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Attorney General Bonta Leads Multistate Opposition to Alabama Law Criminalizing Gender-Affirming Medical Care for Transgender Youth

OAKLAND – California Attorney General Rob Bonta today led a coalition of 21 attorneys general in filing an amicus brief in opposition to an Alabama law, Senate Bill 184 (SB 184), criminalizing evidence-based and medically accepted gender-affirming care for transgender youth. The law, which was preliminarily blocked by the district court, makes it a felony — punishable by up to 10 years in prison and a fine of up to $15,000 — for any person to assist transgender youth in Alabama in accessing gender-affirming care, including puberty blockers and hormone therapy. In the friend-of-the-court brief, the coalition urges the appellate court to affirm the district court’s decision and highlights the extreme harms of the State of Alabama’s intrusions on medical decisions that should be made between doctors and patients and their parents.

“Medical decisions should be between doctors and their patients, not doctors, their patients, and the State of Alabama,” said Attorney General Bonta. “Whether it’s access to abortion or hormone therapy, Alabama’s overreach puts people’s lives and well-being at risk. Let’s be clear: Gender-affirming care doesn’t happen overnight, it’s a rigorous and evidence-based medical process. Criminalizing trans youth, their families, and doctors over access to medical care doesn’t solve anything, it only serves to marginalize and endanger people for who they are. I urge the appellate court to follow the law and strike down Alabama’s discriminatory attack on the rights of transgender Americans.”

Signed into law on April 8, 2022, SB 184 is part of a dangerous, nationwide assault on the right of transgender people to live with dignity, be free from discrimination, and have equal access to healthcare. Alabama’s categorical ban on gender-affirming healthcare for transgender youth ignores broad medical consensus, interferes with medical decisions that providers reach with individual patients and their families, and violates the Equal Protection Clause of the U.S. Constitution. The law specifically targets transgender youth, ignoring the use of the exact same type of medical interventions for treatment to reinforce the gender an individual was assigned at birth. For instance, SB 184 permits doctors to prescribe testosterone for a cisgender male teen suffering from delayed pubertal development, but makes it a felony for a transgender male teen to access the same treatment.

Discrimination and exclusion on the basis of transgender status cause direct economic, emotional, and health harms, including an increased risk of depression, anxiety, substance abuse, and suicide. In contrast to Alabama, the coalition states have adopted laws and policies to combat discrimination against transgender people in healthcare, including policies that guarantee non-discriminatory insurance coverage of gender-affirming medical care for transgender youth. These efforts result in better health outcomes for transgender residents and help safeguard their physical, emotional, and financial well-being.

In the amicus brief, the coalition explains:

  • SB 184 directly harms transgender teens living in and traveling to Alabama and imposes spillover harms on other states;
  • SB 184 would exacerbate the effects of discrimination and inadequate access to healthcare for transgender teens;
  • SB 184 discriminates based on sex, ignores medical standards, and interferes with decisions made between doctors and their patients;
  • SB 184 directly violates equal protection by prohibiting only transgender youth from taking certain medications; and
  • In contrast, policies like those in amici states that ensure access to gender-affirming medical care have improved health outcomes for transgender people and are based on well-established medical standards.

In the filing the amicus brief, Attorney General Bonta is joined by the attorneys general of Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington.

A copy of the amicus brief is available here.