'Our patients just are afraid': Doctors in states neighboring Alabama are preparing for an influx of trans youth after the state passed an anti-trans law

• Doctors who provide trans healthcare in states neighboring Alabama are expecting an influx of patients.
• Recent anti-trans legislation bans doctors in Alabama from providing gender-affirming care to trans kids.

Doctors in states neighboring Alabama are preparing for an influx of trans patients after the state passed a bill barring medical practitioners from providing gender-affirming care to kids.

In response to the law, doctors in Alabama are urging their patients to consider finding healthcare options in neighboring states like Mississippi, Tennessee, and Georgia.

Queer Med, a private clinic that provides LGBT care with offices in 14 states across the country, sent an email − seen by Insider — directing patients to "drive out of" Alabama.

It was prompted by a bill, SB 184, recently signed into law by Alabama Gov. Kay Ivey. The bill criminalizes doctors who provide certain healthcare to trans kids, such as prescribing hormones or performing gender-affirming surgery. Doctors face a 10-year prison sentence under the law.

"We do not yet know if pharmacies in Alabama will be able to fill or mail prescriptions, but out of state pharmacies will be able to fill prescriptions," the email said.

Queer Med in Alabama has about a dozen patients under the age of 19, clinic founder Dr. Izzy Lowell told Insider. The clinic will continue to treat its trans patients at least until May 8 when the law is expected to go into effect, according to the email.

"It's a bizarre position to be in, having taken an oath," Lowell said. "It's against medical ethics to abandon patients, to just stop treating someone and leave them high and dry. That goes against my medical training."

Two federal lawsuits have been filed against SB 184. But if the courts uphold the law, trans kids will not be able to receive hormone therapy or gender-affirming surgery in the state of Alabama until they reach 19.

In states surrounding Alabama, doctors are already expecting influxes of trans kids who are crossing state lines to receive the care they need.

Stacie Pace, who provides gender-affirming hormone therapy at the Other Clinic in Mississippi, told Insider she's been consulting with her lawyer to determine the legality of treating people who come from Alabama to receive healthcare.

"We have to proceed carefully here," she said. "We already receive regular death threats and all kinds of other nonsense just from the normal operations of our business."

Also, going out of state to receive healthcare can be entirely unfeasible for some people.

"It's just a real barrier to care for a lot of our patients," said Lowell. "Many people don't have transportation, so it's a big barrier."

Other families are carefully evaluating the decision to go out of state to receive care.

Jess Eisenberg, a parent of a 5-year-old gender-diverse child, said she and her kid have discussed potentially being able to stay in Alabama while traveling to other states because "the cost of living is so low."

Doctors are fighting back

One of the federal lawsuits in response to SB 184 was filed by two physicians.

The law "targets transgender minors, parents of transgender minors, and physicians who provide medical care to transgender minors," a complaint from Drs. Morissa J. Ladinsky and Hussein D. Abdul-Latif says. "It unlawfully denies necessary and appropriate medical treatment to transgender minors and imposes criminal penalties on parents and health care providers who obtain or provide such care."

If the law gets overturned in court, medical practitioners will still be able to provide healthcare services to trans kids. But if it doesn't, it might only get worse.

For instance, Idaho's House of Representatives in March passed a bill that would threaten anyone who helps a child cross state lines to receive trans healthcare with life imprisonment. Lowell fears that Alabama will institute a similar kind of law.

Pace, the doctor with the Other Clinic in Mississippi, shares the same concern.

"We want to do everything we can to help them, of course," Pace said. "But we don't want to give Alabama legislators any avenue to come at us and potentially shut us down as well."

Doctors have long been proponents of providing gender-affirming healthcare. And research studies frequently show that trans kids who receive gender-affirming care have better mental health than those who do not.

"Our patients just are afraid, don't know what to do," Lowell said. "You're telling someone who's a teenager that their whole existence is wrong and they shouldn't be who they are."