South Dakota is now one of more than a dozen states that are considering or have passed a law to prevent transgender kids from getting gender-affirming treatment.
Gov. Kristi Noem has signed the bill into law, but it could land the state in court.
Those who support the law say children and their parents who seek gender-related surgeries and medication need more time before making irreversible decisions.
Republican State Sen. Al Novstrup, R-Aberdeen, says young people don't always make the right decision and offers an example from his childhood.
When Novstrup was in high school he worked at a grain bin. After one particularly exhausting day, Norvstrup said he laid down on the living room floor and took off his glasses.
His mom walked by and stepped on his glasses.
“My rapid-fire decision was to yell at mom, ‘Mom, you’re an old cow,'" Novstrup said. "Bad decision. Real bad decision. Many times, rapid decisions in a young brain does not end well.”
Norvstrup is a prime sponsor of the state bill that restricts transgender minors from accessing hormone therapy, puberty blockers and surgery to affirm gender.
The bill made its way from the Republican-controlled legislature to Gov. Noem’s desk for approval in less than two weeks.
But, parents of transgender children say the new law takes away important options for their kids.
“Puberty pausers have really given him time to breathe," said Elizabeth Broekemeier, a Sioux Falls mother. Her son was 11 when he started to question where he fit on the gender spectrum. Her son’s transition started with a conversation.
“We had reached out to our child’s pediatrician and said, ‘Hey, he’s come out. He’s expressed he’s transgender. What do we need to do?’ So, we scheduled an appointment with our pediatrician," Broekemeier said.
Their pediatrician had an extensive interview with their son who recommended a pediatrician specializing in gender dysphoria. That’s the distress over a mismatch between someone’s gender identity and their sex at birth. Then came another extensive interview and sessions with a counselor.
“We weren’t even referred to see a specialist until he had gone through almost a year of therapy. So, again, it’s not this overnight switch and you’re receiving medication," she said. "It’s a gradual, deliberate, cautious approach to it.”
Only then was Broekemeier’s son able to discuss treatment options like puberty blockers. And that’s as far as the conversation has gone. He’s now 13.
“One hundred percent, there has never been a discussion on surgery while he is underage," Broekemeier said. "Absolutely not. I can tell you right now, that is false, here in South Dakota.”
But Republican lawmakers heard different experiences from people who testified FOR the bill. Two people from out of state told lawmakers they now regret their gender transition. That includes a California teenager Chloe Cole, who calls herself a former trans kid. She has spoken publicly about the failure of her medical treatments. Cole has also spoken in support of similar bills in other states.
Republican Rep. Taylor Rehfeldt, R- Sioux Falls, is a registered nurse who supports preventing young people from seeking gender affirming treatment. She said there were a lot of different opinions on both sides of the issue.
“It’s hard to make those decisions on both sides of medicine that vary,” Rehfeldt said. “That’s why a lot of the decisions that we make—we have to make the best decision that we currently have, which is what we did.”
One local mental health counselor said the medical information lawmakers leaned on to make their decision is ‘ill-informed.”
The South Dakota State Medical Association said the bill will cause physicians to compromise their medical judgement for what treatment is in the best interest of patients.
"Access to care for transgender people is an important means of improving health outcomes. Receiving care is linked to reductions in the rate of suicide attempts, decreased rates of depression and anxiety, and decreased substance use in transgender people," said Lucio Margallo, president of SDSMA. "These positive health effects extend to children and adolescents as well."
Even though Gov. Noem has signed the new law, there are still questions about exactly what it covers. Because puberty blockers temporarily help to stabilize the mental health of a patient, some Republicans question whether the law would ban that kind of care.
“Because the law talks about a change in anatomy and to affirm identification with a different sex,” said Sen. Mike Diedrich, R-Rapid City, who is also the Vice President of Governmental Affairs with Monument Health.
He said language in the new law may not speak clearly about some temporary medication options.
“The question really becomes does utilizing for stabilization, mental health treatment on a temporary basis, does that fall under that prohibition?” Diedrich said.
Regardless of the answer, Diedrich expects the law will get challenged in court. That’s already happened with similar laws in other states.
Parent Elizabeth Broekemeier said it’s not hard to imagine what will happen to her son once the law goes into effect. He will no longer have access to puberty blockers.
“It’s something that I have to imagine. I have to start thinking about right now. It’s difficult to think about," Broekemeier said."
South Dakota’s law will go into effect on July 1. Doctors have until the end of the year to stop using drug and hormone treatments for their gender dysphoria patients.
