Alabama trans teens, parents, and doctors fight against ‘hell’ of health-care and bathroom bills
The Daily Beast
March 7, 2022
Alabama trans youth and their families are fighting back against two bills, while also contemplating having to leave the state to safeguard the teenagers’ health and happiness.
The transition care she has received so far has made Harleigh Walker, 14, “find who I truly was, and I worry having it taken away might take me to mentally dark places that are scary to think about.”
A 17-year-old trans boy, whose mother requested anonymity, tells The Daily Beast, “It’s scary. I’m very scared. I feel defeated, helpless. If the bill passes, I will not have access to testosterone, and getting off testosterone abruptly would have some not-fun side effects.”
Both young people live in Alabama, where a bill, HB 266, would ban the prescription and administration of puberty-blocking and hormone medications for trans minors aged up to 19. The bill, awaiting a House vote, is likely to pass, and be signed into law by Governor Kay Ivey.
A maximum 0f 10 years’ imprisonment awaits anyone deemed to have broken the law, having committed what would be newly defined as a class C felony. The ACLU says the law would not only criminalize health-care providers, but also parents and children.
“Adults are free to do what they want to do, but this is to protect children,” Rep. Wes Allen, the Republican sponsor of the bill, has said.
“We don’t want parents to be abusing their children. We don’t want to make that an option, because that’s what it is: It’s child abuse. This is just to protect children,” Republican state Sen. Shay Shelnutt, sponsor of companion bill SB 184, has said. (Sen. Shelnutt did not respond to requests for comment.)
Underpinning HB 266 is the belief that, as it states, “The sex of a person is the biological state of being female or male, based on sex organs, chromosomes, and endogenous hormone profiles, and is genetically encoded into a person at the moment of conception, and it cannot be changed.” The bill also prevents school staff from supporting trans students, and requires them to out trans students to parents and caregivers.
A further bill, HB 322, proposes that anyone using toilets and locker rooms in Alabama’s K-12 schools must do so according to the sex stated on their birth certificate, effectively banning trans kids from using the facilities that accord with their gender identity.
The Daily Beast has learned that two legal challenges to the health-care ban are being finalized by groups including the ACLU and National Center for Lesbian Rights (NCLR), both seeking to ensure an injunction is placed on the bill if and when it passes and before the law takes effect—as happened last year in Arkansas, which became the first state to ratify a ban on health care for trans teens.
However, Alabama’s trans youth, their parents, and doctors are still fearful, especially having seen the highly publicized interventions in Texas by Governor Greg Abbott and Attorney General Ken Paxton, who also deem trans teen health care to be “child abuse,” and where Abbott has instructed the Department of Family and Protective Services (DFPS) to investigate families and medical care providers that provide affirming care.
Last week, a Texas judge blocked an investigation of one family, though DFPS investigations of other families are reportedly ongoing. The same judge will this week rule on whether a block on all investigations statewide will be issued. Other effects of Abbott’s directive are being felt. On Friday, the Houston Chronicle reported that the Texas Children’s Hospital in the city had paused administering gender-affirming hormone treatments.
Nearly 200 anti-LGBTQ bills have been introduced in state legislatures so far this year, the majority focused on restricting young trans people’s access to health care, bathrooms, and playing sports at school. Ivey signed a sports ban into law in Alabama last year. She did not respond to requests from The Daily Beast for comment on whether she would sign the health care and bathroom bans into law if they should land on her desk. In candid interviews with The Daily Beast, trans youth, their families, and medical specialists revealed how the bills’ presence in Alabama was causing confusion, upheaval, and misery—while also galvanizing teenagers and their parents to fight back.
The 17-year-old trans boy told The Daily Beast that Republican legislators were “doing it for votes with an election coming up and stuff. I don’t think my rights to healthcare should be up for debate or a political thing. It’s just a bunch of people catering to Republican and right-wing voters. They think I should not have the right to say what should and shouldn’t be done to my body. There’s lots of hate and bigotry against trans youth. I want to ask the senators, ‘What makes you think that you know better over a doctor and parent what is good for a child?’”
