Respect Equality

Alabama Gov. Ivey signs bill criminalizing gender-affirming care into law

"I believe very strongly that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl,” Alabama Gov. Kay Ivey (R) said Friday.
Alabama Gov. Kay Ivey speaks to supporters at her watch party after winning the Republican nomination for governor of Alabama at the Renaissance Hotel in Montgomery, Ala., on June 5, 2018. (Butch Dill/AP File)

Story at a glance

  • Alabama Gov. Kay Ivey on Friday signed into law a first-of-its-kind bill criminalizing gender-affirming care for minors.

  • The law makes it a felony, punishable by up to a decade in prison, to provide medications like puberty blockers or hormone therapies to minors.

  •  Ivey on Friday also enacted a law preventing trans students from accessing facilities in schools that match their gender identity and prohibits kindergarten through fifth grade teachers from engaging in instruction related to sexual orientation or gender identity.

Alabama Gov. Kay Ivey (R) on Friday enacted the nation’s first law criminalizing gender-affirming care for transgender and nonbinary youth, making it a felony – punishable by up to a decade in prison – for doctors to provide or recommend puberty blockers or hormone therapies or other gender-affirming interventions to patients younger than 19 years old.

“There are very real challenges facing our young people, especially with today’s societal pressures and modern culture,” Ivey said Friday in a statement. “I believe very strongly that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl.”

“We should especially protect our children from these radical, life-altering drugs and surgeries when they are at such a vulnerable stage in life,” Ivey said.

Alabama lawmakers had sent the measure to Ivey’s desk on Thursday – an action that was immediately met with a warning from the American Civil Liberties Union (ACLU), Lambda Legal, the Transgender Law Center and the law firm Cooley LLP threatening to sue the state should the bill be signed into law.

“If the state moves forward in passing this unconstitutional bill, we’ll see them in court,” Kaitlin Welborn, staff attorney for the ACLU of Alabama, said Thursday.


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Just one other state – Arkansas – has passed legislation to restrict access to gender-affirming care for minors, though a federal judge in July blocked its enforcement pending the outcome of an ACLU lawsuit.

More than 30 bills under consideration in state legislatures aim to restrict access to gender-affirming health care for trans and nonbinary minors, according to the group Freedom for All Americans, which tracks such legislation.

But that tally excludes efforts to restrict access to gender-affirming care outside of state legislatures. In Texas, Gov. Greg Abbott (R) in February ordered state agencies to investigate the parents of trans and nonbinary minors for “abusing” their children by allowing them to receive gender-affirming care. 

Those investigations have since been halted following a statewide injunction from a Texas judge.

Ivey on Friday also signed into law a bill preventing transgender students from using gender-segregated facilities like restrooms or locker rooms consistent with their gender identity. An amendment to the now-law bars kindergarten through fifth grade educators from engaging in classroom instruction related to sexual orientation and gender identity in a manner that is not “age appropriate or developmentally appropriate.”

Similar legislation was recently signed into law in Florida. Its critics have called it – and others like it – the “Don’t Say Gay” law for allegedly targeting LGBTQ+ students and children with LGBTQ+ family members.

Ivey on Friday said she strongly disagreed with that characterization.

“We are talking about five-year-olds for crying out loud,” she said. “We need to focus on what matters — core instruction like reading and math.”