Ban on gender-affirming care for transgender children heads to Noem's desk for signing

PIERRE — The South Dakota Senate voted 30-4 Thursday to limit several forms of gender affirming health care for transgender children, including banning puberty blockers and hormone treatment. The highly controversial bill now heads to Gov. Kristi Noem's desk for final approval.

It's the first time a bill severely limiting health care for transgender children has passed through House and Senate committees as well as the legislative bodies in South Dakota. Noem has also signaled support for House Bill 1080.

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If signed into law, the bill will limit doctors from providing five types of health care to patients younger than 18:

1. Prescribe or administer any drug to delay or stop normal puberty;

2. Prescribe or administer testosterone, estrogen, or progesterone, in amounts greater than would normally be produced endogenously in a healthy individual of the same age and sex;

3. Perform any sterilizing surgery, including castration, hysterectomy, oophorectomy, orchiectomy, penectomy, and vasectomy;

4. Perform any surgery that artificially constructs tissue having the appearance of genitalia differing from the minor's sex, including metoidioplasty, phalloplasty, and vaginoplasty; or

5. Remove any healthy or non-diseased body part or tissue.

During the debate on the bill, where two amendments were introduced but failed, a lone pride flag was held by a viewer in the gallery.

The bill vote fell along party lines, with 30 Republicans voting for it and four Democrats voting against it.

What did supporters of the transgender health care ban say?

Supporters of the bill like Sen. Al Novstrup, R-Aberdeen, said that HB 1080 would protect children, ensuring they would not be provided with "permanent physical damage."

"We need to stand in the gap for vulnerable children and guide them towards true health and healing," he said.

More:Push to limit access to gender-affirming care for youth passes in South Dakota House

Novstrup said as soon as the child turns 18, they could begin their transition.

Sen. John Wiik, R-Big Stone City, added he has three children going through puberty currently and it can be a scary time. He said allowing children to take drugs to "delay the inevitable" was not the answer, when arguing against an amendment brought by Sen. Tim Reed, R-Brookings, that would have allowed children to access puberty blockers.

Amendments to allow puberty blockers, access to mental health therapy fail

Reed, at the beginning of the Senate debate, introduced an amendment that would have allowed minors to have access to puberty blockers. The amendment still would have banned surgery and hormone treatment.

"Puberty blockers can calm a child [with] anxiety so that counseling can begin," he said. "Blockers have a place helping families navigate through an extremely difficult situation. We need to be able to give these kids a chance."

Reed explained by allowing children to have access to puberty blockers, the health care treatment could prove vital to preventing suicides.

"Let's let the parents, the children and the doctor work together to figure out what's best for that child, so they can have the best life possible and not end up in suicide," he said.

While the yeses and no echoed loudly from the chamber during the voice vote on the amendment, Reed called for a visual count of who supported the amendment. Nine senators, four Democrats and five Republicans, stood in support of the amendment, while 25 stayed seated, signaling the amendment's defeat.

Reed ultimately voted for HB 1080.

Sen. Reynold Nesiba, D-Sioux Falls, introduced a second amendment that would've required the Department of Social Services to provide mental health counseling for minors experiencing gender dysphoria.

"We're going to make them rely on counseling, let's do no harm," Nesiba said. "Let's help these kids. Let's make sure that if they need medical assistance, that they are going to be able to get access to this."

Nesiba's amendment also failed.

What did those against the ban of gender-affirming care say?

Sen. Liz Larson, D-Sioux Falls, said the Legislature should not be in the doctor's office and getting involved in medical decisions.

"It's an overreach, and it's an invasion of the private decision which should be occurring between families and their expert care teams," Larson said.

Sen. Shawn Bordeaux, D-Mission, said he supported the Two-Spirit Indigenous community. He added when he speaks with younger constituents, they tell him they feel like the Legislature is picking on them when the state has other pressing issues to contend with.

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Both Bordeaux and Larson pointed to the committee hearings on HB 1080, when proponents used the testimony from people out-of-state to speak about why the ban on gender-affirming care was needed.

"It looks like this is a an effort that's being driven from the outside and we hear across the country that people are trying to push for these things," Bordeaux said. "This isn't a South Dakota issue. This rarely affects anybody in South Dakota, I believe."

ACLU and Transformation Project react

The South Dakota chapter of the American Civil Liberties Union said lawmakers ignored the overwhelming opposition from South Dakota medical experts, parents, transgender youth and advocates.

"House Bill 1080 is a devastating and dangerous violation of the rights and privacy of transgender South Dakotans, their families and their medical providers,” said Samantha Chapman, ACLU of South Dakota advocacy manager. “Medical decisions belong to patients (and their parents) and their doctors – not the government. The only controversy in providing life-saving gender-affirming care for transgender youth in South Dakota is the one fabricated by legislators who want to see this harmful bill become law.”

Chapman added similar legislation introduced in Alabama and Arkansas are currently in the courts.

The ACLU argues HB 1080 violates the U.S. Constitution in three separate, concurrent ways: discrimination against individuals based on sex, discrimination against individuals based on transgender status and a violation of parents' rights under the Due Process Clause.

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Susan Williams, executive director of the Transformation Project, a Sioux Falls non-profit dedicated to bringing awareness about transgender issues, wrote on Twitter she felt betrayed by the decision made in the Capitol.

"I feel confused and don't know if these people really don't understand us, or simply don't care," she said. "It makes me feel singled out, isolated and alone. This is a very hard time, yet knowing that we are experiencing this together and having each other to lean on that makes me feel a little bit better. We are here to support each other."

Protests planned against bill

After HB1080 cleared Senate Health and Human Services committee Wednesday, collective action calls by the Transformation Project were posted across social media.

The group asked for people to join protests at various legislative coffees on Saturday in Sioux Falls, Brookings, and Rapid City. A protest in Vermillion is also planned.

The Sioux Falls protest is planned for 9:30 a.m. Saturday at The Hub at Southeast Technical College.

This article originally appeared on Sioux Falls Argus Leader: South Dakota Senate passes ban on gender-affirming care for trans children