Dr. Morissa Ladinsky, Associate Professor of Pediatrics at the University of Alabama, Birmingham, said gender-affirming care was in peril for the “several hundred kids” aged from 5 to 20 from Alabama, southern Tennessee, the Florida Panhandle, and the western edge of Georgia she and her team look after. Dr. Ladinsky says she will defy the law if the bill passes.
“The health-care bill would put my partners and I in a place no physician ever dreams of being in,” Dr. Ladinsky told The Daily Beast. “For us to cease a course of successful medical therapy without medical indications to do so blatantly violates the ethics of the medical profession. It’s called ‘medical abandonment.’ So, would we violate the ethics we take an oath to protect versus risking a felony charge? I have had three years to think about this. I know what I would do. I will never abandon my patients. I will risk a felony conviction. Part of the oath when we become doctors is that we will provide the highest quality of care for our patients and that we will never turn our back on them.”
“Sadly, many of the young people are entering the system after a suicide attempt,” Dr. Ladinsky added. “We are seeing more and more of those.” The value of the care she and her team provide is that many of the young people, some of whom have been rejected by their families, go on to live “whole productive lives.”
Her team administers counseling, support, referrals, and prescribes drugs like puberty blockers, which Dr. Ladinsky insisted had been used safely and usefully for 30 years in pediatric medicine, and were now the subject of “ridiculous misinformation” by those seeking to pass the legislation.
Dr. Ladinksy let out a curdled sigh of disgust at the name of the health-care bill, the Alabama Vulnerable Child Compassion and Protection Act. “These children are vulnerable, but not vulnerable in the way Republican lawmakers say they are. They are vulnerable and at risk of harm from them—not from us or the vital health care they receive.”
Dr. Ladinsky hopes the care trans children receive will not be jeopardized, but she is incredulous that they, their parents, and clinicians should be being demonized and criminalized in the service of Republican political power play. “Looking at Texas, when you get edicts from a governor and attorney general, you know you’re under a curtain of hell. Those who don’t care to understand a nuanced population of kids are taking the country backward, and you also play with fire when you marginalize children. It doesn’t sit well. They talk about abuse, when it is they who are abusing the children in my care.”
Harleigh Walker, who lives in east Alabama with dad Jeff, mom Lisa, and brother Robert, told The Daily Beast: “It’s been a lot, from last year checking to see what was happening with the sports bill—I am not that into sports, but some trans friends are—to this year, and the medical and bathroom bills, which would directly impact me, which is scary to think about. I may not be able to have the health care I desperately need to go on with my transition.”
Jeff tells The Daily Beast that banning Harleigh’s treatments would mean the family would have to relocate. “We may not be able to get the same treatment, therapies, and advice as we’ve been getting the last five years. That’s scary for us. It means a lot that our own state wants to attack us.” Son Robert serves in the Alabama National Guard, “so I take this pretty personally as a citizen,” Jeff says. “I feel like these are very partisan bills to fire up a specific base of voters, and there’s nothing else behind them other than that.”
“To me, politicians in Alabama are elected to represent their districts, and that includes trans people,” says Harleigh. “To have them propose and support these bills feels like they’re not doing their job properly.”
Jeff said living under the shadow of the bills had brought “an extreme level of stress,” and while the family had enjoyed the support of school and community, “it would only take one school administrator to enforce a bill like the bathroom bill and that would be a really bad day for us. It would send Harleigh into the boys’ bathroom, and Harleigh’s not a boy. Harleigh won’t be able to go to the bathroom if the bill is enforced. She will refuse, which may lead to other health complications for her.”
Harleigh said that “no one bats an eye” when she uses the girls’ bathroom. “If you put me in the boys’ bathroom it would cause problems for me and the people around me. It would just be awkward for something as simple as going to the bathroom. If I can’t go to the bathroom, it’s not good for my health, and I won’t be able to learn and concentrate.”
The 17-year-old boy’s mother, who requested anonymity for her and her son as they will be plaintiffs in a likely future lawsuit against the state if the health-care bill passes, told The Daily Beast, it was “awful” the family might be forced to move out of state in order for her son to receive the medication and care that he needs.
