Alabama’s Ban on Childhood Puberty Blockers and Cross-Sex Hormones Reinstated By Unanimous Appeals Court

Alabama’s Ban on Childhood Puberty Blockers and Cross-Sex Hormones Reinstated By Unanimous Appeals Court

The U.S. Court of Appeals for the 11th Circuit has unanimously upheld Alabama’s prohibition against use of puberty blockers and cross-sex hormones to minors if based on gender identity confusion. To the extent there might be medical (as opposed to psychological) necessity, such procedures are allowed.

A District Court judge issued an injunction against the law.

From the Opinion, a description of the law:

This appeal centers around section 4(a)(1)–(3) of Alabama’s Vulnerable Child Compassion and Protection Act (the “Act”). Section 4(a)(1)–(3) of the Act states that “no person shall engage in or cause” the prescription or administration of puberty blocking medication or cross-sex hormone treatment to a minor “for the purpose of attempting to alter the appearance of or affirm the minor’s perception of his or her gender or sex, if that appearance or perception is inconsistent with the minor’s sex.” Thus, section 4(a)(1)–(3) makes it a crime in the State of Alabama to take part in providing puberty blockers or cross-sex hormone treatment to a minor for purposes of treating a discordance between the minor’s biological sex and sense of gender identity.

The plaintiffs tried to portray the case as one about parental rights to treat their children medically. The Appeals Court rejected that argument:

Shortly after the Act was signed into law, a group of transgender minors, their parents, and other concerned individuals challenged the Act’s constitutionality, claiming that it violates the Due Process Clause and the Equal Protection Clause of the Fourteenth Amendment. As part of that lawsuit, the district court issued a preliminary injunction enjoining Alabama from enforcing section 4(a)(1)–(3) of the Act pending trial, having determined that the plaintiffs are substantially likely to succeed on both of the aforementioned claims. Specifically, as to the due process claim, the district court held that there is a constitutional right to “treat [one’s] children with transitioning medications subject to medically accepted standards” and that the restrictions of section 4(a)(1)–(3) likely impermissibly infringe upon that constitutional right. As to the equal protection claim, the district court held that section 4(a)(1)–(3) classifies on the basis of sex by classifying on the basis of gender nonconformity and likely amounts to unlawful discrimination under the intermediate scrutiny standard applicable to sexbased classifications.

On review, we hold that the district court abused its discretion in issuing this preliminary injunction because it applied the wrong standard of scrutiny. The plaintiffs have not presented any authority that supports the existence of a constitutional right to “treat [one’s] children with transitioning medications subject to medically accepted standards.” Nor have they shown that section 4(a)(1)–(3) classifies on the basis of sex or any other protected characteristic. Accordingly, section 4(a)(1)–(3) is subject only to rational basis review. Because the district court erred by reviewing the statute under a heightened standard of scrutiny, its determination that the plaintiffs have established a substantial likelihood of success on the merits cannot stand. We therefore vacate the preliminary injunction.

The medical community, which is almost completely corrupted on these issues, weighed in against the law in the District Court:

On April 29, 2022, the United States filed a motion to intervene, as well as its own motion for preliminary injunction similarly seeking to prevent enforcement of the Act. Shortly thereafter, fifteen states moved for leave to file an amicus brief in support of Alabama. That was followed by a group of at least twenty-two professional medical and mental health organizations jointly moving for leave to file an amicus brief in support of Plaintiffs. The district court ultimately granted the motion to intervene and the motions to file amicus briefs, giving the United States permission to participate in the preliminary injunction hearing and taking the amicus briefs under advisement.

I’ve witnessed the corruption of the medical establishment first hand. Almost every major medical group supported NY State’s racially discriminatory (against Whites) Covid therapeutic guidelines, and advocated for use of race as a legitimate treatment factor, in the lawsuit I brought to stop the practice.

The Court rejected the Substantive Due Process claim:

In sum, Plaintiffs’ assertion that the Constitution protects the right to treat one’s children with puberty blockers and crosssex hormone therapy is precisely the sort of claim that asks courts to “break new ground in [the] field [of Substantive Due Process]” and therefore ought to elicit the “utmost care” from the judiciary. See Collins, 503 U.S. at 125. The district court held that there is a specific right under the Constitution “to treat [one’s] children with transitioning medications subject to medically accepted standards,” but did so without performing any analysis of whether that specific right is deeply rooted in our nation’s history and tradition. Instead, the district court grounded its ruling in an unprecedented interpretation of parents’ fundamental right to make decisions concerning the “upbringing” and “care, custody, and control” of one’s children. See Pierce, 268 U.S. at 534–35; Troxel, 530 U.S. at 66. That was error. Neither the record nor any binding authority establishes that the “right to treat [one’s] children with transitioning medications subject to medically accepted standards” is a fundamental right protected by the Constitution. And, assuming it is not, then section 4(a)(1)–(3) is subject only to rational basis review—a lenient standard that the law seems to undoubtedly clear. Because the district court erroneously reviewed section 4(a)(1)–(3) with heightened scrutiny, its determination regarding the Parent Plaintiffs’ likelihood of success does not justify the preliminary injunction.

And also the Equal Protection claim:

Having carefully considered all of these positions, we agree with Alabama that section 4(a)(1)–(3) is best understood as a law that targets specific medical interventions for minors, not one that classifies on the basis of any suspect characteristic under the Equal Protection Clause. Section 4(a)(1)–(3) is therefore subject only to rational basis review—a standard that it almost undoubtedly satisfies for the reasons discussed. See supra Section III.A; see also Skrmetti, 73 F.4th at 419 (finding it “highly unlikely” that the plaintiffs could show that Tennessee’s substantially similar law “lacks a rational basis”). Because the district court erroneously departed from that standard, its assessment regarding the Minor Plaintiffs’ likelihood of success as to their equal protection claim cannot support the preliminary injunction.

I think the court was too timid here.

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