North Dakota Governor Signs Bill Making Gender-Affirming Care a Felony

North Dakota Republican Gov. Doug Burgum has signed a bill into law criminalizing the provision of gender-affirming health care for transgender minors.

Burgum signed the legislation Wednesday, and it goes into effect immediately, the Associated Press reports. It had passed the state House and Senate with veto-proof majorities.

The measure makes it a felony to perform gender-affirming surgeries on minors for the purpose of transition and a misdemeanor to prescribe hormones or puberty blockers. The penalty for the felony charge would be a prison term of up to 10 years in prison and a $20,000 fine; for the misdemeanor, it would be up to 360 days in prison and a $3,000 fine.

Burgum released a statement Thursday morning saying the law is “aimed at protecting children from the life-altering ramifications of gender reassignment surgeries,” although he noted that health care professionals have testified these surgeries are not being performed in the state. Genital surgery is not generally recommended for minors.

The law allows the use of puberty blockers for early-onset puberty and certain other conditions, but not for gender transition. However, young people who are already receiving puberty blockers or hormones can continue to do so. This treatment is endorsed by every major medical association.

“Going forward, thoughtful debate around these complex medical policies should demonstrate compassion and understanding for all North Dakota youth and their families,” Burgum said in his statement, according to the AP.

Civil rights groups quickly condemned Burgum’s action. “By signing this bill into law, Gov. Burgum has put the government in charge of making vital decisions traditionally reserved for parents in North Dakota,” Cody Schuler, advocacy manager for the American Civil Liberties Union of North Dakota, said in a press release. “This ban won’t stop North Dakotans from being trans, but it will deny them critical support that helps struggling transgender youth grow up to become thriving transgender adults.

“Gov. Burgum and supporters of House Bill 1254 have chosen fearmongering, misrepresentations, intimidation and extremist politics over the rights of families and the lives of transgender youth in North Dakota. But this fight is far from over — we are determined to build a future where North Dakota is a safe place to raise every child. As our politicians continue to fail trans youth, it is up to each and every one of us to rise against their fear and ignorance and surround these young people with strength, safety and love.”

Cathryn Oakley, state legislative director and senior counsel at the Human Rights Campaign, released this statement: “In signing this bill, Governor Burgum has sided with extremist lawmakers who are interfering with the rights of parents and acting as if they know more about how to support transgender children than medical experts and parents do. North Dakota lawmakers have shown nothing but hostility for transgender folks this legislative session, but denying children the ability to get the care they need to be and stay healthy is simply cruel. The Governor’s decision to support this discriminatory legislation will have a devastating impact on families and children in this state.”

Earlier this month, Burgum signed two trans-exclusionary sports bills into law. They bar trans girls and women from competing on female teams; one affects K-12 public schools, the other state colleges and universities. He vetoed a bill that would have barred teachers from using students’ preferred pronouns, and legislators tried but failed to override that veto.

Other states that have outlawed most or all gender-affirming care for trans minors through legislation are Alabama, Arizona, Arkansas, Georgia, Idaho, Iowa, Mississippi, South Dakota, Tennessee, Utah, and West Virginia. Florida has put a ban in place through its medical boards and is considering a bill for an even stricter measure. Missouri's attorney general has put out severe restrictions on this care. The Alabama and Arkansas bans are temporarily blocked by court action. Bans are pending in several other states.