His mother said the family had called Alabama home for 23 years. It was awful to hear her parenting and care be described as “child abuse.” “It’s like they’re saying I can’t be a parent, and I don’t have control over a child’s medical care. If my child is diabetic and needed insulin, I would get that insulin. It’s frustrating. If this bill passes, we will definitely have to move. We’re his parents. He’s the most important thing. We just hope it doesn’t pass.”
The family may move to Colorado or New York, the mother said, although, with so many anti-trans bills in Republican state legislatures, she said she and her husband had asked themselves, “What state is it safe for us to go to?”
The mother began to cry. “It’s so frustrating. People should know how it feels to be under attack as the parent of a transgender child. I wish our legislators would meet us and our kids. The consequences of them not receiving medical assistance can be really bad. They are going to jail parents and doctors, the people who know these children the best. Alabama is going the same way as Texas. It’s a shame.”
Her son tells The Daily Beast he wants to do all he can to fight the bills, “and if that can help other kids like me, that would be great too.”
Trace Trice, a social work instructor who lives in northeast Alabama with her 17-year-old trans son Phin and husband Perry, said current events were “really, really scary, and not going away and it needs to. People need to know there are trans folks and trans families in Alabama, and we are fighting back against these bills.”
The idea that Phin may be denied testosterone, which he has taken for just over two years, is “outrageous. It’s saved his life. I don’t understand what the problem is. I’m just so outraged.”
Phin has said to his mom, “I just want to live my life. That’s really what should matter—that I am living my life as a 17-year-old. Why is this even happening? It’s so unfair.”
Trace paused. “What do you say to your kid when they’re just not wrong?”
“It’s just health care. It’s not affecting anybody else”
Kaitlin Welborn, Reproductive Rights Staff Attorney at the ACLU of Alabama, who is helping craft the ACLU’s lawsuit if the health-care ban passes, told The Daily Beast that the health-care and bathroom bills—the health-care bill most likely first—could be voted on in 11 remaining days of Alabama’s legislative session, which ends on April 7. A full lawsuit had been prepared the last time the health-care bill almost passed.
“We want to sue immediately if the bill passes and secure a preliminary injunction, so the law never goes into effect,” Welborn said. “Even so, we are concerned on the effects on young trans people of this cruel and heinous bill passing. It doesn’t just prohibit prescribing puberty blockers and hormones, it prohibits causing any of that to happen—so parents, doctors, and children can be prosecuted, anyone deemed to have caused the care to take place.”
Welborn said the health-care ban “is a greatest hits of constitutional violations,” violating Section 1557 of the Affordable Care Act, which prohibits discrimination on the grounds of sex, which—in the landmark Supreme Court “Bostock” ruling of June 2020—now encompasses sexual orientation and gender identity. The Biden administration’s intervention last week over Governor Abbott’s Texas directive, outlining bluntly how it falls foul of federal laws and guidelines, should also be uppermost in Alabama’s legislators’ minds, Welborn said, as they consider possibly losing millions in federal health-care program funding.
Asaf Orr, NCLR senior staff attorney and director of its transgender youth project, told The Daily Beast that Alabama’s health-care ban also violated the equal protection and due process clauses of the Constitution.
“When a state passes a piece of legislation, it has to show it has a legitimate basis for doing so,” Orr said. “There is no legitimate basis for criminalizing medical providers for providing a standard of care for gender dysphoria and infringing on the constitutional rights of parents to consent for appropriate medical treatments provided by their children’s medical care providers.”
Orr confirmed the NCLR would co-file another planned lawsuit. “It can’t stand. We need to make sure that it gets challenged, and to make sure the courts hear the full range of horrors a bill like this will cause.”
Until now, and the panic caused by the Republican bills, the trans teens and their families had been progressing with their lives and treatments. The 17-year-old boy came out as trans at age 14. He was “very lucky” to have supportive parents and brother. At a previous school, the boy’s teachers had not used his choice of pronouns, classmates had called him slurs, and it didn’t feel safe to go to the bathroom. Now he is at an accepting school.
