South Dakota Governor Kristi Noem signed a bill on Monday prohibiting surgical and non-surgical gender-affirming treatments for transgender youth. The law will take effect on July 1.

H.B. 1080, known as the “Help Not Harm” bill, was first presented to the South Dakota House in January and was signed into law less than a month later. South Dakota now joins Utah to become the second state this year to ban gender-affirming care for trans minors.

Gender-affirming care (GAC) is any combination of social, legal, and medical measures that help people feel happy, healthy, and safe in their gender. GAC takes a holistic approach to ensure a person’s mental and physical needs surrounding their gender identity and expression are met. GAC is for anyone who needs it.

The bill bars doctors from prescribing puberty blockers, cross-sex hormones, or performing surgery on minors under 18 who identify as transgender or nonbinary. The bill also instructs doctors to “systematically reduce” blockers and hormones for those already receiving them. The cutoff date for stopping treatment is December 31, 2023.

Supporters of the bill argue that it protects children from irreversible and harmful medical interventions they may regret later in life. They claim that most children who experience gender dysphoria will eventually outgrow it and accept their biological sex.

However, opponents of the bill say that it violates the rights and autonomy of trans youth, their parents, and their doctors and that it is unconstitutional to single out one group of people and categorically ban all care. They also cite evidence that gender-affirming care improves the mental health and well-being of trans youth and that denying them access to such care can lead to depression, anxiety, self-harm, and suicide.

The ACLU of South Dakota has announced that it will challenge the law in court, saying it is “cruel and unconstitutional” and that it will “harm trans youth and their families”. The ACLU argues that H.B. 1080 violates the equal protection, due process, and privacy rights of trans youth and the First Amendment rights of doctors to provide accurate and honest information to their patients.

Beyond the obvious fact that this bill will force the de-transition of youth who have already started treatment (causing both physical and emotional distress), this bill affects trans youth in South Dakota in several ways. It sends a message that they are not accepted or supported by their state and that their identity and needs are invalid. Telling youth that they are not accepted by society is a dangerous message for the current and future generations that will have many reciprocal consequences.

While there is no exact number published for how many trans youths currently live in South Dakota, we can use population information to help estimate. The Williams Institute published a report in 2017 estimating that 0.6% of adults in the U.S. identify as Transgender, which translates to about 1.4 million people. Applying this percentage to the population of South Dakota, which was about 886,667 in 2020, we can estimate that there are about 5,320 transgender adults in the state. If we then assume that the percentage of transgender youth is similar to that of adults, we can estimate that there are about 1,000 transgender youth based on the number of people under the age of 19, which was 166,667 in 2020.

What are some of the Challenges and risk Transgender youth may face because of HB1080?

  • Feeling invalidated, dehumanized, and stigmatized by the bill and the public debate around it.
  • Increased anxiety, depression, dysphoria, and suicidal thoughts due to the lack of access to gender-affirming care and support.
  • Face potential harm from delaying or stopping their medical transition, such as irreversible changes from puberty, physical and emotional distress, and reduced quality of life.
  • Losing their sense of safety, belonging, and identity in school and society, especially if they are forced to participate in sports and use facilities that do not match their gender identity.
  • Having to deal with legal, financial, and social barriers to access gender-affirming care, such as traveling to other states, finding supportive providers, and facing discrimination and harassment.

What are some ways affected youth can cope despite HB1080?

  • Seeking support from their families, friends, peers, mentors, and allies who affirm and respect their gender identity.
  • Finding online communities and resources that offer information, advice, and solidarity for trans youth.
  • Advocating for their rights and raising awareness about the bill’s impact through social media, protests, and testimonies.
  • Seeking professional help from mental health counselors, therapists, and crisis hotlines trained and experienced in working with trans youth.
  • Exploring other ways to express their gender identities, such as clothing, makeup, hairstyles, and pronouns.