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Alabama Parents Ask Full 11th Circuit to Review Panel Decision that Allows the State to Ban Needed Medical Care for their Children

The panel decision reversing the block on Alabama’s criminal transgender healthcare ban undermines parents’ bedrock right to provide their children with established medical care and conflicts with clear precedent that laws targeting transgender people discriminate based on sex

Alabama families challenging the state’s ban on medical care for their transgender children have asked the full 11th Circuit Court of Appeals to review a panel ruling saying the ban can take effect while their case continues.

The Alabama ban has been blocked since May of 2022 by a preliminary injunction issued by a federal district court following a multi-day evidentiary hearing in which the court heard testimony from parents, health care providers, and medical experts. After considering the evidence, the district court found that the provision of these medical treatments is established care and that being denied these treatments would cause transgender adolescents to suffer serious harm. The district court opinion held that in targeting transgender youth Alabama’s law likely violates the federal Equal Protection Clause and also violates parents’ fundamental right to make medical decisions for their children.

On August 21, a three-judge panel of the 11th Circuit reversed the district court’s decision. In their request for rehearing, the plaintiffs argue the full court should review the panel decision because it conflicts with Supreme Court and 11th Circuit precedent dictating that all laws discriminating based on sex should be subjected to heightened scrutiny under the Equal Protection Clause, and because the ban violates parents’ longstanding right to make medical decisions for their children, rather than cede that power to the state. 

The Alabama families challenging the law are represented by GLBTQ Legal Advocates & Defenders, the National Center for Lesbian Rights, The Southern Poverty Law Center, and Human Rights Campaign.

Jennifer Levi, Senior Director of Transgender and Queer Rights at GLBTQ Legal Advocates & Defenders said:
“As the district court concluded after hearing days of testimony from parents, doctors, and medical experts, enforcement of Alabama’s criminal transgender healthcare ban will harm thousands of transgender adolescents across Alabama. It will also put Alabama parents in the excruciating position of not being able to get the medical care their children need to thrive. We will support these parents and their kids in pushing back against that dangerous reality on every level.”   

Shannon Minter, Legal Director at the National Center for Lesbian Rights said:
“Our clients and other Alabama families have a right to protect their transgender children and ensure they get the support they need. The panel’s decision tramples on that right and conflicts with clearly established Supreme Court and 11th Circuit law. We hope the full court will review this case and prevent this devastating criminal ban from taking effect.” 

Scott McCoy, Deputy Legal Director for LGBTQ Rights and Special Litigation at Southern Poverty Law Center said:
“Allowing SB 184 to take effect would serve no purpose other than preventing parents from obtaining the medical care their children need. Every federal district court that has heard the evidence presented has come to the same conclusion: the established medical treatments recommended for transgender adolescents are safe, effective, and lifesaving for some youth, and there is no legitimate reason to ban them.”

Sarah Warbelow, Legal Director at Human Rights Campaign said:
“Parents, not the government, are best situated to make medical decisions for their children. That understanding is deeply rooted in our common understanding and our legal foundations. Allowing this ban to take effect would be a shocking reversal of firmly established precedent and a jarring intrusion into private family decisions.” 

The Southern Poverty Law Center (SPLC), the National Center for Lesbian Rights (NCLR), GLBTQ Legal Advocates & Defenders (GLAD), and the Human Rights Campaign (HRC) are joined in the litigation by co-counsel King & Spalding LLP and Lightfoot, Franklin & White LLC.

Learn more about the case.

News

Update on the federal challenge to Alabama’s law banning medical care for transgender minors and access to care:

The most important thing to know is that the preliminary injunction blocking enforcement of Alabama’s law is still in effect and will remain in effect at least for the next two to three months, and possibly longer.

As you likely are aware, on August 21, 2023, a three-judge panel of the Eleventh Circuit issued a decision disagreeing with a ruling by a federal district court judge in Alabama blocking enforcement of Alabama’s criminal ban on the prescription or administration of puberty blockers or hormone therapy for transgender adolescents.  

Judge Burke issued his preliminary injunction last May, blocking any enforcement of Alabama’s law since that time.

The most important thing to know is that the preliminary injunction blocking enforcement of Alabama’s law is still in effect and will remain in effect at least for the next two to three months, and possibly longer.

Based on the ordinary legal process, an appellate decision reversing a preliminary injunction by a federal district court judge does not take effect immediately. The federal rules of civil procedure require that the plaintiffs be given 21 days to ask the entire court to review the decision (this is known as seeking rehearing en banc). The legal team representing the plaintiffs in Alabama intends to do so.  

Our petition for rehearing en banc must be filed by September 11. The preliminary injunction must remain in place until the Eleventh Circuit either denies that request or, if they accept the request and agree to review the panel decision, until they issue a decision.