He wants to train to be a psychologist at the University of Alabama and “be able to fully transition and see the person I become.” If he had to leave the house and state he has lived in his whole life, “it would be a lot,” he says. His mother is upset at the thought of leaving family and friends. Her mother lives next door. It is not just the thought of “starting from scratch” that scares her, but not having enough financial resources to live where they wish.
Harleigh Walker’s brother Robert has three more years of National Guard service to complete, so if the Walker family need to leave the state to ensure Harleigh has the health care she needs, “it would mean splitting our own family up,” said dad Jeff. “It’s infuriating because it’s needless. The people of Alabama are not asking for these bills, but they are presented and made inflammatory to invoke fear in people.”
Harleigh adds she will have to go to a new school and leave her life and friends behind. “It would be awful. The fact I have to even consider leaving is the worst part. It’s just health care. It’s not affecting anybody else. I don’t understand why it’s even on the table.”
Jeff thinks that if legislators actually sat down with trans kids and families like theirs, “it may not change their minds, but it may give them a different point of view. It’s not child abuse. It’s not something Harleigh has chosen for her life, it’s who she is.”
“It’s annoying to hear this is something I or my parents chose,” said Harleigh. “My parents wouldn’t choose a life for me of constantly battling legislators, or dealing with bullies at school. To hear someone say my parents are guilty of child abuse is really frustrating and hurtful. My parents live and work for me every day, so I can be who I am. They are there for me no matter what.”
“We’re just a family,” said Jeff. “We’re not out of the ordinary. We go eat Mexican on Tuesday nights, we watch movies, go on family vacations. We love our kids. We’re just like everyone else. Harleigh is no different to any 14-year-old girl. She listens to records. She’s on social media. The way being trans is painted in the media is so different to real life.”
Like other trans children and their parents, Trace Trice thinks politicians are merely playing for votes in legislating against her child. “There’s a phrase in the South, ‘Bless your heart,’ which is perfect depending on the inflection you use. I wish someone would bless their heart, so they would get one.” Trace is despairing at the intrusion into decisions she feels should just be between her, her child, and medical professionals, and wonders “where it will stop. Should I call you when he has a dermatology appointment or flu shot?”
Alabama has many other problems, Trace says. In legislating against trans youth, “they are serving up a solution to something which has never been a problem. It’s all based in fear, and utterly ridiculous.”
She wonders, as a social worker, whether under the new law if she is expected to turn herself in for ensuring her son has proper medical care, “and to live his authentic life. Prior to this, he was unhappy. Now he is settled in his identity We have his name legally changed, his birth certificate changed, and we’re planning to have his gender marker changed. He’s living his life authentically, but how does that look if these bills are passed?”
Trace says her family was materially privileged to be able to find the best for Phin, but she worries for poorer families, or families with younger trans children. Will they have to leave the state, or deal with the court and other systems, with officials who may be keen to enforce the new laws? “Senator Shelnutt and Representative Allen have opened up a horrible Pandora’s box, and I don’t know how mad it’s going to get.”
The family have lived in Alabama since 1998, yet now talk about leaving it “all the time,” said Trace. She and her husband love their jobs, home, community, and are disbelieving that their close-knit family could be split apart, or have to move, because of the bills.
When a neighbor put six Trump flags up in their yard, Trace put a Pride flag up in theirs “just to say, ‘We are here, and not ashamed.’ Alabama breaks my heart, and it doesn’t have to be this way. It is such a beautiful state with such wonderful people, but I wish I knew how to quit her.”
“I feel like with all these laws I am being erased”
Rep. Andrew Sorrell, who is co-sponsoring the bathroom bill, claimed to The Daily Beast that in the city of Muscle Shoals in his district there was “a transgender boy using the female bathrooms right now. He came in with his attorneys. The school offered him the use of a faculty restroom and single person single-use restroom. They said no, they wanted the trans boy in female bathrooms, and of course the locker rooms and everything else. This bill is addressing problems we’re having in our own city.”
