BREAKING: Eleventh Circuit allows enforcement of Alabama's ban on gender-affirming care for minors

[In It to Win It]

Chris Geidner
@chrisgeidner

BREAKING: A three-judge panel of the Eleventh Circuit allows enforcement of Alabama's ban on gender-affirming care for minors — reversing a trial court's injunction. The appeals court panel was all Trump appointees. More to come at Law Dork: https://lawdork.com

Here is the appeals court's opinion in Eknes-Tucker v. Alabama:

courtlistener.com
Opinion – #125, Att. #1 in Paul Eknes-Tucker v. Governor of the State of Alabama (11th Cir.,...

The full appeals court had previously upheld a school bathroom ban last December, a decision cited repeatedly here.

Judge Barbara Lagoa, a Trump appointee to the 11th Circuit who Trump also considered for #SCOTUS, wrote both decisions.

Link to tweet

[InAbLuEsTaTe]

1. I'm callin BULLSHIT on this transphobic decision!!

[Autumn]

2. Anyone want to convince me that these courts have not been weaponized?

[Celerity]

5. Sweden puts brakes on treatments for trans minors (just showing this isn't at all limited to the US)

Sweden, the first country to introduce legal gender reassignment, has begun restricting gender reassignment hormone treatments for minors, as it, like many Western countries, grapples with the highly-sensitive issue.

https://www.france24.com/en/live-news/20230208-sweden-puts-brakes-on-treatments-for-trans-minors

The prestigious Karolinska University Hospital near Stockholm began restricting gender reassignment hormone treatments before the government chose to do so © Jonathan NACKSTRAND / AFP

With the number of diagnoses soaring, the medical community faces the dilemma of weighing precaution against the risks associated with not offering treatment to those suffering from "gender dysphoria". Sweden decided in February 2022 to halt hormone therapy for minors except in very rare cases, and in December, the National Board of Health and Welfare said mastectomies for teenage girls wanting to transition should be limited to a research setting. "The uncertain state of knowledge calls for caution," Board department head Thomas Linden said in a statement in December.

So-called puberty blockers have been used in young teens contemplating gender transition to delay the onset of unwanted physical changes. Like many other countries, Sweden has seen a sharp rise in cases of gender dysphoria, a condition where a person may experience distress as a result of a mismatch between their biological sex and the gender they identify as. According to the Board of Health and Welfare, approximately 8,900 people were diagnosed with gender dysphoria in Sweden between 1998 and 2021, in a country of around 10 million.

In 2021 alone, about 820 new cases were registered. The trend is particularly visible among 13- to 17-year-olds born female, with an increase of 1,500 percent since 2008. "It used to be a male phenomenon and now there is a strong female over-representation," psychiatrist Mikael Landen, chief physician at Sahlgrenska University Hospital in Gothenburg, told AFP. Landen, who contributed to the scientific study on which the Board of Health based its decision, said the reasons for this increase remain largely a "mystery". "Tolerance has been high in Sweden for at least the last 25 years, so you can't say it has changed," he said when asked if it was simply a result of a more accepting society.

Western debate

The profile of those diagnosed is often complex, according to Linden, as gender dysphoria often occurs in those also suffering from other diagnoses, such as attention deficit and eating disorders or autism. In May 2021 -- before the Swedish authorities' decision to restrict gender reassignment hormone treatments -- the prestigious Karolinska Hospital in Stockholm chose to restrict such hormone treatments to research projects only. Other countries are weighing the same questions. Neighbouring Finland took a similar decision in 2020, while France has called for "the utmost reserve" on hormone treatments for young people.

snip

[Autumn]

7. Is Sweden putting the brakes on treatments for trans minors out of hatred? That's what I see

happening here.

[Mosby]

15. Don't see any hatred from doctors, I see concern for their patients.

Sweden, a pioneer in LGBTQ rights, is now restricting gender-affirming treatments for minors, citing concerns about their long-term side effects.

Sweden’s National Board of Health and Welfare explains that the reason behind the rollback is that little is known about the effects of these treatments over the long term and "the risks outweigh the benefits currently".

However, experts say those treatments were designed for exceptional cases in the first place.