While this process unfolds, the preliminary injunction remains in effect, which means the Alabama ban cannot be enforced. Medical providers in Alabama are continuing to provide care to transgender adolescents and will continue to provide care as long as the preliminary injunction is in effect.    

That said, depending on how the Eleventh Circuit rules, there may come a point at which the preliminary injunction is no longer in effect, so parents of transgender adolescents in Alabama should be prepared for that possibility as one they may have to face down the road. If that were to happen, the law does not bar parents from taking their children out of state to seek care, from getting prescriptions filled in Alabama, or from administering medications to their children. The law in Alabama applies only to doctors and other healthcare providers.

Please stay tuned for more updates, and feel free to reach out with any questions to any of our legal team organizations:

GLBTQ Legal Advocates & Defenders
Legal Help Line: www.GLADAnswers.org
Contact: Amanda Johnston, ajohnston@glad.org

National Center for Lesbian Rights
Legal Help Line: www.nclrights.org/get-help
Contact: Shannon Minter, sminter@nclrights.org

Human Rights Campaign
Legal Help Line: www.thehrcfoundation.org/impact-litigation-and-advocacy
Contact: Aryn Fields, aryn.fields@hrc.org

Southern Poverty Law Center
Contact: Kimberly Allen, kimberly.allen@splcenter.org

For direct help navigating care in Alabama, including 1-on-1 conversations about your family’s situation and emergency funding, contact the Southern Transgender Youth Emergency Project, a project of the Campaign for Southern Equality, led in Alabama in partnership with the Magic City Acceptance Center and Prism United. 

News

Statement on 11th Circuit Ruling Reversing Injunction on Alabama Transgender Healthcare Ban

Today, a three-judge panel of the 11th Circuit Court of Appeals issued a decision reversing a federal district court ruling blocking enforcement of Alabama’s law banning medical care for transgender adolescents. The district court opinion, which was issued last spring, held that Alabama’s law likely violated the federal Equal Protection Clause and parents’ fundamental right to make medical decisions for their children. Thus far, every single federal district court to hear a similar challenge has ruled similarly, holding that these state bans discriminate against transgender minors and burden their parents’ constitutionally protected rights. The 11th Circuit panel disagreed, holding that Alabama’s law does not discriminate based on sex or transgender status and is therefore subject only to the lowest level of constitutional review.  

The Alabama families challenging the law in Boe v. Marshall are represented by the National Center for Lesbian Rights, GLBTQ Legal Advocates & Defenders, The Southern Poverty Law Center, and Human Rights Campaign, who issued the following statement:

“This is a deeply disappointing decision that is difficult to reconcile with the 11th Circuit’s prior rulings and with the Supreme Court’s clear guidance that discrimination because a person is transgender is sex discrimination. Our clients are devastated by this decision, which leaves them vulnerable to what the district court—after hearing several days of testimony from parents, doctors, and experts–found to be irreparable harm as a result of losing the medical care they have been receiving and that has enabled them to thrive. 

While this is a setback, we are confident that it is only a temporary one. Every federal district court that has heard the evidence presented in these cases has come to the same conclusion: these medical treatments are safe, effective, and lifesaving for some youth, and there is no legitimate reason to ban them. We believe that at the end of the day, our nation’s courts will protect these vulnerable youth and block these harmful laws, which serve no purpose other than to prevent parents from obtaining the medical care their children need. Parents, not the government, are best situated to make these medical decisions for their children. These laws are a shocking example of government overreach and a jarring intrusion into private family decisions. This case is far from over, and we will continue to aggressively seek legal protection for these families.”   

The Southern Poverty Law Center (SPLC), the National Center for Lesbian Rights (NCLR), GLBTQ Legal Advocates & Defenders (GLAD), and the Human Rights Campaign (HRC) are joined in the litigation by co-counsel King & Spalding LLP and Lightfoot, Franklin & White LLC.

Learn more about the case.

Boe v. Marshall

This case is also known as Eknes-Tucker v. Ivey.

Facing criminal penalties and a devastating loss of essential medical care for their children, Alabama parents, medical providers, and Rev. Eknes-Tucker of Pilgrim UCC Church in Birmingham are asking a federal court to block a law criminalizing well-established medical care for transgender youth from taking effect.

A hearing on plaintiffs motion for a temporary restraining order and preliminary injunction took place on May 5, 2022 in Montgomery. Days later, a federal judge halted the law from being enforced while the lawsuit continued.

In August, families, medical experts, faith groups, and 21 states filed amicus (friend-of-the-court) briefs urging the court not to reinstate the law criminalizing healthcare for transgender youth. You can find those filings below.

Later that month, a three-judge panel of the 11th Circuit Court of Appeals issued a decision ending the freeze on the ban. Alabama parents have since requested a hearing by the full 11th Circuit to reinstate the pause so their children can continue accessing essential medical care.