Rep. Sorrell said he did not accept that transgender people are transgender. He said the trans boy “wants the rest of the world to participate in the fantasy he is a different gender. And that’s where we have to draw the line. As Americans, you have the right to make whatever dumb decisions you want as long as you don’t infringe on other people’s liberties. When you put a boy in a girls’ bathroom, you’re infringing on all girls’ rights.”
Dr. Ladinsky said both the health-care and bathroom bills were being used not just to stoke the Republican voter base in Alabama, but to grow it. The effect on her patients has been “devastating.” She recalled attending one clinic last year when another version of the health-care bill was being considered, and walking into room after room of trans patients and their loved ones in tears. The same questions were being repeated by those weeping: “Is it really going to happen?” “What states can we go to?”
The ongoing legal challenge to the health-care ban in Arkansas gives Dr. Ladinsky hope that the same legal challenges will be mounted in Alabama. “A culture wedge issue has transformed into a high-stakes political issue. It’s utterly pathetic when there are so many other real issues to focus on,” she said.
Dr. Ladinsky is seeing the effects of the bill being discussed in raw real time. “Patients’ anxiety levels are through the roof. Young trans people are scared of being even further marginalized at school by peers and their teachers. They are worried whatever safe spaces they have will be taken away. They are not sleeping. We are seeing cutting and self-harm, suicide attempts. They tell us: ‘What does it matter anymore? I feel like with all these laws I am being erased.’”
Rep. Sorrell repeated a claim to The Daily Beast made by colleague Rep. Scott Stadthagen, the bathroom bill’s chief sponsor, that there had been “multiple instances of transgender boys raping girls in female bathrooms” in Alabama. “Those of us co-sponsoring the bill feel like we’re protecting the daughters of Alabama,” Rep. Sorrell said.
The Daily Beast asked Rep. Sorrell to detail the specific incidents.
“I don’t know them off the top of my head,” Rep. Sorrell replied, “but I can tell you this has happened in Alabama several times in the last 10 years.”
1819 News reported that Rep. Stadthagen “cited seven incidents that had taken place in Morgan and Cullman Counties alone, although those incidents did not involve any criminal prosecutions.” A report in The Montgomery Advertiser revealed that at least one of the incidents cited by Rep. Stadthagen did not involve a trans aggressor.
Rep. Sorrell said The Daily Beast should reach out to Rep. Stadthagen to provide proof of the incidents. The Daily Beast did so, and Rep. Stadthagen did not respond. The Daily Beast reached out to the sheriff of Morgan County and did not receive a response.
“Trans people do not do what Scott Stadthagen claims they are doing,” Sydney Duncan, Attorney Director of the Magic City Legal Center, told The Daily Beast. “It is cis, straight men doing these things, but he is not offering a bill insisting straight men stay out of women’s bathrooms. Of course not! He’s offering a trans bill instead.”
“My clients are scared to death,” said Duncan. “Parents are scared to death. As an attorney and trans woman, it is incredibly disheartening that legislators are so easily swayed by things that aren’t true. We’ve told them over and over again about the numbers of suicide attempts and other horrible statistics affecting young trans people. This is dangerous, and will absolutely cost lives. This is not a medical bill. It’s a suicide bill. The legislators are not trying to solve problems. They’re trying to win votes.”
Duncan is hopeful legal challenges will be successful to “a miserable law.” For her, the bills underscore the belief that trans people “are coming from heartbreak, hurt, or trying to recover from a deep wound. Most of us just want to live and find a better way to exist. The truth is this is a joyful experience and a wonderful life.”
Republican legislators cleave to a very different worldview. “I don’t believe people are transgender at all, I believe you are born with the gender you really are,” Rep. Sorrell told The Daily Beast. “You can do things to yourself, but that’s not really changing you. If you’re an adult in America and you want to have transgender surgery, have at it. It’s a free country. What you don’t have the right to do is infringe on my daughter’s right to privacy in a bathroom.”
Rep. Sorrell said he had received “no criticism” in his district for his views or the proposed bills, and he was determined to see both pieces of legislation passed.
