treatment and planned treatment could be put on hold by Alabama's new law.

"If you just saw us in the mall or walking down the street, you would see a 15-year-old girl because that's just who she is," Jeff Walker, H.W.'s father, told the American Independent Foundation. "That's what she looks like and that's how she presents herself. What [H.W.] is most afraid of is if she stops this care, she's going to develop those characteristics that are not her, right?"

Walker said his daughter became more confident after she received gender-affirming care.

"My child went from shy and reserved, and today I can't even imagine describing her as shy and reserved and quiet, to blossoming into the young lady that she has become, who's out here in the front right leading trying to lead the charge for trans youth in America to be accepted and get the care they need," he said.

H.W. stated in an announcement for the lawsuit, "I chose to be proud of who I am. The possibility of losing access to my medical care because of this law causes me deep anxiety."

Another plaintiff in the lawsuit, who is referred to as C.W., is a 13-year-old transgender girl. C.W. began puberty-suppressing treatment in 2019, which "made an incredible difference in C.W.'s life, health, and happiness," the complaint said. Since the law would put an end to this treatment, C.W.'s family has considered relocating to another state.

Jeff White and Christa White, C.W.'s parents, spoke to the American Independent Foundation.

Christa White said "it would be agonizing" if her daughter had to go off puberty blockers and experienced bullying and harassment as a result.

When describing what gender-affirming care has meant for her daughter, Christa White said, "The light in her eyes was back."

She explained that when C.W. met with an endocrinologist and talked through what this type of health care would be like for her, "You could tell just by her smile that she knew that's where she needed to be. And it was an amazing moment to witness. And all of us were tearing up and the joy was just palpable.”

Jeff White said that moving out of Alabama would present a lot of additional expenses for the family since the state is an affordable place to live compared to states where he sees a better political environment for his daughter.

"The level of organization involved in doing this simultaneously in tons of places all over the country is very concerning to us. It's like there's a cultural imperative that there be fewer trans people, period. And so this is the assembling of the government apparatus to make that happen," he said.

White said anti-trans bills across the nation are also a source of worry. The medical care ban bill Ivey signed into law is only one of a tidal wave of bills focusing on trans youth. In 2022, state legislators introduced at least 238 anti-LGBTQ bills, the majority of which have targeted trans people specifically, NBC News reported in March.

Plaintiffs in the Human Rights Campaign lawsuit include "Mary Doe," a 13-year-old transgender girl, and "John Doe," a 17-year-old transgender boy. "Mary" began attending a new school after she started dressing according to her gender, and is known by her current gender-affirming name rather than her deadname, according to the complaint, which explained that she is "private about the fact that she is transgender." She began taking puberty blockers last year. This means that if she stops receiving this care, it will become apparent to other people who were not aware she is transgender, and Mary would be outed as a result, according to lawyers.

"John" would have to end hormone treatments entirely. He would also not be able to receive the chest reconstruction surgery that a physician said he could schedule later this year since the age of majority in Alabama is 19, the complaint says.

On the same day that Ivey signed a bill into law that punishes doctors with criminal penalties for providing gender-affirming care, she approved a school bathroom bill that includes a provision similar to Florida's "don't say gay or trans" bill. The law will go into effect on the first day of the third month after Ivey signed the bill.

In addition to Alabama's law banning gender-affirming treatments, Arizona Gov. Doug Ducey signed a medical care ban into law in March. It will not go into effect until March 31, 2023. The bill bans gender-affirming surgeries for minors, but not hormone treatments or puberty blockers.

Republican lawmakers in Arkansas and Tennesee passed bills banning gender-affirming care in 2021. Last April, Arkansas state lawmakers overrode a veto from Republican Gov. Asa Hutchinson to pass a law banning all gender-affirming care for trans youth. A federal judge halted the Arkansas law before it could go into effect.

Last May, Tennessee Gov. Bill Lee signed into law a ban on hormone treatments for prepubertal minors, despite the fact that best practices for gender-affirming care direct physicians to not prescribe such treatments to trans youth until they have entered puberty.

Published with permission of The American Independent Foundation.