Doctors and families with transgender children seek injunction against Alabama bill criminalizing gender-affirming care to minors
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Doctors and families with transgender children seek injunction against Alabama bill criminalizing gender-affirming care to minors

Two doctors joined two parents on behalf of their minor children to file a complaint Tuesday in federal court against the governor and the district attorneys of Alabama, Shelby County, and Jefferson County, to block Alabama’s Vulnerable Child Compassion and Protection Act (“VCCPA”) from going into effect on May 8, 2022.

The VCCPA, signed into law by defendant Governor Kay Ivey on April 8, 2022, prohibits persons from “engag[ing] in or caus[ing]” the prescription or administration of puberty-blocking medication, testosterone or estrogen hormones, surgeries that sterilize, sex reassignment surgeries to genitalia, and chest reconstruction surgery if such “practice is performed 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 as defined in this act.” Conviction under the Act is a Class C felony, punishable by up to 10 years in prison or a fine of up to $15,000.00.

The two parents representing their transgender children, filing suit under pseudonyms and collectively referred to as the Transgender Plaintiffs, assert that the VCCPA violates their 14th Amendment rights, namely the Equal Protection Clause, as well as the families’ parental decision-making rights. Because the VCCPA singles out and prohibits these medications and procedures only for transgender minors, the Transgender Plaintiffs claim the VCCPA discriminates against them based on their sex and transgender status. If the VCCPA law is allowed to go into effect, the law will disrupt their ability to continue receiving medically necessary treatment for gender dysphoria.

Additionally, all the plaintiffs assert that the VCCPA deprives them of their right to Procedural Due Process because the term”caus[ing]” is not clear enough to provide notice to ordinary people regarding when it is violated and such indefiniteness encourages arbitrary or discriminatory enforcement.

Finally, the doctor-plaintiffs assert that the Act is preempted by the Affordable Care Act (“ACA”) under Section 1557, which prohibits discrimination on the basis of sex by healthcare providers who receive federal financial assistance. The two doctor-plaintiffs, Dr. Morissa Ladinsky and Dr. Hussein D. Abdul-Latif, who are recipients of federal financial assistance, assert it is impossible to comply with both the ACA and the VCCPA—compliance with the VCCPA would lead to civil liabilities under the ACA, and noncompliance would result in criminal penalties under the VCCPA.

The goal of gender dysphoria treatment, which the complaint states is “safe, effective, and medically necessary,” is typically to reduce psychological distress through measures that allow transgender people to “live in alignment with their gender identity.” When such medically necessary treatment is withheld, gender dysphoria can cause “anxiety, depression, and self-harm, including suicidality.” Medical research has shown that gender identity is biologically based and unchangeable. Accordingly, the plaintiffs state that the VCCPA will result in “severe psychological distress and irreversible physical changes” to patients, like the Transgender Plaintiffs, already undergoing treatment for gender dysphoria, which “will result in long-lasting damage to their health.”