Rep. Sorrell said he “rejected the premise” that his and other legislators’ actions amounted to bullying an already marginalized group for political gain, and went on to blame trans youth and their families for the need for legislation.
“We’re not the ones who made the decision to have transgender surgery,” Rep. Sorrell said. “They’re the ones who put us in this position, not the reverse. They’re the instigators, we’re responding.” He then appeared to advocate for conversion therapy for trans youth, who he said they should have counseling to be told, “they are what God created them to be, not confuse them by encouraging them to have surgery and puberty blockers.” (No surgical procedures are performed on gender-diverse minors in Alabama, according to Dr. Ladinsky.)
Duncan said part of the reason that Republican anti-trans strategies were working was because many Americans do not know a trans person, and so myths and misinformation about their lives can flourish, “and once you mention ‘danger to children,’ that is intended to scare parents. None of it is rational or grounded in facts, and so you can’t really have a rational conversation with legislators about it. You talk to legislators, and think maybe they’ve come away with a better understanding of something, and then they say, ‘My pastor says I must protect people from the ‘trans agenda.’ You can’t do anything with that. You’re fighting with dogma.”
Duncan is optimistic that the law is squarely on trans advocates’ side, particularly with the talisman of the Supreme Court’s “Bostock” decision that sex discrimination encompassed discrimination on the grounds of sexual orientation and gender identity. But, Duncan said, Republican legislators want and may indeed win the culture or political war they are determined to have by playing to their base.
Rep. Sorrell rejected the idea—if one believes God creates life—that God had created trans children as trans. “You aren’t born trans. Trans is a decision you make,” he told The Daily Beast.
To hear God used against his daughter upsets Jeff Walker, who is from a devoutly religious family himself. “I believe God is being used as a tool to fire up the voter base. We are not living an ungodly life in this family. That’s as false as it can be. I believe we have a family that loves each other and we’re very close, and that God smiles down on that.”
“We had to speak up. There was no other choice”
Máni Blunt, Alabama Programs Manager for TransFamily Support Services, which helps connect trans kids and their families with the most appropriate forms of care, told The Daily Beast that the organization’s young trans clients and families in Alabama were “absolutely terrified. They’re frightened of losing the medical support they have, and, that Alabama starts classifying affirming care as ‘child abuse,’ as Senator Shelnutt has said. Having access to affirming care and affirming peers is suicide prevention and mental health care. It’s important for them to have that kind of autonomy, freedom, and peace of mind.”
Blunt said it was especially important to keep affirming health care intact because many young trans people do not have supportive families; having a requirement to report someone’s gender identity to a parent who is not supportive could worsen the young person’s situation—especially in a state that already lacks discrimination protections for LGBTQ people.
The NCLR’s Asaf Orr said the rash of anti-trans bills reminded him of the bills aimed at undermining marriage equality before it became a federal reality. “During that time, LGBTQ folks did an incredible job educating the public about what marriage equality meant, and I am seeing the same incredible work by young trans people and their families right now showing that trans kids are like all kids, and just need the support to reach their full potential.”
In some ways, Trace Trice says she wishes that all the activism wasn’t necessary, and that her son Phin had had the opportunity of coming out in a more accepting state, and done so as quietly and privately as he wished. But in their family, “we’re not designed to be bystanders,” said Trace. “We can’t not say anything. We had to speak up. This is our life. There was no other choice.”
If she had one final plea to Republican legislators, Trace said, it would be, “Please don’t do this. Please don’t take my son’s treatment away from him. It’s so vital, and it’s saving his life. There are so many other things Alabama needs. It doesn’t need these hateful bills. She really doesn’t.”
Harleigh Walker wants to go on to law school, become a lawyer, then maybe go into politics—maybe even become president. “That’s up there, definitely,” she said, laughing and also absolutely serious.
Her dad Jeff hopes that the Republican animus against trans kids passes, but fears “it’s here to stay” for some time, or at least until federal law and legal challenges ultimately sink them.
“To trans kids anywhere being discriminated against, I want to say, ‘You’re not alone, we are fighting this fight,’” Harleigh said. “We will get through this. You are not alone.”