"We had a protocol in place which was designed for very rare and extreme cases and suddenly the demand exploded so we continued to use that protocol,” said Mikael Landen, a psychiatrist specialising in gender dysphoria who contributed to the scientific study on which Sweden’s health authority based its decision.

“Maybe we shouldn’t have done that. But I wouldn’t be the one criticising the clinicians for doing that because it was difficult, they wanted to help these patients," he told AFP.

Sweden, like many other western countries, has in recent years seen a sharp rise in diagnoses of gender dysphoria.

According to the Swedish health authority, the trend is particularly visible among 13- to 17-year-olds assigned female at birth, with an increase of 1,500 per cent between 2008 and 2018.

Experts say the reasons for this increase remain largely a "mystery".

....

https://www.euronews.com/next/2023/02/16/as-spain-advances-trans-rights-sweden-backtracks-on-gender-affirming-treatments-for-teens

[Autumn]

17. The hatred here comes from republicans politicians and it trickles down to their supporters.

[vercetti2021]

22. Also remember this

Sweden now has a right wing government. So it TOTALLY doesn't somehow have anything to do with the rights quest of restricting our rights. NOPE NOT AT ALL.

The benefits outweigh all risks. When it comes to saving their lives, its all bullshit by the now far right Sweden Gov.

[Celerity]

32. The medical authorities here are separate from the government under our instrument of law. Also, the

pause was already happening in multiple places well before our national elections last fall (Sept 11th, 2022), the one in which the nationalist RW Sweden Democrats ended up in a power sharing agreement, called the Tidö Agreement (Tidöavtalet).

The Sweden Democrats are not officially in the government (regeringen), but they do influence some of its policies via Tidöavtalet. The 'government' here means the PM and all of his/her departmental ministers. It does not mean all of the Riksdag (parliament).

No Swedish political entity enacted or indirectly caused any of the changes as to how minors are treated in terms of medical gender reassignment treatment. They lack the constitutional power to do so under our instrument of law. This separation of powers is what caused so much of the Sturm und Drang here during the first 6 or so months of Covid. It took acts of the Riksdag (parliament) in order for the Government (regeringen) to start to more assert its will over official policy.

[Ms. Toad]

28. This is nonsense.

Puberty blockers have been in use for approximately 4 decades. The effects of these treatments over the long term is well known, and overwhelmingly safe.

[Celerity]

18. Trans people here have been overall accepted here for decades. The people making the medical

decisions about treatments for minors are non politically appointed doctors and scientists, many of whom are professionally and/or academically involved in the gender reassignment medical process sector, so I do not think hate has much, if anything, to do with it. It stems from concerns for their patients.

Sweden is MASSIVELY more LGBTQ friendly than the US on balance, in my experience of living and travelling both nations. It is the most accepting country in terms of LGBTQ I have ever been in (and we are very well travelled globally).

The only problems my wife and I have ever really had here have been from some sectors of the immigrant and/or refugee communities, almost always young male Muslims and Christians from the Middle East and Africa, and almost always when they are in groups.

We have never been physically attacked, but there have been a couple pretty tense situs, almost all of them in some dodgy neighbourhood (we deffo do not make a habit of going to certain suburbs, especially places like Tensta, Fittja, or Rinkeby, etc, that is just asking for trouble) or around the clubbing scene (outside Stureplan nightclubs for instance). Stureplan is the biggest, most posh entertainment district in Stockholm, and it draws a shedload of young, non ethnic Swede immigrant/refugee males nowadays. 95% of them are all good, we have so many friends from those communities who are wonderful people, but every now and then you get a group with too many assholes in it. Almost all of our gay male friends get it worse from those types than we, as a lesbian couple, do. Our trans friends even more than that.

[Autumn]

19. Here in the US the politicians make medical decisions while ignoring advice from the medical field.

It's pretty damn sad.

[Celerity]

21. Yes. it is pretty much madness in the US when it comes to that.

[Ms. Toad]

29. Refusing to provide gender-affirming care to their patients during the critical years

is not concern for their patients, particularly when they are touting false information to support it.

Puberty blockers have been in use for nearly 4 decades. The long-term effects are known and overwhelmingly safe.

