skip to Main Content

North Dakota Families Ask Judge to Block Ban on Best-Practice Health Care for Transgender Youth

Court hears witness testimony as families request preliminary injunction halting enforcement as lawsuit proceeds

01.19.2024 (PRESS RELEASE) — Today a North Dakota District Court heard the testimonies of a transgender child, the father of a transgender child, their doctor, and North Dakota psychiatrist who treats transgender youth in a lawsuit challenging North Dakota’s ban on best-practice medical care for transgender and nonbinary youth.

The families say the health care ban violates the North Dakota Constitution by singling out transgender children for unequal treatment under the law and represents an unacceptable governmental intrusion into families’ private lives and personal decisions. They have asked the court to issue a preliminary injunction to prevent further harm to North Dakota’s transgender and nonbinary youth while the case is pending.

Said Brittany Stewart of Gender Justice, lead attorney for the families and doctor:

“The families who brought this case have made clear how dramatically their lives improved when they were able to get the health care they need, and how badly they continue to be harmed every day this law remains in effect. We are hopeful the court has now heard enough to stop the government’s unfair treatment of these kids based explicitly and exclusively on their gender.”

Represented by Gender Justice, the Lawyering Project, and Ciresi Conlin LLP, the three North Dakota families describe in the lawsuit, filed in September 2023, how their lives and health care have been significantly disrupted by the law.

In emotional testimony, T.D. (age 12), a transgender boy, told of how scared, sad, and worried about his future he became when North Dakota legislators passed the health care ban. He said he, like many students, recites the Pledge of Allegiance at school every day, but questions whether it still applies to him.

“It says ‘liberty and justice for all,’ but I don’t feel like I’m getting that justice if I’m not able to get the things that non-transgender children can get,” said T.D., referring to the health care that is now banned only for transgender and nonbinary children in North Dakota.

Peter Roe, father of plaintiff Pamela Roe (age 15), described the tremendous struggles he and his wife went through when Pamela came out as transgender before they were able to accept it, the extreme psychological turmoil Pamela went through before she was able to get the care she needs, and the dramatic improvements in their family’s lives once she finally began treatment for her gender dysphoria. The family, who live in Bismarck, must now take off work and school and travel more than six hours round trip to continue Pamela’s care in Minnesota, and they frequently experience additional disruptions due to the difficulty of travel in North Dakota’s long and unpredictable winters.

“It feels like the state is throwing obstacles in front of us,” testified Roe. “I have a kid who has severe gender dysphoria, and I’m trying to do what the medical community says I should be doing in getting her gender affirming care.

“The state is infringing on our decision-making as parents,” he said.

Passed by the North Dakota legislature and signed by Gov. Doug Burgum in April 2023, the law makes it a misdemeanor — with a sentence of up to 360 days in jail and $3,000 in fines — for doctors to provide best-practice healthcare to transgender or nonbinary youth. It remains legal for doctors to prescribe identical healthcare to children who are not transgender.

Every major medical organization, including the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association, supports the provision of age-appropriate, evidence-based healthcare for transgender and nonbinary people.

Dr. Gabriela Balf, a psychiatrist based in Bismarck, testified that she was aware of two young people in North Dakota who had died by suicide because of the trauma they suffered when they were unable to get the medical care they needed for the gender dysphoria they were experiencing.

Speaking of her inability to refer her own transgender patients for best-practice medical care under the health care ban, Dr. Balf said:

“Morally, for me, it’s very hard to accept that I know of a treatment and I have to tell [my patients], ‘No, this is not [available] in your home state.’”

Recent research published by the American Medical Association shows that when transgender and nonbinary kids received the very same care that’s been banned for them in North Dakota, their odds of depression decreased by 60 percent and their odds of self-harm and suicide decreased by 73 percent.

“In response to overwhelming scientific evidence and consensus among doctors and all major medical associations, our opposition has managed to muster only junk science, debunked research, and witnesses of dubious expertise,” said Tanya Pellegrini, senior counsel with the Lawyering Project and co-counsel for the families.

“We are confident that this court will see through their efforts to muddy the waters and find this law in clear violation of the constitutional rights of families to parent their children as they see fit, and of transgender kids to pursue their own happiness and be protected the same as every other North Dakota citizen under the law,” said Stewart.