A federal judge on Friday afternoon launched the possibility that state law making drugs illegal for transgender young people could go into effect Sunday without a ruling on a motion by families of transgender youth and doctors trying to block the law.
But US District Judge Liles C. Burke said he and his staff would “do nothing else” until an injunction was ruled.
“I want a well-reasoned order that’s fair on the law,” he said. “I just ask everyone to be patient.”
The statement came at the end of a two-day hearing focused on the research and experience behind current treatments for gender dysphoria and eventual SB 184, which could put doctors in jail for up to 10 years for prescribing puberty blockers and hormones to transgender youth, had a legitimate basis or violated equal protection and free speech guarantees under the United States Constitution.
Plaintiffs, who include parents of Alabama transgender children ages 12 to 17 and two doctors and a minister who work with them, testified during the hearing that access to drugs was critical to the physical and psychological health of young people. who needed it. Families said in court documents that access to puberty blockers or hormones had led to major improvements in their well-being and doctors and physicians repeatedly stressed that the drugs were part of widely accepted standards of care for the such statement.
Jeffrey Doss, a Birmingham attorney representing the plaintiffs, said in a concluding statement Friday that the law’s blanket ban on transgender treatments was unconstitutional and unprecedented.
“This is an untested proposal,” he said. “The state proposes a large-scale experiment. All transgender youth in Alabama suffering from gender dysphoria should be guinea pigs.”
Prosecutors at the Alabama Attorney General’s Office and their witnesses have repeatedly questioned the effectiveness of the treatments and pointed out the potential risks in the treatments, focusing specifically on the potential for reduced fertility later in life.
“By pressing the pause button, Alabama is halting an experiment on our kids,” Alabama Attorney General Edmund LaCour said in closing discussions. “Nothing in the Constitution requires Alabama to undergo unproven and sterilizing treatments.”
Friday was largely devoted to state witnesses, after plaintiffs mostly finished with their witnesses on Thursday. James Cantor, a Toronto-based psychiatrist, testified for the state that studies of transgender health outcomes had not done enough work separating outcomes from psychotherapy and medication in evaluating the benefits of one or the other.
“The studies that have come out can’t unpack if psychotherapy or pharmaceuticals make a difference,” Cantor said.
Upon cross-examination by Melody Eagan, an attorney for the plaintiffs, Cantor acknowledged that he does not treat children or adolescents under the age of 16 suffering from gender dysphoria. Eagan also read a report Cantor cited as an example of her argument showing that the authors had jointly studied the effects of psychotherapy and drug psychotherapy.
Dr Armand Antommaria, director of the ethics center at Cincinnati Children’s Hospital, said in earlier testimony Friday that observational studies, in which individuals received treatments and were studied for subsequent effects, provided information and allowed those who needed medical intervention for gender dysphoria to get it.
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“I would be afraid that randomized control trials of the intervention would be unethical,” he said. “Even if it could be performed ethically, they would have substantial methodological limitations.”
SB 184, one of the many approved in recent years by the Alabama legislature against transgender young people, also bans genital and reconstructive surgeries on young people. Doctors and health professionals have repeatedly stressed that the procedures are not performed in Alabama. It also prohibits public and private school officials from hiding “information relating to a child’s perception that her gender or sex is inconsistent with her sex.”
Health workers on Thursday likened cutting drugs to ceasing treatment for a cancer patient. Antommaria said Friday that the law would force doctors to break the law or violate their ethical obligations towards plaintiffs.
“They would be placed in the untenable position of violating the ethical obligation for patients to comply with the law or to fulfill professional obligations to their patients and be criminally charged,” he said.
The lawsuit, which the United States Department of Justice joined, also argues that the law is discriminatory, as it allows the use of puberty blockers for young people who are not transgender.
Deputy Attorney General Barrett Bowdre raised the issue with Antommaria, asking about the possibilities of people who received gender-affirming treatment to stop treatment and align with their birth sex, a process he called giving up.
The plaintiffs’ witnesses said lack of experience in their experience was rare and could reflect the success of the treatments early in life. Antommaria said in response to Bowdre that “experience in the field suggests that the withdrawal rate is low.”
State attorneys also cited European studies that questioned the effectiveness of the drugs, although plaintiffs noted that no European country had banned the treatments the way Alabama did.
The state also called Sydney Wright, a 23-year-old from Cedar Bluff who claimed she sought and received testosterone treatments in Georgia when she was 19. Wright said a counselor no longer in practice in the state wrote a recommendation for her, but that taking the drug led to emergency room visits and permanent alteration of her voice.
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“At the end of every single day, I was a woman,” she said. “I couldn’t escape what I was trying to escape. In the end, you have to come to terms with that.”
During cross-examination, Wright said he knew nothing about the Alabama treatment procedures or the benefits plaintiffs in the lawsuit could experience. Wright also acknowledged that she took testosterone at age 19 as an adult. SB 184 would not make it illegal.
Burke did not suggest how he would pronounce on seeking an injunction on Thursday or Friday, though he often asked questions about the scope of the Alabama ban. At one point during Cantor’s testimony, the judge, referring to the testimony on European countries, wondered if any nation in the world had enacted a ban similar to that of Alabama. Cantor said he didn’t know about it.
Dr Morissa Ladinsky, an associate professor of pediatrics at the University of Alabama Birmingham and a plaintiff’s witness, said on Friday that if the law goes into effect on Sunday, the UAB will stop writing prescriptions for transgender youth. An injunction that came a few days later, she said, would result in only minimal disruption to patients’ regimens. But she said there would be “serious concerns” if the wait were to last for months.
“It would be natural for any family with a transgender child to feel anxious, scared and in a place of limbo,” she said. “So let’s hope the wheels of justice work as they should and we can allay these anxieties sooner rather than later.”
Contact advertiser Montgomery reporter Brian Lyman at 334-240-0185 or firstname.lastname@example.org.