A South Dakota legislative committee approved a bill this week that would penalize medical professionals who prescribe hormone treatments or perform sex change surgeries for gender dysphoric children under age 16. Supporters of the measure argue the listed interventions are not healthcare but rather criminal acts against children too young to understand the long-term, irreversible effects.
The House State Affairs Committee passed an amended version of the measure by an 8-5 vote on Wednesday after a contentious hearing. The bill now awaits a vote in the full House, where it is expected to pass.
If enacted, the Vulnerable Child Protection Act would make it a Class 1 misdemeanor for physicians, physicians assistants, clinical nurse specialists, or nurse practitioners to perform sex change surgery procedures, including castrations and mastectomies, on children and teens under 16. It would also criminalize prescribing, dispensing, administering, or supplying puberty-blocking medication or cross-sex hormones—testosterone to girls or estrogen to boys—to a child or teen who identifies as the opposite sex.
The bill provides an exception for medical professionals treating minors with medically verified genetic disorders of sex development, sometimes called intersex conditions.
The original version of the bill applied to children under age 18, including emancipated minors, and made the offense a Class 4 felony. During the committee hearing, the bill’s sponsor, state Rep. Fred Deutsch, a Republican, moved to amend the bill to change the age and reduce the penalty. Deutsch said he made the changes to give the measure a greater chance of passing. The Class 4 felony penalty mirrored that of performing female genital mutilation, but Deutsch said he believed “a lower penalty would affect the same result as a higher penalty.” He also said the age limit was “the most challenging issue” for his team, but he opted to lower it to “focus on the most vulnerable of the vulnerable children as the initial place to start the bill.”
Earlier this month, Deutsch said, “The solution for children’s identification with the opposite sex isn’t to poison their bodies with megadoses of the wrong hormones, to chemically or surgically castrate and sterilize them, or to remove healthy breasts and reproductive organs. The solution is compassionate care, and that doesn’t include catastrophically and irreversibly altering their bodies.”
Critics argue the measure bans life-saving care for transgender youth. Nearly 35 percent of transgender high schoolers reported they had attempted suicide in the latest Youth Risk Behavior Survey by the Centers for Disease Control and Prevention. LGBT advocates argue puberty blockers, cross-sex hormones, and sex change surgeries can mitigate those risks by helping individuals with gender dysphoria feel more comfortable in their own bodies.
But many medical professionals disagree, arguing hormones and surgery are ineffective at dealing with the underlying mental health conditions that lead to suicide attempts. Critics of hormone treatments also point out that they are medically experimental and self-fulfilling, locking children into further transition.
“There is nothing healthy about stopping normal puberty because puberty is not a disease,” wrote endocrinologist Michael K. Laidlaw in an article for Public Discourse last week. He outlined the consequences of administering the puberty-blocking drug Lupron to gender dysphoric children, including permanently reducing bone density, altering female pelvic development, and impairing brain and neuropsychiatric development.
Pediatrician Michelle Cretella, the executive director of the American College of Pediatricians, has similar concerns.
“There is not a single long-term study demonstrating the safety or efficacy of puberty blockers, wrong sex hormones, and the surgical removal of healthy breasts and sex organs in response to gender identity distress in minors,” she said, noting that there was plenty of scientific evidence for potential harm, including severe bone loss, memory impairment, sexual dysfunction, sterility, heart attacks, strokes, and cancers. “When we drop the medical euphemisms and call these procedures what they really are: the chemical castration, sterilization, and mutilation of emotionally distressed children, it’s clear we are talking about criminal acts being carried out by doctors.”