Lawmakers send transgender youth health care ban to Noem’s desk

By: - February 9, 2023 3:30 pm
The Senate floor in the South Dakota Capitol at Pierre. (Joshua Haiar/SD Searchlight)

The Senate floor in the South Dakota Capitol at Pierre. (Joshua Haiar/SD Searchlight)

South Dakota legislators sent a bill to Gov. Kristi Noem’s desk Thursday that would ban some forms of health care for transgender youth. 

Noem will now decide whether to sign the bill into law. She previously expressed support for the legislation. 

Ban on youth transgender care passes committee after impassioned debate

Supporters said the bill would protect children and parents from making decisions they might later regret, while opponents said it intrudes on private medical decisions and puts transgender children at risk of harm from a lack of necessary medical care. The bill comes amid a national debate on the subject, with multiple states passing or considering similar legislation.

Sen. Al Novstrup, R-Aberdeen, the bill’s prime sponsor in the Senate, advocated for the bill’s passage during the Senate debate.

“We need to stand up for the vulnerable children in our state,” Novstrup said. “We care deeply about children who are struggling with their identities, and want to provide them with true, meaningful help, not permanent physical damage.”

The bill passed by a vote of 30-4, with one senator excused. The no votes came from the chamber’s four Democrats: Sens. Shawn Bordeaux of Mission, Red Dawn Foster of Pine Ridge, and Liz Larson and Reynold Nesiba of Sioux Falls. Sen. Josh Klumb, R-Mitchell, was excused.

Failed amendments

Nesiba proposed an unsuccessful amendment that would have required the state Department of Social Services to make mental health counseling available for children with gender dysphoria. He said if the state bans all other forms of health care for transgender children, there should be some protection for the remaining form of legal care.

“If you vote for this amendment, at least you can say that you’re serious about not doing harm, that we want to help,” Nesiba said. “We want to make sure these kids have access to counseling.”

Sen. Tim Reed, R-Brookings, also tried unsuccessfully to amend the bill. His amendment would have allowed prescription puberty blockers for children.

“Puberty blockers can calm a child’s anxiety so that counseling can begin,” Reed said. “Blockers have a place helping families navigate through an extremely difficult situation.”

Bill language

The final version of the bill would apply to health care professionals treating children younger than 18. It would ban the prescribing of puberty blockers; the prescribing of testosterone, estrogen or progesterone in amounts “greater than would normally be produced” by a healthy person; the performing of several forms of surgeries; and the removing of “any healthy or non-diseased body part or tissue.” 

There are exemptions allowing the banned treatments in situations the bill describes as a “disorder of sex development” – such as when a child has “irresolvably ambiguous” physical sex characteristics. The exemptions also cover children who need treatment for an infection, injury, disease or disorder that has been caused or exacerbated by any of the banned procedures.

Another section of the bill allows for systematic reductions of any drug or hormone treatments already underway when the bill becomes law, if the immediate termination of the treatments would cause harm to the patient.

The bill would authorize lawsuits against any health care professionals who perform the banned procedures, and subject them to the revocation of their professional licenses. 


Prior hearings on the bill – especially those in legislative committees, where private citizens are allowed to speak – included hours of impassioned testimony. Thursday, civil rights and LGBTQ advocacy groups immediately condemned the bill’s final legislative passage.

“Discrimination against a marginalized group is a distraction from the state’s real needs and hurts us all,” said a written statement from Samantha Chapman, advocacy manager for the American Civil Liberties Union of South Dakota.

Susan Williams, executive director of The Transformation Project in Sioux Falls, issued a statement addressing transgender youth on social media.

“Attacks from the SD State Legislature can make you forget that there are thousands of allies in this state who value you & want you to live a long & happy life right here in South Dakota,” Williams wrote. “We love you & will continue fighting for you each & every day.”

The ACLU and Transformation Project are among the groups encouraging protests prior to Saturday morning legislative forums in multiple cities. 



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Seth Tupper
Seth Tupper

Seth is editor-in-chief of South Dakota Searchlight. He was previously a supervising senior producer for South Dakota Public Broadcasting and a newspaper journalist in Rapid City and Mitchell.