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Panel hears oral arguments over Alabama's law banning gender-affirming care

MARY LOUISE KELLY, HOST:

To Alabama now, where the state is asking a federal appeals court to let it enforce a law that bans gender-affirming medical treatments for transgender youth. A federal judge temporarily blocked most of the law while parents and health care providers pursue a constitutional challenge. A three-judge panel of the 11th U.S. Circuit Court of Appeals heard oral arguments in Montgomery today. NPR's Debbie Elliott was there in the court, and she is with us now. Hey there, Deb.

DEBBIE ELLIOTT, BYLINE: Hi, Mary Louise.

KELLY: OK. So I want to understand. Just what exactly is this law? What does it do?

ELLIOTT: It essentially criminalizes treatments and surgeries that would alter the sex assigned at birth for anyone under the age of 19. Now, that includes treatments such as hormone therapy or puberty blockers. Parents, doctors or other health care providers who violate the law would then face potential felony charges that carry penalties up to 10 years in prison and a $15,000 fine.

KELLY: OK. So walk me through how these arguments played out there in the courtroom for the 11th Circuit today.

ELLIOTT: So this is Alabama's appeal. The state wants to enforce its law, and it's asking this appeals court to lift the injunction. Parents and doctors are arguing that it should stay in place while they pursue their lawsuit. They're suing over two key issues here. One, they're alleging discrimination against transgender minors by denying them access to medically necessary care and, secondly, that this impedes the fundamental right of parents to make medical decisions for their minor children. Now, listening to the arguments today and some of the questions from the judges, they seem to be centering on this equal protection question - right? - whether or not this law discriminates.

KELLY: OK. Explain Alabama's thinking here. How does the state justify the law?

ELLIOTT: So Alabama's solicitor general, Edmund LaCour, was arguing today. He pretty much says the state has the authority to do this. They can regulate medicine in trying to protect children. And he cited risks - bone density issues, loss of fertility, future loss of sexual function from some of these treatments. LaCour says this is not discrimination because the state doesn't ban being transgender, for instance, or all treatment for minors who are gender nonconforming, only the ones the state has deemed risky. Here's what he told me after the hearing outside the Montgomery Federal Courthouse.

EDMUND LACOUR: Therapy is absolutely allowed. We don't try to direct any sort of type of therapy. There is no prohibition, for example, on social transition. We just simply recognize that these particular medical treatments and surgeries have permanent, lasting harms.

KELLY: OK. So there's Alabama's solicitor general laying out their claim that the state has the authority to police what it sees as risky medical treatments. What did lawyers for parents, lawyers for health care providers have to say about that today?

ELLIOTT: That these treatments are not risky, they're part of widely recognized standard of care for kids with gender dysphoria - and they were citing dozens of medical organizations on that - and that abruptly ending them for some youth could cause irreparable harm. Here's attorney Jeffrey Doss, who represents the plaintiffs, also talking to me outside the courthouse.

JEFFREY DOSS: You have essential medical care for kids, and you have parents who are very concerned for those kids. And you have doctors who are trying to help the kids. And the state is stepping in and saying, absolutely not. We know best, and we are the ones who are going to make this decision for you, parents. And that should be chilling for everyone.

ELLIOTT: So the court did not indicate when they may rule on this.

KELLY: That is NPR's Debbie Elliott in Montgomery, Ala. Thanks, Deb.

ELLIOTT: You're welcome. Transcript provided by NPR, Copyright NPR.

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NPR National Correspondent Debbie Elliott can be heard telling stories from her native South. She covers the latest news and politics, and is attuned to the region's rich culture and history.