South Dakota passes ‘Help Not Harm’ bill blocking under-18s from having sex change surgery

South Dakota has become the latest state in the US to ban sex-change surgery for minors.

The Republican-controlled state passed the ‘Help Not Harm’ bill yesterday making it illegal to carry out gender-affirming surgery on youngsters under 18 years old.

Gov. Kristi Noem, who signed the bill into law, said the move was ‘protecting kids from harmful, permanent medical procedures’.

Lawmakers also overwhelmingly voted to block doctors from prescribing puberty blockers or hormone treatments to minors.

Utah outlawed surgeries last month and said minors could only start hormone therapy if they had a diagnosis of gender dysphoria. Alabama, Arkansas, Florida and Texas have all previously banned surgeries and hormone therapies for minors — although the block in Alabama and Arkansas is currently on hold. Arizona has banned surgeries for minors.

Gov. Kristi Noem, shown above, who signed the bill into law said it would protect children from harmful, permanent medical procedures. There are an estimated 500 transgender children in South Dakota

There is growing concern that access to life-altering treatments has become too easy for trans children, who are often vulnerable and suffer from other health problems.

Another nine states — including Missouri, Oklahoma, and South Carolina — have also tabled legislation against trans care for minors. Democrat-controlled states New Jersey and New Hampshire are also considering a ban.

Yesterday, South Dakota’s Senate voted 30 to four to send the bill to the governor after the state House advanced the bill in a 60-10 vote.

Signing it into law, Ms Noem said: ‘South Dakota’s kids are our future. With this legislation, we are protecting kids from harmful, permanent medical procedures.’

She added: ‘I will always stand up for the next generation of South Dakotans.’ 

The bill will take effect on July 1, and will see healthcare providers who violate the law facing civil suits and the potential to lose their licenses.

Last year the state passed a separate bill that said participants in female school sports leagues in public K12 schools and some private schools and universities were required to be biologically female.

This map shows the proportion of children aged between 13 and 17 years old that identified as transgender by state. The darker colors indicate a higher proportion of youngsters. In New York and New Mexico, it is as high as three percent

This map shows the proportion of the population identifying as transgender by state. Those with the darkest color have almost one percent of their population in this category

Trans groups in the state have already slammed the legislation for limiting surgeries.

The American Civil Liberties Union of South Dakota said: ‘This ban doesn’t stop young people in South Dakota from being trans, but it will deny them critical support that helps struggling transgender youth grow up to become thriving transgender adults.’

They added: ‘As much as Governor Noem wants to force these young people to live a lie, we know they are strong enough to live their truth, and we will always fight for communities and policies that protect their freedom to do so.’

Susan Williams, executive director of the Transformation Project Advocacy Network, said: ‘Our community is sad. Our community is angry. Worst of all, our community is scared.

‘I feel betrayed by the elected officials who are supposed to protect my family that just voted against us.’

An estimated 500 children aged 13 to 17 years identify as transgender in South Dakota, according to a report by the University of California, Los Angeles (UCLA), equivalent to one in 110 children in the state. 

The report dates from last year, however, and is likely to be an underestimate because of the difficulty of estimating the number of transgender people.

This is just above the lowest state, Wyoming, where an estimated 200 children are trans. 

The number of Americans identifying as trans has rocketed in recent years, though.

The same UCLA report found the number of Americans who identified as trans nearly doubled from 2017 to 2020, with 300,000 now identifying as such.

This rise has been strongest among young people, and that is where legislators have so far focused their efforts.

Around 1.5 percent of American teens identify as trans, the highest of any age group.

Many trans-identifying children will undergo hormone treatments, hoping to prevent themselves from developing sex-based characteristics linked to their birth gender.

These often include puberty blockers, which push back the start of the process, and medication that boosts either estrogen or testosterone levels.

Puberty blockers are used to pause puberty and consider whether they want to transition.

By stopping the body’s production of sex hormones, gendered characteristics like a deeper voice in men or the development of breasts in women can be halted.

The long-term effects of these drugs are not fully understood, but it can take years for the body to naturally start producing hormones after stopping the drugs.

The Food and Drug Administration has approved the drugs to stop precocious puberty – when a child goes through the process earlier than when is healthy – but they are used off-label for trans care.

Hormone therapy can then trigger desired sexual characteristics in a trans teen.

By giving a person born as a female testosterone, or a person born male estrogen, they will instead develop traits that match their wanted gender.

The long-term consequences of taking these drugs in youth has not yet been determined, leaving many experts fearful of the recent increase in their use.

Gender-affirming operations, often called top or bottom surgery, will either make changes to a child’s genitalia or chest to match that of their new sex.

These are irreversible and can leave a person infertile.