In March 2021, the state Senate of Alabama voted to criminalize the treatment of transgender youth with puberty blockers, hormone therapy, or surgery. Sponsored by Republican Senator Shay Shelnutt, the measure, dubbed the Vulnerable Child Compassion and Protection Act, got approved by a 23-4 majority vote in the Senate. The state House of Representatives has already approved a companion bill.

These two bills would make it a crime for medical professionals to treat transgender kids under 19 with gender-affirming care. Violators could face a $15,000 fine or up to a 10-year prison sentence.

The bill also requires school staff to "out" transgender students to their parents regardless of whether or not they are ready to do so.

"Children aren't mature enough to make these decisions on surgeries and drugs," said Shelnutt to the Associated Press, "The whole point is to protect kids."

Similar measures have been considered across the country; however, Alabama would be the first state to pass such a bill. Parents and members of the transgender community, along with medical experts, have opposed the bills saying it is dangerous and that lawmakers do not understand the already tricky process to receive gender-affirming care.

According to the Alabama Chapter of the American Academy of Pediatrics, the bill could also unintentionally outlaw routine infant circumcisions.

Executive Director Linda Lee said that members became concerned about the language regarding "removing any healthy or non-diseased body part or tissue" under a list of prohibited treatments. Lee added that the bill was changed, but "it still doesn't fix the problem of the confusing language" for doctors who perform circumcision to remove the foreskin from the penis. The amendment drafted by officials from the chapter was not adopted.

The American Academy of Pediatrics opposes bills regulating the medical care of transgender youth. Academy President Dr. Lee Savio released a statement on the issue in March:

"Several state legislatures have introduced bills that would prohibit gender-affirming care for gender-diverse and transgender youth and forbid transgender youth from participating on sports teams according to their gender identity," he said, "These bills are dangerous. If left unchallenged, there will be transgender teens in certain zip codes who will be unable to access basic medical care, and pediatricians in certain zip codes who would be criminalized for providing medical care."

A section of the bill would prohibit a list of treatments if performed to "alter the appearance of or affirm the minor's perception of his or her sex." Doctors typically perform circumcisions within the first ten days after birth. Although widely practiced in the United States, the procedure changes the appearance of a child's genitals. The author of the bill, Senator Shelnutt, could not be reached for comment.

The American Academy of Pediatrics said that the benefits of circumcisions outweigh the risks. Routine circumcision is practiced in some communities for religious and cultural reasons.

Executive Director of Chabad of Alabama, Rabbi Yossi Friedman, said that ritual circumcision is one of the oldest Jewish traditions. It celebrates new life and is held when a child is circumcised on the eighth day after birth. These circumcisions are similar to medical ones but are performed by trained Jewish practitioners.

When asked what would happen if the law was passed, Friedman said that if it were interpreted to include circumcision, it would likely be challenged as an infringement on religious liberty.

He also added, "I'm going to go jail. That's what's going to happen. Because I'm not going to stop practicing my Judaism."

Friedman said that people supporting the law should think about the possible consequences, including those that would unintentionally prevent parents from raising children within their faith traditions. "The very people who support this law in most cases would be very hesitant to come along and have the government tell us what to do as parents and how we raise our children."

According to him, concerns about the medical treatment of transgender youth should be addressed outside the legal system. "Every time a law is passed, every time the government takes a step, there are unintended consequences."