Alabama approves ban on medical care for transgender youth

Alabama lawmakers voted Thursday to criminalize medical care for transitioning transgender youth, adopting some of the most restrictive language in the country and threatening doctors and nurses with up to 10 years in prison.

The legislation was approved as conservative lawmakers across the country focused their attention on transgender people and other LGBTQ issues. They have pursued a series of bills aimed at limiting what doctors call gender-affirming care, restricting what students learn about gender and sexuality in the classroom, and banning some transgender students from participating in school sports.

Thursday, Alabama lawmakers also advanced legislation this would require students to use restrooms and locker rooms for the gender listed on their original birth certificates. It also included an amendment that would restrict classroom discussions of gender and sexuality from kindergarten through fifth grade — a version of what critics are calling a “Don’t Say Gay” measure that goes further than some other states.

But the Medical Care Bill has become one of the most far-reaching, as it would make it a crime to prescribe puberty-blocking hormones or drugs or to perform gender-affirming surgeries. Nor would it allow educators and school nurses to “encourage or coerce” students to conceal from their parents “the fact that the minor’s perception of his or her gender or sex is inconsistent with the minor’s sex” .

Governor Kay Ivey, a Republican, has not said whether she will sign the legislation. His office did not immediately respond to a request for comment.

The measures have been condemned by the transgender community as well as by the medical establishment. In recent years, other states have considered, and in some cases approved, legislation aimed at preventing doctors and nurses from providing gender-affirming care to young people, although none have created an offense at the crime level.

Critics of the Alabama bill also argue that it could spur lawmakers in other states to enforce such restrictions. “It’s a scaremongering attempt, but it sets other states up to go very far,” said Shelby Chestnut, director of policy and programs at the Transgender Law Center.

Proponents of the legislation – called the “Compassionate and Protecting Vulnerable Children Act” – argue that the measure was intended to protect children. In the bill, the sponsors argued that “minors, and often their parents, are unable to understand and fully appreciate the risks and consequences to life, including permanent sterility, that result from use of puberty blockers, cross-sex hormones and surgical interventions. .”

“Their brains are not developed to make long-term decisions about what these drugs and surgeries are doing to their bodies,” said Wes Allen, the Republican lawmaker who introduced the bill to the State House, during the debate on the bill on Thursday.

The American Medical Association has called these types of measures “a government intrusion into the practice of medicine that harms the health of transgender and gender-diverse children and adults.”

In a letter to the National Governors Association last yearthe organization said transitioning care is medically necessary and giving up care could have devastating consequences, as transgender people are up to three times more likely than the general population to report or be diagnosed with mental health issues and have an increased risk of suicide.

Some activists worry that these measures could heighten the risk.

“We’re going to see more and more of our kids leaving,” said TC Caldwell, director of community engagement for the Knights and Orchids Society, a Selma organization that provides resources for transgender youth. “I fear that people will leave. Alabama is home. It’s home to many of us who don’t want to leave and many of us who can’t afford to leave – who shouldn’t have to.

More than a dozen states have considered legislation in recent years aimed at blocking gender-affirming care for young people. Last summer, a federal court blocked Arkansas from enforcing a law that made it the first state to ban doctors from providing sex-confirming hormone therapy, puberty blockers or sex reassignment surgery to anyone under the age of 18.

In Arizona, Governor Doug Ducey signed legislation last month blocking certain forms of gender-affirming care for minors. Tennessee lawmakers also approved a bill this year that would ban providing hormone drugs to children before puberty. But these measures are not considered criminal-level offences.

Idaho lawmakers are considering even more restrictive legislation, making it a crime punishable by as severe a penalty as life imprisonment for parents to seek gender-affirming health care for their children, even if they want it. did while leaving the state. the the bill passed at the State House.

“If we don’t allow minors to get tattoos, smoke cigarettes and drink alcohol or sign legal contracts,” said Bruce Skaug, the Idaho Republican lawmaker who sponsored the legislation, “why would we allow them to make decisions to cut organs based on their feelings during puberty?”

The flurry of legislation and debate in state capitals represents the biggest push by groups opposing transgender rights since the nationwide campaign to limit bathroom access in 2017 and 2018.

In February, Governor Greg Abbott of Texas ordered state agencies to investigate parents for child abuse if they provided certain medical treatments to their transgender children – an effort that was temporarily halted last month by a court order.

Several states, including Alabama, have also banned transgender students who compete in interscholastic competitions from playing on teams that match their gender identity.

In late March, Governor Ron DeSantis of Florida signed into law a measure prohibiting public school teachers at certain grade levels from teaching students about sexual orientation or gender identity. The law has inspired lawmakers in other states to consider similar measures, called “Don’t Say Gay” by critics. Ohio lawmakers have introduced a measure that mirrors that of Florida. And in Texas, the lieutenant governor said this week that he intends to make such a measure a priority.

Advocates for the transgender community argue that the legislation and surrounding rhetoric endanger children who are already vulnerable as they struggle with their gender identity.

“Puberty is hard enough,” said Felicia Scalzetti, organizer of Hometown Action, an advocacy group that has protested the legislation. “Imagine walking through it while feeling out of body.”

“Visibility is important,” they said. “Children must be able to see each other without fear of reprisals.”

As Alabama lawmakers considered the gender-affirming medical care bill, they heard moving testimony from at least one person who expressed regret over the transition, as well as others who made argue that lawmakers were preparing to punish the doctors and nurses they attribute to care they considered essential. and saving.

“You are asking me to one day handcuff these people who are heroes in my life and arrest the people who saved my daughter,” said David Fuller, father of a transgender girl and police officer in Gadsden, Kenya. Alabama. legislators during a hearing. “Please don’t ask me to do this. »