S. Dakota lawmakers push bill to bar transgender youth care

A state House committee voted Tuesday to advance a bill that would ban gender-affirming care for transgender youth in South Dakota.

Supporters argued a bill barring youth from accessing puberty blockers, hormones and surgery would protect adolescents from irreversible damage, while opponents argued it only blocks them from becoming their authentic selves.

Republican Rep. Bethany Soye’s bill passed through a House committee on health and human services Tuesday morning with a dominant vote from Republicans. Despite testimonies from health care providers, legal advocates and transgender youth, the bill will move on to a vote in the Republican-dominated House. Soye said she had Gov. Kristi Noem's support for the bill, which targets transgender individuals below the age of 18.

After nearly two hours of discussion, all eight Republicans on the committee voted for the bill, while the only two Democrats opposed it, adding South Dakota to the list of at least 18 other states pushing legislation to block transgender youth health care this year.

Utah’s Republican governor signeda ban on gender-affirming care last week, and similar bans have passed in Arkansas and Alabama, but they are being challenged in court.

Testifiers in support of the bill spoke from personal experience, either as patients who regretted decisions to undergo surgery as young adults experiencing gender dysphoria, or as doctors who argued “normal” puberty was a “cure” for gender dysphoria.

Don Oliver, a retired pediatrician from Rapid City, said he disagreed with guidance from leading medical associations — such as the American Medical Association — that support gender-affirming care as medically necessary.

“We as a profession have lost our way, lost our bearing, lost our anchor,” Oliver said.

Opponents criticized the bill on the grounds of overreach into healthcare concerns between patients and doctors, and for infringing on civil rights.

“Gender-affirming care is part of comprehensive primary care,” said Daniel Heinemann, chief officer of Sanford Health and chair of South Dakota's American Academy of Family Physicians. “Family physicians are deeply concerned by the growing trend of recent legislative efforts to criminalize care directed at specific patient hospitalizations.”

Heinemann said gender diversity is a normal part of the human existence.

Samantha Chapman, a member of the American Civil Liberties Union of South Dakota, said, “It is impossible to discriminate against a person for being transgender without discriminating against that individual based on sex."

Soye raised this bill as a matter of consent. She compared a child’s inability to consent to gender affirmation procedures to their inability to consent to purchasing cigarettes, drinking alcohol or joining the military. She also questioned the health care profession, saying, “the fact is the medical community can get things wrong."

Opponents to the bill noted that a young person's decision-making is heavily factored into the procedure of certifying treatment.

Dr. Anne Dilenschneider, a mental health care provider with New Idea Counseling, said gender dysphoria diagnoses take months. The process factors in a child's social skills, emotional skills, medical history and disabilities before addressing gender, and that involves reports from teachers and other certified adults close to the patient.

“This experience of gender dsyphoria or gender incongruence has to be marked and sustained over time, and that means years. This wasn't a kid who was on TikTok and says, ‘Hi, I’m trans,'" Dilenschneider said.

She added that the bill's misinformed language, such as “chemical castration,” upset her most.

Other opponents included 16-year-old Elliot Morehead of Sioux Falls, who skipped their physics test to testify at the Capitol.

“I’m transgender and I’m proud,” Morehead said.

Morehead told the committee it took six months of therapy to receive a referral to simply discuss hormone therapy and other affirming treatments. They said telling children to grow out of gender dysphoria is like telling someone struggling with depression to “just be happy.”

Democratic Reps. Kameron Nelson and Erin Healy opposed the bill for sex-based discrimination. They cautioned fellow voters the bill would cost the state and taxpayers millions of dollars spent in litigating a complete ruling.

Morehead was also disappointed in the committee's ruling but said they would remain optimistic. Despite having discussed leaving the state to pursue healthcare available to them, they want to keep up the fight.

“If we leave, the next generation is left behind," Morehead said. "That's why I'm staying here and continuing to fight."