North Dakota Teens Medical Care Ban Goes To Court


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A legal challenge to North Dakota’s gender-affirming care ban for minors heads to trial on Monday, following a lawsuit filed by transgender children’s families and a medical professional who argue the law violates constitutional rights.

The case, which joins similar challenges in numerous other states that have enacted comparable bans, has undergone significant changes since its initial filing in late 2023. Recent court decisions have narrowed the scope, removing the families and children as plaintiffs and leaving only a pediatric endocrinologist to pursue the case.

“Our argument is that all North Dakotans have a right to access health care that helps improve their lives and well-being, and our clients are no different,” said lead counsel Brittany Stewart, senior staff attorney at Gender Justice, a nonprofit advocating gender equity.

The legislation, which received strong support from the Republican-controlled legislature and was signed by then-Governor Doug Burgum in April 2023, imposes criminal penalties on healthcare providers. Under the law, prescribing hormone treatments or puberty blockers to transgender youth becomes a misdemeanor, while performing gender-affirming surgery carries felony charges.

Republican Representative Bill Tveit, who introduced the bill, expressed concerns about irreversible medical interventions for minors. “We were creating an atmosphere where if you felt you had that situation, that you were of that mentality, that we would go ahead and cut off body parts and affirm where you’re at without trying to guide you through it,” Tveit said. “Maybe it was a wrong thought at that age, and if you want to make that decision when you’re of age … that’s your prerogative once you’re an adult.”

Critics of the ban highlight its detrimental impact on transgender youth, noting that gender-affirming surgeries were not performed on minors in North Dakota even before the ban. Recent CDC data indicates concerning trends among transgender and gender-questioning teens, with elevated rates of bullying and suicide attempts.

Stewart emphasized the law’s adverse effects, stating, “When you ban the only medically supported care for a specific condition and only for young people who are under 18, you’re not protecting those kids. You’re actively harming those children.”

While the law includes a grandfather clause for youth already receiving treatment, implementation challenges have forced families to seek care out of state, with some traveling up to eight hours round trip for brief medical appointments.

The ban faces opposition from major medical organizations, including the American Academy of Pediatrics and American Medical Association, who maintain that gender-affirming care can be medically necessary. Research indicates higher suicide risks among transgender individuals forced to live as their assigned birth gender.

North Dakota joins 25 other states with similar restrictions, many facing legal challenges. Federal courts have already invalidated bans in Arkansas and Florida, though appeals continue. As the eight-day trial commences in Bismarck, the timing of the judge’s decision remains uncertain.