[vercetti2021]

23. Likely

They are controlled by a right wing gov now

[walkingman]

3. The GOP's goal is to take us back to 1950 and they are making progress. Fight the Power!

[Tickle]

24. How so? NT

[walkingman]

27. Racism, homophobia, fear, misogyny, white supremacy, culture wars

When it comes to GOP, they will go after any group that doesn't have the political power to fight back!

[Sympthsical]

4. That was a pretty fiery attack on the district court

Don't see that too often.

This is all going to end up in front of Supreme Court. Who knows how that will go.

[DemocratInPa]

9. Sadly, I can tell you how it's going to go.

[Sympthsical]

14. Probably on this

I don't always assume the Court is always going to do the right-wing option. Look at a cases like Halaand or Allen v. Mulligan (Native American adoption and Alabama redistricting, respectively).

But this is a culture war object, and the Court is likelier to go with the conservative option in many of those cases.

But sometimes you get Roberts and a sympathetic conservative. Sometimes. But yeah, if I were a betting person, I'd lean likelier to uphold bans.

[bucolic_frolic]

6. Ah! I see. So the State owns those children and the legislature controls them

and it's all blessed by the court. Um, parents?

[unblock]

12. "parent's rights" are only for right-wingers with cis-children, silly.

[Bleacher Creature]

8. They spend so much time and effort picking on the most vulnerable among us.

It's days like this that I wish I believed in heaven and hell.

[MOMFUDSKI]

10. Do we even have a shot at

keeping it all from swirling down the proverbial toilet? Wow

[unblock]

11. regarding the idiotic notion that the law "equally restricts use of puberty blockers":

this is stupid on its face.

my daughter (assigned male at birth) uses spironolactone, a testosterone-blocker. good thing we're in connecticut and not alabama. if we were in alabama, the law would prevent her from getting appropriate medical care because she is biologically male, while a biological female can get spironolactone for a variety of conditions. so of course it's sex discrimination.

it does my daughter no good to say oh, but there are some boys who are assigned male at birth who are being equally discriminated against.

by the 11th circuit logic, a law banning interracial marriage would be legal and constitutional, because both races are allowed to marry within their own race and are equally banned from marrying with someone from the other race, so the 11th circuit would claim it's not racial discrimination

of course, the supreme court rejected that bigoted logic in loving v virginia (1967), but that bigoted logic is alive and well at the 11th circuit.

[Hassin Bin Sober]

26. Yeah, I did a double take on that.

Are they claiming these drugs are also denied for CIS kids that have other (non trans) medical needs for the drugs?

[Takket]

13. will this be appealed for a ruling from the entire 11th circuit?

[former9thward]

31. Maybe, maybe not.

The full 11th circuit does not have to accept an appeal for the entire circuit. If they don't it would appealed to the SC and they may or may not take the case.

[Takket]

16. what about the deeply rooted traditions precedent of Dobbs?

Since Trans care become medically possible it has been the standard treatment without objection. In Dobbs, Alito set a precedent that anything that is, or is not, a deeply rooted tradition should remain that way (or be eliminated if it is not).

This would seem to make this court's decision a violation of that standard set by SCOTUS.

[unblock]

20. and regarding the due process clause,

what do these bigots think "life, liberty, and property" means if not to live your life as you see fit?

the state is basically, among other things, mandating that man who is assigned female at birth is not allowed to grow a beard, and that a woman who is assigned male at birth must grow lots of body hair.

how does liberty not include living your life as a woman, or as a man, if that's how you feel is right for you?

right-wingers simply don't believe in a right to liberty. they believe in a right to live how *they* want you to live.

[Tickle]

25. It's for minors not

not young adults

[Ms. Toad]

30. And that is the age at which gender affirming care is most critical.

It is the age at which hormone-driven secondary sex characteristics develop - beyond that point it can be extremely challenging and costly to alter one's appearance enough for outer presentation to match gender. That mismatch is often very traumatizing, and can lead to lifelong emotional (and often physical) trauma. Especially in today's political atmosphere, trans women who have gone through puberty without puberty blockers are verbally and physically attacked for simple acts like trying to use a public bathroom.