The Biden administration and liberal legal groups are gearing up to battle red state laws that prohibit children from receiving transgender hormone treatment.
Gov. Kay Ivey (R.) signed a bill into law last week that makes Alabama the third state to ban children from receiving hormone therapy and puberty blockers. The legislation, however, is already in jeopardy. The Biden Justice Department in March warned state attorneys general against enforcing hormone-treatment bans for minors, saying they run afoul of federal anti-discrimination laws. Liberal legal groups including the American Civil Liberties Union promised this week to "use the full force of the law" to challenge the Alabama legislation in court—a move that blocked a similar law in Arkansas last year.
The White House this week slammed the Alabama law, with press secretary Jen Psaki saying during a press conference that hormone therapy for minors is "lifesaving health care." Steve Marshall, the Republican attorney general of Alabama, said his state is prepared to stand up to liberal groups' legal challenges and White House opposition, which he called "predictable and of very little interest to Alabamians."
"It is undoubtedly difficult for the Biden administration, including the Department of Justice, to accept that Alabama is a sovereign state," Marshall told the Washington Free Beacon. "We're prepared to act like it."
Alabama is just the latest state to face challenges over its hormone-treatment ban for children. Arkansas last year became the first state to ban the practice, but a federal court blocked the law in response to a legal challenge from the ACLU. The group, along with other liberal organizations such as the Southern Poverty Law Center and Human Rights Campaign, has vowed to challenge a similar law passed this year in Arizona. When Texas governor Greg Abbott (R.) in February ordered state social services to investigate parents whose children receive hormone treatment, a Texas appeals court blocked the order following another ACLU legal challenge.
The legal efforts come as the Biden administration last month endorsed "gender-affirming care," including hormone therapy and sex-reassignment procedures, for transgender children, calling the treatments "crucial" for their well-being. In the statements commemorating "Transgender Day of Visibility," the White House and Department of Health and Human Services cited a study from an LGBT group funded by a hormone-drug manufacturer, the Free Beacon reported. That same day, the Justice Department wrote the letter to state attorneys general warning that laws preventing children from "seeking gender-affirming care" amount to unlawful discrimination.
The Justice Department has not announced whether it will join the liberal legal groups to challenge the Alabama or Arizona laws. The department did not respond to a request for comment.
Despite the Biden administration's endorsement, access to puberty blockers for minors is unpopular: It is supported by just 49 percent of Democrats, 24 percent of independents, and 12 percent of Republicans, according to a March YouGov poll.
There is limited research about the physical and mental effects of transgender treatment for children. Broader studies on transgender adults show alarming rates of suicide post-transition. A 30-year study in Sweden found that people who transitioned are 20 times more likely to commit suicide after 10 years. The Obama administration in 2016 said there was insufficient evidence to support transgender procedures for Medicare recipients.
"Based on a thorough review of the clinical evidence available at this time, there is not enough evidence to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria," the Centers for Medicare and Medicaid Services said in 2016.
During the 2020 election, then-candidate Joe Biden said he supported children transitioning, saying there "should be zero discrimination" for an "8-year-old child or a 10-year-old child" who decides to be transgender. Once in office, Biden signed an executive order that requires federal agencies to enforce anti-discrimination laws based on "gender identity." The Justice Department later stated that Title IX "protects transgender students from discrimination on the basis of gender identity"—a move that paved the way for the Justice Department's March letter.
Legislatures in 19 states have introduced legislation to ban hormone treatment for minors, but Arizona, Alabama, and Tennessee are the only states to sign the prohibitions into law. Tennessee enacted its law last year, which bans transgender hormone treatment prior to puberty, but transgender activists claim the restriction is irrelevant because transgender minors typically receive hormone therapy after they begin puberty.