The United States Court of Appeals for the 11th Circuit today granted a request by Alabama Attorney Steve Marshall to begin enforcing the state’s ban on gender-affirming care for minors.

The law, titled Vulnerable Child Compassion and Protection Act, prohibits anyone under the age of 19 from receiving puberty blockers, hormone therapy or gender-affirming surgeries. It also punishes a doctor who “prescribes or administers” the treatments with a felony conviction and up to 10 years in jail.

Alabama’s law was signed by Gov. Kay Ivey in 2022 but never went into effect. U.S. District Judge Liles Burke blocked the medication ban after a hearing where families who have transgender children challenged its constitutionality.

The issue has been tied up in federal and appellate courts for the past two years.

In August the federal appeals court reversed the initial injunction issued by Burke, but plaintiffs requested that a full panel of judges reconsider the ruling. That prevented any enforcement from taking place.

Marshall requested in November that the court still allow him to immediately begin enforcing the law, calling the plaintiff’s move a “delay tactic.”

“The physical and psychological safety of our children can now be better protected from these untested and life-altering chemical and surgical procedures through the implementation of the Alabama Vulnerable Child Compassion and Protection Act,” Marshall said in a release Thursday.

“This is a significant victory for our country, for children, and for common sense.”

Alabama previously allowed the prescription of puberty blockers or hormones for transgender children. The medications delay puberty and are considered evidence-based care for children and adults, according to the American Academy of Pediatrics. Gender-affirming surgeries have never been performed in the state for minors.

Lawyers representing parents of transgender adolescents said in a news release today that “Alabama’s transgender healthcare ban will harm thousands of transgender adolescents across the state and will put parents in the excruciating position of not being able to get the medical care their children need to thrive.”

“The district court issued its preliminary order blocking the ban after hearing days of testimony from parents, doctors, and medical experts about the devastating impact of this ban and the lack of any medical justification for it. Today’s ruling will hurt parents and children in the state. We will continue to challenge this unlawful ban and to support parents and their kids in pushing back against the dangerous reality of being denied access to necessary, best-practice medical care.”

A full trial on the constitutionality of the ban is scheduled for August 2024.

When asked in September how the Attorney General’s office plans to enforce the law, a spokesperson said “the office does not answer questions about how we intend to investigate and/or enforce any criminal law.”