Children who struggle with gender dysphoria (distress associated with profound discomfort with one’s biological sex) have become a target for political activists and interest groups.
These activists are pushing a radical agenda claiming that the solution to these children’s distress is to push experimental, life-altering drugs and surgeries that prevent healthy puberty, radically alter the child’s hormonal balance, remove healthy external or internal organs and body parts, and inflict potentially permanent sterilization.
Activists have intensified this push despite the fact that there has been no demonstrable benefit from such extreme measures—and despite multiple studies showing that if young children who experience gender dysphoria are allowed to mature naturally, the large majority of them grow out of their gender dysphoria by the time they become adults.
In response, European nations such as England and Sweden are turning away from hormonal interventions that disrupt the natural maturation of children, and states like Alabama are passing commonsense laws that prohibit these dangerous, unproven, and unnecessary medical procedures for minors. But activists and interest groups, along with the Biden administration, sued Alabama, claiming the right to perform these procedures on children. So Alliance Defending Freedom worked alongside the Alabama Attorney General’s Office to defend the state’s law.
What is Alabama Senate Bill 184?
In April 2022, Alabama passed Senate Bill 184 (SB 184), or the Alabama Vulnerable Child Compassion and Protection Act.
SB 184 prohibits the administration of puberty blockers, cross-sex hormones, and surgeries on minors who experience discomfort with their biological sex. These experimental medical interventions can have harmful, lifelong, and irreversible consequences.
Additionally, the bill prohibits nurses, counselors, teachers, principals, or other school officials from withholding information from parents about their child’s perception that his or her gender or sex is inconsistent with his or her sex.
Activist groups challenged Alabama’s law
In response to SB 184, a handful of doctors and parents—represented by politicized interest groups such as the Human Rights Campaign, the Southern Poverty Law Center, and the American Civil Liberties Union—immediately sued, claiming that Alabama’s law protecting minors violated the U.S. Constitution. The Biden administration also intervened to challenge Alabama’s law.
In May 2022, a federal court enjoined Alabama from enforcing the parts of SB 184 that prohibit the administration of puberty blockers and cross-sex hormones on minors but allowed the prohibitions on surgeries and schools withholding information from parents to remain in effect. Alabama then appealed the partial injunction to the U.S. Court of Appeals for the 11th Circuit. Thankfully, the 11th Circuit lifted the lower court’s injunction, allowing the law to take effect while the case proceeded.
In December 2022, at the request of the Alabama attorney general, ADF joined the Attorney General’s Office to represent the state in defending SB 184 to protect children from harmful, irreversible, and unnecessary medical procedures.
Following the election of President Donald Trump, the federal government dismissed its legal challenge in March 2025, signaling the Trump administration’s support of commonsense laws like Alabama’s. The ACLU and other activist organizations dismissed their lawsuit shortly thereafter.
“Alabama rightly enacted a law that protects children’s welfare—supporting their natural development and ensuring that children experiencing gender dysphoria have a chance for healing and compassionate mental-health support,” said ADF Senior Counsel Jonathan Scruggs.
“Across the globe, we’re seeing a refreshing return to sanity after radical gender ideology devastated far too many young lives. Alliance Defending Freedom has been honored to support Alabama and the leadership of Alabama Attorney General Marshall to protect children and families. We applaud Alabama and the 24 other states that are following the science, protecting children, and working to stop an unsafe medical experiment that has gone on far too long.”
The bottom line
The medical field exists to promote health and human flourishing. But drugs like cross-sex hormones and surgeries that permanently alter children’s bodies have lifelong irreversible consequences, including sterility.
They destroy health, turn children into lifelong patients, and irreparably deprive them of the fulfillment and basic human right of becoming parents later in their lives, all with no proven long-term benefits.
These irreversible drugs and surgeries are not the answer for children who are experiencing discomfort with their sex. Alabama’s law recognizes that children suffering discomfort with their sex are best served by compassionate mental-health care that gives them time and support to grow into comfort with their bodies and with their true identities as male and female.
Boe v. Marshall
- April 2022: Alabama passed the Alabama Vulnerable Child Compassion and Protection Act (SB 184). The law was immediately challenged by multiple politicized interest groups, and the Biden administration joined in challenging the law.
- May 2022: A federal district court enjoined Alabama from enforcing the parts of SB 184 prohibiting the administration of puberty blockers and cross-sex hormones on minors but allowed the prohibitions on surgeries and schools withholding information from parents to remain in effect. Alabama then appealed the partial injunction to the U.S. Court of Appeals for the 11th Circuit.
- December 2022: ADF filed a motion of admission to join Alabama in defending its commonsense law.
- August 2023: The 11th Circuit lifted the lower court’s injunction, allowing SB 184 to take effect while the case proceeds.
- March 2025: Following President Donald Trump’s election, the federal government dismissed the legal challenge brought by the previous administration.
- May 2025: The ACLU and the other activist organizations dismissed their portion of the lawsuit.
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