Alabama became the first state to criminalize the use of puberty blockers to treat transgender people under age 19. In line with some other Republican-led states, legislators also passed a law requiring students to use bathrooms corresponding to their sex at birth and prohibiting discussion of gender and sexual identity in the lower grades.

Several critics derided the limitation on such discussions as the “Don’t Say Gay” law.

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In April this year, the two GOP bills were signed into law by Republican Gov. Kay Ivey. Advocacy groups quickly filed a lawsuit challenging the medication ban.

It is reported that the Republicans argue the bills are needed to protect children and that decisions on gender-affirming medications should wait until adulthood. Critics have reportedly said politicians are interfering with medical decisions that belong with families and their doctors.

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Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, a national advocacy group for the LGBTQ community, called the two pieces of legislation “the single most anti-transgender legislative package in history.”

What does the treatment ban do?

The law, titled the “Alabama Vulnerable Child Compassion and Protection Act,” makes it a crime to prescribe or administer to anyone under 19 puberty blockers or hormone treatment “for the purpose of attempting to alter the appearance of or affirm the minor’s perception of his or her gender or sex.”

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Legislators made it a Class C felony to violate the law. This means, doctors who prescribe or administer such medication would be subject to up to 10 years in prison.

The law, unless blocked by the courts, also bans surgeries for the purpose of altering gender appearance, but doctors say those are generally not performed on minors.

What are the criticisms?

Several doctors, families and advocacy organizations have reportedly claimed that politicians are inserting themselves into decisions that belong with families and medical teams.

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The measures have prompted swift backlash from medical experts, Democratic President Joe Biden’s administration, the US Department of Justice and the families of trans youth. Doctors say the Alabama law is contrary to peer-reviewed research and applies a criminal label to standard medical care. 

Several health experts also say that minors with gender dysphoria who do not receive appropriate medical care face dramatically increased risk of suicide and serious depression.