South Dakota Gov. Kristi Noem has signed a bill prohibiting people under 18 from accessing gender-affirming health care treatments into law.
Under the bill, which was passed by both chambers of the state legislature on party-line votes, doctors are prohibited from prescribing any health care treatment for gender dysphoria, or that would “alter the appearance of” a minor’s body or “validate a minor’s perception of” a gender identity that does not match their assigned sex at birth.
The bill makes South Dakota the sixth state to place some type of restrictions on gender-affirming health treatments intended to assist a person in transitioning.
That includes interventions like puberty blockers, hormone therapy, and gender confirmation surgery — although experts note that surgery is already rarely performed on minors.
Supporters of the bill say it’s needed to protect young people from making irreversible medical decisions that they may later come to regret once they “grow out of” their feelings of gender dysphoria.
But opponents of the bill, including health care providers and most major medical organizations, argue that some less invasive gender-affirming treatments are beneficial to trans-identifying youth and can reduce feelings of suicidal ideation.
“South Dakota’s kids are our future,” Noem said on Monday after signing the bill. “With this legislation, we are protecting kids from harmful, permanent medical procedures. I will always stand up for the next generation of South Dakotans.”
Opponents have also criticized the bill for overstepping and infringing on personal health care decisions and parental rights by inserting the state into private, family decisions.
They also accuse Noem of pushing divisive legislation to make herself a more appealing candidate to social conservatives ahead of a possible 2024 run for the presidency.
“This ban denies transgender and nonbinary youth crucial support and care. Even in the face of professional guidance from every major medical and mental health association in the country that supports this type of care, politicians are intruding into the private medical decisions best left to transgender young people and their families,” Casey Pick, the director of law and policy for The Trevor Project, the nation’s largest LGBTQ suicide prevention group, said in a statement.
“We are committed to keep fighting for the rights of young trans South Dakotans to access the best-practice, medically necessary health care they need to survive and thrive. We are here for you and we aren’t going anywhere,” Pick added.
According to The Trevor Project’s 2022 U.S. National Survey on LGBTQ Youth Mental Health by State, 53% of LGBTQ youth in South Dakota seriously considered suicide, with about 1 in 5 attempting to kill themselves. Nationally, about 7 in 10 transgender or nonbinary youth say they’ve experienced discrimination due to their gender identity — a factor that can affect a person’s decision to contemplate suicide.
Additionally, polling by The Trevor Project finds that 86% of trans and nonbinary youth say recent debates over anti-LGBTQ bills, like measures to ban gender-affirming care, have negatively impacted their mental health.
However, advocates point to a 2021 peer-reviewed study by The Trevor Project that indicates that gender-affirming care may actually reduce suicidal ideation.
The study, which examined 9,000 youth who received gender-affirming care, found that trans and nonbinary youth who received such treatments were 40% less likely to report feeling depressed or having attempted suicide in the past year than their peers who did not receive such treatments.
U.S. Rep. Becca Balint has introduced a bill to protect and expand access to gender-affirming care for transgender individuals at a time when the Trump administration is seeking to restrict the practice.
The Vermont Democrat's bill -- the Transgender Health Care Access Act -- establishes grants to support medical education programs and professional training in transition-related care, and to expand access to such services in rural communities.
She introduced the bill on March 31, coinciding with Transgender Day of Visibility.
The congresswoman noted in a news release that in a survey of students at 10 medical schools, nearly 4 in 5 students did not feel competent at treating transgender patients suffering from gender dysphoria.
The U.S. State Department has ordered officials worldwide to deny visas to transgender athletes attempting to come to the U.S. for sports competitions.
It is also ordering permanent visa bans against transgender people whose gender marker on their application doesn't match their assigned sex at birth.
A State Department cable obtained by The Guardian instructs visa officers to enforce a section of the Immigration and Nationality Act that allows the United States to refuse entry to any visa applicant who commits identity fraud or misrepresents who they are.
Unlike regular visa denials, anyone violating that section can be permanently refused entry to the United States, effectively constituting a lifelong ban.
An Ohio law prohibiting transgender youth from accessing gender-affirming care has been declared unconstitutional by a state appeals court. The court has permanently blocked officials from enforcing the ban.
On March 18, a three-judge panel of the state's 10th District Court of Appeals overturned a lower court's ruling that allowed the state to enforce the ban, reported NBC News.
The ban on gender-affirming care -- which passed along with a ban on transgender women and girls from participating on female-designated sports teams -- was passed in late 2023 but was later vetoed by Republican Gov. Mike DeWine.
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