Alabama Lawmakers Pass Bill Making Giving Gender-Affirming Treatment to Kids a Felony Crime

On Thursday, Alabama became the latest US state to pass a bill criminalizing giving gender-affirming treatment to transgender youth. However, it is the first time a state has made doing so a felony offense.

Senate Bill 184 passed the Alabama House of Representatives on Thursday by a vote of 66 to 28, having been pushed to the front of the agenda alongside several other similar bills, including the first bill banning trans people from bathrooms and locker rooms of the gender they assume in eight years, HB 322. That bill also limits instruction on LGBTQ topics in public schools, similarly to Florida’s so-called “Don’t Say Gay” law.

Called the Vulnerable Child Protection Act, SB 184 says that anyone who provides gender-affirming procedures to anyone under the age of 18 can be convicted of a felony and face up to 10 years in prison and a $15,000 fine. That could include prescribing puberty blockers, hormone replacement therapy, or gender-affirming surgeries.

According to the UCLA School of Law, 15 US states have passed or introduced similar bills, including Arizona and Arkansas, while similar efforts in Utah, Indiana, Florida, and Mississippi have all been defeated., including by successful governors’ vetos. The bans threaten the healthcare of roughly 58,000 trans youth, according to their estimate.

In Texas, a trans youth healthcare ban has encountered trouble getting through the legislature, but that hasn’t stopped Attorney General Ken Paxton and Governor Greg Abbott from declaring parents child abusers if they affirm their trans kid’s gender and ordering Child Protective Services to investigate such cases, potentially leading to taking children from their families. A Texas court temporarily enjoined the practice last month.

Ahead of the vote in the Alabama House on Thursday, the Cotton State’s sole openly gay lawmaker, Democratic Rep. Neil Rafferty, furiously denounced the bill and its backers, telling them, “Don’t you dare call me a friend after this.”

“It’s hard enough growing up being different,” Rafferty said, according to AL.com. “It’s even harder growing up being different, and then have a state legislature, your elected officials, the leaders of this state, put a target on children’s backs, put a target on the parents’ backs, and once again get in the middle of their decisions.”

Taking a cue from Texas, the bill’s sponsor, Republican Sen. Shay Shelnutt, called gender-affirming healthcare “child abuse.”

"We don’t want parents to be abusing their children. We don’t want to make that an option, because that’s what it is; it’s child abuse. This is just to protect children," Shelnutt said when the bill was introduced in February.

According to experts, Alabama’s bill misinforms on what gender-affirming treatment for children looks like. For example, it bans minors from receiving gender-affirming "surgical procedures," but those surgeries, already extremely rare for minors, are already barred for patients in The Cotton State before the age of legal majority for medical decisions, which is 19. However, for other procedures, the general age of consent for healthcare in Alabama is 14 years old.

"When lawmakers attempt to practice medicine with a life without a license, they realize quickly that there was a lot more they didn't understand than what they thought they did," Morissa Ladinsky, an associate professor of pediatrics at the University of Alabama at Birmingham, told ABC News.

The professor also noted that the bill incorrectly states that puberty blockers can cause infertility or other health risks when those risks are only present in people who begin taking them after finishing puberty.

Almost every leading medical and mental health professional organization in the US opposes such legislation, “which interferes with their ability to provide best-practice, often life-saving care," according to the Human Rights Campaign, a nationwide LGBTQ rights advocacy group.

"This legislation targets vulnerable young people and puts them at great risk of physical and mental harm," Mark Del Monte, chief executive of the American Academy of Pediatrics, said in a statement. "Criminalizing evidence-based, medically necessary services is dangerous."

By comparison, China’s first specialized trans youth clinic opened in Shanghai in November 2021. Luo Feihong, director of the endocrine and genetic metabolic department of the Children's Hospital where the new clinic is attached, told the Global Times that their multidisciplinary approach is “of great help to reduce the negative emotions of these children and adolescents, improve their academic performance, improve their family relations and build a harmonious society.”