Alabama doctors, parents of transgender kids sue to block law banning cross-sex hormones for children

Plaintiffs, represented by the ACLU and the Southern Poverty Law Center, claim the law violates Obamacare and federal anti-discrimination law

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The parents of two Alabama children who identify as transgender joined with two medical doctors in suing Alabama Gov. Kay Ivey and other state officials in an attempt to block the state's new law banning cross-sex hormones and so-called "puberty-blocking" drugs for minors. 

The parents and doctors – represented by a bevy of left-leaning law firms including the American Civil Liberties Union (ACLU), the Southern Poverty Law Center (SPLC), and the Human Rights Campaign, among others – claim that S.B. 184, which Ivey signed Friday, violates federal non-discrimination law, including a provision of the Affordable Care Act, also known as Obamacare.

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"I believe very strongly that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl," Ivey said Friday in a statement. "We should especially protect our children from these radical, life-altering drugs and surgeries when they are at such a vulnerable stage in life."

Gov. Kay Ivey takes questions from reporters during a press conference at the Alabama State Capitol Building in Montgomery, Ala., on Wednesday, April 7, 2021.

Gov. Kay Ivey takes questions from reporters during a press conference at the Alabama State Capitol Building in Montgomery, Ala., on Wednesday, April 7, 2021. (Reuters)

"By signing SB 184 Governor Ivey has told kind, loving, and loyal Alabama families that they cannot stay here without denying their children the basic medical care they need," Dr. Morissa Ladinsky, one of the doctors suing the state, said in a statement Monday. "She has undermined the health and well-being of Alabama children and put doctors like me in the horrifying position of choosing between ignoring the medical needs of our patients or risking being sent to prison."

The lawsuit claims that the law's "prohibitions on the provision of safe, effective, and medically necessary care for transgender minors lack a rational foundation and serve no legitimate purpose." The lawsuit cites the American Medical Association, the American Academy of Pediatrics, the Pediatric Endocrine Society, the American Psychological Association, and other medical and mental health associations that support the use of cross-sex hormones and so-called "puberty-blocking" drugs to treat gender dysphoria, the persistent and painful state of identifying as the gender opposite one's biological sex.

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The suit claims that the law violates Section 1557 of the Affordable Care Act, which states that "an individual shall not … be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity" that receives federal funding. The lawsuit also claims violations of the Equal Protection Clause and due process in the 14th Amendment. 

MONTGOMERY, AL - MARCH 22: Exterior view of the Alabama State Capitol on March 22, 2020 in Montgomery, Alabama.

MONTGOMERY, AL - MARCH 22: Exterior view of the Alabama State Capitol on March 22, 2020 in Montgomery, Alabama. (Photo by Taylor Hill/Getty Images)

The lawsuit seeks a declaration that the law violates federal law, an injunction against Alabama officials preventing its enforcement, and attorney's fees. 

Some doctors have warned against the use of such medical interventions, however.

Most hormone treatments "are only FDA approved as puberty blockers in children for the purpose of treating central precocious puberty and not for gender dysphoria," Dr. Michael Laidlaw, an independent private practice endocrinologist in Rocklin, California, told Fox News in December 2021.

April 10, 2017: Kay Ivey walks in to be sworn in as the next Governor of Alabama in Montgomery, Ala. 

April 10, 2017: Kay Ivey walks in to be sworn in as the next Governor of Alabama in Montgomery, Ala.  (AP)

"Central precocious puberty is a medical condition in which a child starts puberty at an abnormally young age, say age 4," Laidlaw explained. "Medications like Supprelin LA are used to stop this abnormal puberty. Then once the child reaches a typical age for puberty (say age 11 or 12), the medication is stopped, and then normal puberty will resume."

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"The off-label use of these medications for gender dysphoria is completely different," the endocrinologist added. "In this case the healthy child has already begun normal puberty. But then the medication is given to block normal puberty. Blocking normal puberty has numerous unhealthy side effects including loss of normal bone development, interference with normal brain and social development, and importantly causes infertility and sexual dysfunction. Many of these effects will be irreversible."