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North Dakota's Republican governor, Doug Burgum, has signed legislation to ban minors from gender-affirming care. Photo courtesy of North Dakota Gov. Doug Burgum/Twitter
North Dakota’s Republican governor, Doug Burgum, has signed legislation to ban minors from gender-affirming care. Photo courtesy of North Dakota Gov. Doug Burgum/Twitter

April 21 (UPI) — North Dakota’s Republican governor, Doug Burgum, has signed a controversial bill to ban most minors from receiving medical and surgical forms of gender-affirming care under threat that their doctors could be jailed for up to 10 years for doing so.

With the signing of House Bill 1254, North Dakota becomes the 15th state to ban gender-affirming care for minors and the third to criminalize it, according to the Movement Advancement Project.

The bill was signed Wednesday as Republicans the country over seek to restrict or ban gender-affirming care, particularly for minors, despite major medical organizations — including the American Medical Association and the American Academy of Pediatrics — endorsing the medical therapy while opposing politicians interfering in the doctor-patient relationship.

According to the Office of the Assistant Secretary of Health, gender-affirming care is “patient-centered” and consists of non-medical and medical services, with some medical therapies, including puberty blockers, being reversible, and gender-affirming surgeries being “[t]ypically used in adulthood or case-by-case in adolescence.”

North Dakota’s bill specifically bans gender-affirming surgeries and medicines, including puberty blockers, for those under 18, with exceptions in place for minors diagnosed with a sexual development disorder or whose “biological sex characteristics … are irresolvably ambiguous.”

Under the bill doctors who perform gender-affirming surgeries could be charged with a class B felony, which is punishable with up to 10 years’ imprisonment, while prescribing medicine with the purpose of “aligning the minor’s sex with the minor’s perception of the minor’s sex” is to be treated as a class A misdemeanor, an offense that can be published with up to a year behind bars.

In a statement emailed to UPI on Thursday, Burgum said the bill is “aimed at protecting children from the life-altering ramifications of gender reassignment surgeries,” while adding that physicians and other healthcare providers have testified that “these types of surgeries have not been and are not being performed on minors in North Dakota.”

“Courts have not overturned similar surgical prohibitions for minors across the country, and H.B. 1254 still allows medication for early onset puberty and other rare circumstances with parental consent,” he said. “Children currently receiving gender-affirming care will still be able to receive treatment under this legislation.”

Burgum’s signing of the legislation was met with staunch criticism from civil rights and LGBTQ organizations that call H.B. 1254 government overreach.

“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 statement.

“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.”

Cathryn Oakley, state legislative director and senior counsel with the Human Rights Campaign, accused Burgum of having sided with extremist state lawmakers who are “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 the children the ability to get the care they need to be and stay healthy is simply cruel,” Oakley said.

Burgum signed the bill after last week having signed what advocates described as anti-LGBTQ legislation that bans transgender athletes from competing in women’s sports.



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