Latest filings:

New Report:

A new report by legal and medical experts from Yale Law School, the Yale School of Medicine’s Child Study Center and Departments of Psychiatry and Pediatrics, and the University of Texas Southwestern gives an in-depth analysis of misleading scientific claims that informed Alabama’s move to criminalize medical treatment for transgender youth.

Additional Information:

The law, SB 184, punishes parents and their children’s doctors for providing – or even suggesting – well-established essential medical care for their transgender children. The punishment can include up to 10 years in prison.

The filing in U.S. District Court for the Middle District of Alabama – Northern Division is on behalf of four Alabama parents, a private practice pediatrician, a clinical psychologist with the UAB medical system, and Reverend Paul Eknes-Tucker, Senior Pastor at Pilgrim United Church of Christ in Birmingham. The court filing explains that the law strips them of the right to make important decisions about their children’s healthcare.

The plaintiffs are represented by GLAD, the National Center for Lesbian Rights, the Southern Poverty Law Center, the Human Rights Campaign, Lightfoot, Franklin & White LLC, and King & Spalding LLP.

Corbitt v. Taylor

GLAD co-authored an amicus (friend of the court) brief in the 11th Circuit case Corbitt v. Taylor about Alabama’s needless and unjust requirement for transgender people to undergo surgery to update their driver’s license. As the brief explains,

“The Amici Curiae write to highlight the arbitrary and irrational nature of Alabama’s policy to require transgender people to undergo genital surgery to obtain an accurate driver’s license. Requiring surgery contradicts the medical consensus and standards of care and presents an insurmountable barrier for many transgender people to obtain state-issued identification that reflects who they are. This policy inflicts concrete harms on transgender people and undermines social stability by impeding their ability to engage in a wide range of important activities, from voting to obtaining housing and employment. A majority of states and the federal government, understanding the need to track contemporary medical standards and adopt policies that promote economic and social stability and positive health outcomes, have aligned their policies to enable transgender people to obtain identification that matches who they are. In contrast, Alabama’s policy denies transgender people equal protection and serves no legitimate government interests.”

Read the amicus brief.

Amici include the following state, regional, and national organizations:

  • Equality Federation
  • Equality Florida
  • Equality Maine
  • Equality Ohio Education Fund
  • Equality South Dakota
  • Equality Texas
  • Family Equality
  • Fairness Campaign
  • FreeState Justice
  • Maryland’s LGBTQ Advocates
  • Garden State Equality
  • Georgia Equality
  • GLBTQ Legal Advocates & Defenders (GLAD)
  • Lambda Legal Defense and Education Fund
  • MassEquality
  • Mass. Trans Political Coalition
  • National Center for Lesbian Rights
  • One Colorado
  • PROMO
  • Southern Legal Counsel, Inc.
  • TransOhio, Inc.
  • Wyoming Equality

V.L. v. E.L.

March 7, 2016: Victory! The U.S. Supreme Court today reversed the Alabama Supreme Court’s decision in which it refused to recognize a lesbian mother’s Georgia adoption of her three children. GLAD congratulates the adoptive mother, V.L. and her children, as well our friends at NCLR on this important victory for all families. Many thanks to Foley Hoag LLP who joined GLAD in submitting an amicus brief to the Court on behalf of Equality Alabama Foundation, Equality Federation, Georgia Equality, the Human Rights Campaign, Immigration Equality, the National Black Justice Coalition, the National Center for Transgender Equality, the National LGBTQ Task Force, PFLAG, the Stonewall Bar of Georgia, and the Southern Poverty Law Center.

Background:

GLAD and Foley Hoag LLP have filed an amicus brief with the U.S. Supreme Court urging the Court to grant review in the Alabama second-parent adoption case, V.L. v. E.L., No. 15-648.

V.L. and E.L. are former lesbian partners who agreed to have and raise three children together but are now separated. Before their separation, the two had obtained an adoption judgment in Georgia making V.L. a legal parent. After their separation, the birth mother, E.L., took the position that the Alabama courts could disregard Georgia’s judgment of adoption. The Alabama Supreme Court agreed, holding that E.L. was the children’s only legal parent.

The brief urges the Supreme Court to hear the case, arguing that Alabama cannot disregard the Georgia adoption judgment simply because Alabama believes the Georgia court’s adoption order should not have issued in the first place. If states disregard each other’s adoptions, it will severely undermine the security, stability, and predictability of parent-child relations secured by adoption and parentage judgments across the nation.

The amicus brief was filed on behalf of GLAD, Equality Alabama Foundation, Equality Federation, Georgia Equality, the Human Rights Campaign, Immigration Equality, the National Black Justice Coalition, the National Center for Transgender Equality, the National LGBTQ Task Force, PFLAG, the Stonewall Bar of Georgia, and the Southern Poverty Law Center.

The Foley Hoag team on the brief included Marco J. Quina, Claire Laporte, Catherine Deneke, Jenevieve Maerker, and Kevin J. Conroy, with assistance from paralegal Margaret McKane.

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