South Dakota Is Going to Force Trans Kids to Detransition

South Dakota is the first U.S. state to pass legislation that will force transgender youth to detransition, and the second state this year to ban gender-affirming care for people under 18.

Last week, the Republican-dominated state senate passed House Bill 1080, which bans gender-affirming care—including puberty blockers, hormones, and surgery—for people under 18, in a sweeping 30-4 vote. It also gives doctors who treat transgender youth one year to stop providing gender-affirming care to those patients, effectively forcing young trans people to detransition. Gov. Kristi Noem signed it into law on Monday. 

“South Dakota’s kids are our future. With this legislation, we are protecting kids from harmful, permanent medical procedures,” Noem said in a statement. 

Gender-affirming care isn’t harmful; in fact, it’s life-saving. Numerous medical governing bodies, including the American Medical Association, American Psychological Association, the American Psychiatric Association, and the American Academy of Pediatrics, have endorsed gender-affirming care for minors. But that hasn’t stopped several states have contradicted major medical governing bodies in the U.S. by either introducing or ratifying legislation banning gender-affirming care for minors. Now, South Dakota is taking the onslaught against gender-affirming care a step further by forcing young patients to detransition.

This move represents a significant escalation in anti-trans policymaking, and could amplify the harmful impact of gender-affirming care bans popping up across the country.

“Already, transgender youth who are not allowed to transition attempt suicide at a much higher rate,” wrote transgender activist Erin Reed in her newsletter. “Medical detransition will mean extremely distressing changes for trans youth, many of whom have lived as their gender for most of their lives… This is particularly cruel to transgender kids who have been receiving care for a long time and who are known as their gender by all of the peers and adults in their lives.”

If you’re a trans South Dakotan, or someone you love is trans and living in South Dakota, feel free to reach out to anya.zoledziowski@vice.com, or DM her on Twitter: @anyazoledz.

The bill gives healthcare professionals until the end of the year to cease treatment for patients currently receiving various forms of gender-affirming care, including hormone therapy and puberty blockers.

“If the healthcare professional determines and documents in the minor’s medical record that immediately terminating the minor’s use of the drug or hormone would cause harm to the minor, the healthcare professional may institute a period during which the minor’s use of the drug or hormone is systematically reduced,” the bill says. A doctor who violates the new law would be at risk of losing their license and could be sued for damages. 

Opponents of gender-affirming care bans note that regardless of whether it’s done immediately or over a period of time, forcing people to detransition or withholding the option to transition is “terrible.” Indeed, the option to transition is linked to lower suicide rates, and medical governing bodies have deemed it medically necessary for trans youth.

In a bizarre push to justify the bill, Republican Representative Brandei Schaefbauer quoted Dr. Martin Luther King Jr.’s assertion that “morality cannot be legislated, but behavior can be regulated,” Them reported. 

“Even in the face of professional guidance from every major medical and mental health association in the country that supports this type of care, politicians are intruding into the private medical decisions best left to transgender young people and their families,” Casey Pick, director of law and policy for the Trevor Project, a non-profit that advocates for LGBTQ youth mental health, told CNN. 

Studies show that trans people are more likely to experience mental health struggles, including anxiety, depression, PTSD, and thoughts of suicide, than cisgender people. Nearly half of all LGBTQ youth have seriously considered suicide. But, experts say, some of these issues can be mitigated with gender-affirming care, which includes puberty blockers and other therapies. These interventions are safe and effective, and are correlated with better mental health outcomes for trans people. Teens who are able to access gender-affirming therapy typically also have better mental health outcomes than trans people who have to wait until adulthood.

Many bills, including South Dakota’s ban, narrowly define “sex” biologically, relying on hormones, genitalia, and sex chromosomes (the presence or absence of a Y chromosome) to determine whether a person is a man or woman. Critics have rushed to decry such definitions, saying they erase intersex people and fail to acknowledge that the idea of two sexes is too scientifically simplistic.  

Utah was the first state to introduce a gender-affirming care ban in 2023, a year already marked with an onslaught of proposed anti-LGBTQ bills, most of which target trans people. Lawmakers in at least 18 states are considering similar bans, with those passed in Alabama and Arkansas currently held up by legal battles. Mississippi is considering legislation that would force youth to detransition. An impending ban in Florida would ban most gender-affirming care for people under 18, but won’t force people already receiving treatment to detransition. 

At least three states—Oklahoma, South Carolina, and Virginia—have introduced measures that would ban gender-affirming care for some adults. A particularly aggressive bill in Oklahoma proposes banning gender-affirming care for people under 26. 

In 2022, more than 171 anti-trans bills—and more than 300 anti-LGBTQ bills—were introduced in at least 33 states across the U.S., including Oklahoma, Florida, Alaska, Arizona, Utah, Georgia, and Wisconsin. Experts say they expect 2023 to be just as bad, if not worse. “It is already shaping up to be another cruel and record-breaking year,” stated the Trans Legislation Tracker, an open-source site that tracks proposed and passed anti-trans legislation. 

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

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