Judge declines to block North Dakota’s gender-affirming care ban

A North Dakota judge has denied a request to temporarily block a state law preventing transgender minors from accessing gender-affirming medical care, leaving one of the nation’s most stringent transgender health care bans intact.

District Judge Jackson Lofgren on Monday denied a temporary restraining order requested by three North Dakota families with transgender children and a physician who treats transgender youths in a September lawsuit. A hearing for an additional request for a preliminary injunction is slated for January.

“We’re disappointed in this ruling, but we are confident that when all the evidence has been presented, the court will ultimately find that ending the health care ban permanently is the only just, equitable, and constitutional resolution,” Brittany Stewart of Gender Justice, the plaintiffs’ lead attorney, told the Associated Press on Tuesday.

Lofgren, in his ruling, cited the plaintiffs’ “nearly five-month delay” in filing their initial complaint, which argues that the state’s new restrictions on puberty blockers, hormones and surgeries violate the constitutional rights of transgender youths in North Dakota.

The law they are challenging, House Bill 1254, took effect in April, immediately after it was signed by Republican Gov. Doug Burgum, a 2024 GOP presidential candidate.

Under the measure, it is a misdemeanor – punishable by up to 360 days in jail and $3,000 in fines – to prescribe or administer puberty blockers or doses of testosterone or estrogen to transgender minors. Health care providers who perform gender-affirming surgeries on minors are guilty of a felony crime.

It remains legal in the state to provide the same care to children and adolescents who are not transgender.

Gender-affirming health care for both transgender adults and minors is considered medically necessary by every major medical organization, though not all transgender people want or need medical treatment as part of their transition.

Twenty-two states since 2021 have passed laws that heavily restrict or ban gender-affirming health care for transgender minors, including 19 that did so this year. A majority have been challenged in court, and health care bans passed in Montana and Indiana are currently blocked by court orders. A similar Florida ban is partially blocked.

In June, a federal judge in Arkansas permanently blocked the state’s first-in-the-nation ban, ruling it unconstitutional.

Preliminary injunctions halting the enforcement of gender-affirming health care bans in Alabama, Kentucky and Tennessee were lifted over the summer by federal appeals courts. A federal judge in Georgia last month restored the state’s ban on puberty blockers and hormones that had been blocked by a lower court in August.

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