BISMARCK, N.D. — A trial commenced on Monday regarding a lawsuit aimed at overturning North Dakota’s prohibition of gender-affirming medical care for minors. This legal challenge comes from families of transgender children and a physician who argue that this legislation infringes upon the state’s constitution. The trial is notable as North Dakota is among over twenty states that have prohibited such medical interventions for young people, many of which face ongoing judicial scrutiny.
Lead attorney Brittany Stewart from Gender Justice, a non-profit organization advocating for gender equity, stated, “This case is not as complicated as it may seem.” She emphasized that all citizens of North Dakota possess the right to make decisions regarding their healthcare, necessary for individuals to lead fulfilling and healthy lives.
The scope of the legal battle has been narrowed by recent court rulings. A state district judge recently dismissed several claims and removed families and children from the lawsuit, leaving a pediatric endocrinologist as the only remaining plaintiff. The trial, which is taking place in Bismarck, is expected to run for eight days, though a timeline for the ruling remains uncertain.
The ban was initially signed into law in April 2023 by then-Governor Doug Burgum after receiving strong support from the Republican-controlled Legislature. This legislation classifies providing hormone treatments or puberty blockers for transgender children as a misdemeanor, and it categorizes gender-affirming surgeries on minors as a felony.
Joe Quinn, Special Assistant Attorney General, defended the law as a constitutional measure, stating that the legislature is entitled to enact such regulations and asserting that there is no conclusive evidence supporting medical gender transition care for minors. The proponents of this law maintain that it serves to protect children from treatments deemed irreversible.
Supporters, including Republican Rep. Bill Tveit, who was instrumental in introducing the bill, argued that the legislation prevents premature decisions concerning gender identity. Tveit expressed a desire for the trial to validate the law’s intentions.
However, opponents believe that this legislation could adversely impact transgender youth. They point out that gender-affirming surgeries are not performed on minors within North Dakota. A recent survey conducted by the U.S. Centers for Disease Control and Prevention revealed that transgender and gender-questioning teens experience higher levels of bullying in educational environments compared to their peers, with a startling one in four individuals reporting suicide attempts in the past year.
In an interview, Stewart spoke out against the law, claiming, “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.” The legislation does allow for exceptions for minors who had already started treatment before the ban’s enactment. However, Stewart asserted that fears regarding the ambiguity of the law have caused healthcare providers to hesitate in offering these services, forcing families to travel long distances for care.
Even though the judge has ruled that existing patients can continue to receive care, the uncertainty around the law’s application persists, leaving many in limbo regarding their access to necessary treatments. Prior to the ban, at least two pediatric endocrinologists in North Dakota were providing gender-affirming healthcare.
The legal landscape surrounding gender-affirming care is contentious, with 26 states currently enforcing or planning to implement laws that limit or ban such medical support for transgender minors. Many of these states are embroiled in litigation. While some federal judges have declared similar laws in Arkansas and Florida unconstitutional, with a temporary block in place for Montana’s ban, North Dakota’s path remains unclear.
Notably, major medical associations in the U.S., including the American Academy of Pediatrics and the American Medical Association, have opposed these bans, asserting that gender-affirming treatments can be vital for the mental and physical health of transgender individuals. Extensive research has indicated an increased risk of suicidal behavior among transgender youths who must live according to the gender assigned to them at birth.
In summary, as the trial progresses in North Dakota, the implications of the decision will resonate across the country, amidst a wider debate about the rights of transgender minors and access to gender-affirming care.
