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Alabama judge considers whether to block new ban on gender-affirming care for youth


A new law in Alabama bans gender-affirming medical treatments for anyone under 19. It's set to take effect on Sunday. Today, a federal judge is considering whether it can move forward. Families of transgender youth argue that allowing enforcement would cause irreparable harm. Attorneys for Alabama say the law will protect children from risky interventions that they may later regret.

NPR's Debbie Elliott has been covering a two-day hearing in Montgomery. Hi, Debbie.


SHAPIRO: You told us yesterday about the arguments that lawyers made on behalf of the parents of trans young people. Today, lawyers for the state of Alabama presented their witnesses. How are they defending this transgender medical treatment ban?

ELLIOTT: You know, the general theme has been to portray these gender-affirming medicines - we're talking about puberty blockers or cross-sex hormone therapy, for instance - as risky, as unproven, and as experimental interventions. A 23-year-old woman testified that she regretted trying to transition from female to male using testosterone therapy when she was 19 and in the state of Georgia. She said she was under a mental delusion at the time.

Then, there was testimony from Toronto clinical psychologist James Cantor, who said that a majority of youth who are diagnosed with gender dysphoria later desist, meaning that they change their minds and identify with the sex that they were assigned at birth. He testified that there's no medical consensus in the U.S. Now, he says this despite the fact that most major medical associations consider gender-affirming treatments an accepted standard of care for transgender adolescents.

Under cross-examination, he did acknowledge that he treats adults and has no knowledge of how transgender youth are diagnosed and treated in Alabama. He was also forced to agree that some studies have shown that gender-affirming medical care improves mental health outcomes for some transgender youth.

SHAPIRO: So if this law is allowed to take effect on Sunday, what would it do?

ELLIOTT: Well, it would become a felony, punishable by 10 years in prison, for parents and youth to seek or for doctors to provide gender-affirming medical treatments or surgeries for anyone under 19 years old. The families who have sued say this is an unconstitutional infringement on parental autonomy and discriminates against these youth. The U.S. Justice Department agrees and has intervened in this case.

Plaintiffs presented testimony Thursday from medical professionals who say banning the treatments would have a devastating impact and could raise the risk of suicide and other emotional problems for these teenagers. Doctors also testified that the law puts them in this position where they're forced to choose between obeying the law or abandoning their oath to do no harm and face conviction.

SHAPIRO: There's a tight timeline here. So how does the case resolve?

ELLIOTT: Well, now it's up to U.S. District Judge Liles Burke to decide whether or not to block enforcement of the law while the plaintiffs pursue these constitutional questions. We should note that a federal judge in Arkansas blocked a similar law in that state, and based on questions in the Alabama courtroom, Judge Burke is very aware of that ruling.

During closing arguments this evening, plaintiffs' attorney Jeffrey Doss told the judge that Alabama's law criminalizes parents' concern and love for a child and violates fundamental parental freedom. Alabama Solicitor General Edmund LaCour, on the other side, argued that the state has a wide discretion to regulate areas of medical uncertainty. So we're just waiting on Judge Burke to decide, and Sunday is that deadline.

SHAPIRO: NPR's Debbie Elliott. Thank you.

ELLIOTT: You're welcome, Ari. Transcript provided by NPR, Copyright NPR.

NPR National Correspondent Debbie Elliott can be heard telling stories from her native South. She covers the latest news and politics, and is attuned to the region's rich culture and history.