North Dakota Enacts Law Banning Sex Change Surgery, Puberty Blockers for Minors

North Dakota Gov. Doug Burgum on Thursday signed into law an emergency measure banning gender reassignment surgeries for minors.

The bill, known as HB 1254, creates and enacts a new chapter in the North Dakota Century Code. It bans certain medical practices on minors commonly used in the treatment of gender dysphoria and provides a penalty for health care providers who violate this law.

These prohibited practices include castration, vasectomy, hysterectomy, oophorectomy, metoidioplasty, orchiectomy, penectomy, phalloplasty, vaginoplasty, and mastectomy on minors, the bill states.

It also prohibits prescribing, dispensing, administering, or supplying puberty-blocking medication, supraphysiologic doses of testosterone to minor females, and supraphysiologic doses of estrogen to minor males. However, male circumcision is still permitted.

The bill defines a minor as an individual under the age of 18, including emancipated individuals. It also defines “health care provider” as a licensed physician, physician assistant, nurse, or certified medical assistant.

“House Bill 1254 is aimed at protecting children from the life-altering ramifications of gender reassignment surgeries,” Bergum said in a statement obtained by The Epoch Times.

However, he also noted that medical professionals have testified that such surgeries have not been performed on minors in North Dakota and are not currently being performed.

“Going forward, thoughtful debate around these complex medical policies should demonstrate compassion and understanding for all North Dakota youth and their families,” he said.

Penalties

According to the law, health care professionals who carry out sex reassignment surgeries on minors would be committing a class B felony, which can result in up to 10 years imprisonment and a $20,000 fine.

The law also allows prosecutors to charge health care providers with a misdemeanor that carries a maximum punishment of 360 days in prison and a $3,000 fine for administering puberty blockers to minors.

There are exceptions under the law. It does not apply to minors born with a medically verifiable genetic disorder of sex development, such as external biological sex characteristics that are irresolvably ambiguous or a disorder of sexual development diagnosed by a physician through genetic testing. It also does not apply to medical procedures performed on minors before the effective date of the law.

Burgum noted in his statement that the law still allows medication treatment with parental consent for early-onset puberty and other rare circumstances. The Food and Drug Administration approved such medications for the treatment of early-onset puberty 30 years ago.

“Children currently receiving gender-affirming care will still be able to receive treatment under this legislation,” he added.

The medications used to treat gender-questioning youth have not been specifically approved by the FDA for that purpose. However, they have been used for many years “off-label,” which is a common practice for many medical conditions.

The bill was introduced by state Reps. Bill Tveit, Dick Anderson, Larry Bellew, Brandon Prichard, Karen Rohr, Lori VanWinkle, and state Sens. Keit Boehm, David Clemens, Judy Estenson, Larry Luick, Janne Myrdal, and Shawn Vedaa.

The bill received support from GOP lawmakers with enough votes to override a veto, despite some Republicans voting against it alongside all Democrats.

Similar Measures

Such medical and surgical practices, commonly referred to as “gender-affirming care,” have been available for more than a decade in the United States and are endorsed by major medical groups.

Concerns have been raised about children changing their minds as they get older. Commonly known as “detransitioners,” some have been vocal in their objection to “gender-affirming care,” expressing regret for undergoing life-altering surgical or medical treatments.

North Dakota has become one of 14 states to pass laws aimed at protecting children from making life-altering medical decisions. Several other Republican-led states across the United States have also passed measures intended to protect sex-designated sports and spaces, including women-only teams and bathrooms. These laws are intended to prevent minors from undergoing gender-affirming medical procedures or participating in sports teams that don’t align with their biological sex at birth.

Other measures have been aimed at stopping classroom instruction on sexual orientation for young children in pre-K through grade 3, banning sexually-explicit books from school libraries and classrooms, and strengthening the rights of parents to direct their children’s education.

North Dakota also signed a ban earlier this month, effectively banning boys who identify as female from joining female sports teams in K-12 and college. This marked a change in Burgum’s stance after he vetoed a similar bill in 2021 when the House and Senate didn’t have enough votes to override his veto.