Conservative lawmakers in South Dakota are proposing a bill that would criminalize doctors treating gender dysphoria patients under the age of 16 with hormones, puberty-blocking medications, or gender transition surgeries.
Democrats and libertarians who oppose the bill argue that it would prevent gender dysphoric teenagers from accessing needed treatment like puberty-blockers. Going through puberty and experiencing bodily changes like growing breasts can be traumatizing for transgender youth, and puberty blockers are known to decrease suicide risk among transgender people, according to a study published Thursday in the journal Pediatrics.
“It certainly argues against the misguided notion that gender-affirming care is inherently harmful and should be legislatively banned,” said Dr. Jack Turban, the Harvard psychiatrist who led the study, told NBC News. Turban added that there is a “growing evidence base suggesting that gender-affirming medical care for transgender youth is associated with superior mental health outcomes in adulthood.”
According to the bill, HR 1057, doctors would be prohibited from giving treatment to children under age 16 “when such procedures are done to cause the minor to feel or appear as the opposite sex.” Were the bill to become law, doctors would face misdemeanor felony charges with a maximum penalty of up to a year in prison and a maximum $2,000 fine. Similar bills are also pending in Kentucky, Georgia, and Texas legislatures. But transgender advocates say the bill targets a red herring and that doctors are not prescribing hormone replacement therapy (HRT) to children without first following proper standards of care.
One 17-year-old South Dakota resident, Andrew, told The Daily Beast, he had to go to eight sessions with a psychiatrist to get recommended for HRT, then had to undergo blood tests and talk with his doctor about the effects of HRT and learn how to inject himself with testosterone. He said the process took six months and required parental consent at each step.
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“It is not a simple process by any means,” Andrew said. “Doctors aren’t prescribing HRT to little kids.”
In South Dakota, Republicans hold a supermajority in the legislature, but Republican Governor Kristi Noem has expressed hesitancy around this particular bill. She told reporters on Friday, “When you take public policy and try to fill parenting gaps with more government, you have to be very careful about the precedent you’re setting.” But Noem refused to say whether or not she would sign the bill if it came to her desk. This is not the state’s first brush with an anti-transgender bill. In 2016, South Dakota’s legislature passed a bill limiting transgender students’ bathroom access that was vetoed by then-governor Dennis Daugaard, a Republican. Noem, however, has said that she would have signed that bill.
Mara Keisling, executive director of The National Center for Transgender Equality, said in a statement that the legislation gets between patients and doctors. “Doctors and other medical professionals, not politicians, should decide the appropriate medical care for transgender youth. This is one of the most extreme and dangerous pieces of legislation in the country and threatens doctors with prison simply for providing necessary health care.”
Dr. Alexis Chávez, a psychiatrist and medical director at the Trevor Project, also opposes the bill, telling the New York Times, “They’re not using actual evidence. They’re not using the research. They’re not listening to any health care providers. And they’re advancing something that’s very dangerous to make a statement.”