North Dakota bills restricting transgender health care, sports participation head to Burgum's desk

Supporters say the bills protect fairness in sports and the innocence of children. Opponents say the legislation is harmful and discriminatory toward transgender people.

North Dakota Legislature
The North Dakota Capitol in Bismarck.
Photo illustration by Troy Becker

BISMARCK — The North Dakota Senate on Monday, April 3, advanced a raft of bills affecting transgender people, including restrictions on health care and sports participation that now go to Gov. Doug Burgum.

All of the legislation passed the state House of Representatives and Senate by veto-proof margins.

Some of the bills will go back to the House to agree on Senate amendments. House-Senate conference committees would reconcile any differences that might arise over the bills.

Supporters say the bills protect fairness in sports, safety and privacy of women in restrooms, and the innocence of children.

Opponents say the legislation is harmful and discriminatory toward transgender people, who are more likely to suffer from mental health issues.


Burgum last week vetoed a bill that would restrict how schools treat transgender students’ preferred pronouns. The Senate overrode his veto, 37-9. The House on Monday sustained the veto, 56-36.

Gender-affirming care

The Senate voted 37-10 on Monday to pass House Bill 1254, which would ban and criminalize gender-affirming care for transgender minors. The bill will go to Burgum’s desk.

Under the proposal sponsored by Rep. Bill Tveit, R-Hazen, doctors who perform sex reassignment surgeries on minors would be guilty of a Class B felony, punishable by up to 10 years in prison and a $20,000 fine.

The legislation also would charge medical professionals who prescribe hormone treatment or puberty blockers to transgender minors with a Class A misdemeanor, punishable by up to 360 days in prison and a $3,000 fine.

The Senate rejected amendments that would have softened the criminal penalties for prescribing hormone treatment and puberty blockers. The failed amendments also would have allowed doctors to prescribe puberty-blocking drugs to transgender minors if they had undergone at least one year of mental health care.

Supporters of the legislation say it would protect children from irreversible harm to their bodies. They allege that doctors who perform gender-affirming care are preying on adolescents for financial gain.

Sen. Keith Boehm, R-Mandan, referred to gender-affirming care as “child mutilation” and falsely stated that puberty blockers “permanently sterilize a child.”

“If someone, once they are an adult, wants to sterilize themselves or cut off body parts, they have every right to do so — not children,” Boehm said.


A man with a mustache squints and gives a lopsided grin in a headshot photo.
Sen. Keith Boehm, R-Mandan.

Physicians, mental health professionals and LGBTQ advocates have contended that outlawing the prescription of puberty blockers and hormone treatment to transgender adolescents would have disastrous effects for a group that is already at high risk for suicide, mental health issues and drug abuse.

Sen. Judy Lee, a West Fargo Republican who chairs the Human Services Committee, said passing anti-transgender legislation gives the appearance that North Dakota is “closing our doors to everybody who doesn’t think and look and act just like us.”

“What somebody else does with their life has no impact on you or me,” Lee said.

Doctors who perform gender-affirming care have testified in bill hearings that transgender minors never undergo sex reassignment surgery in North Dakota.

Children diagnosed with gender dysphoria may receive puberty blockers to delay the development of secondary sex characteristics, like facial hair or breasts. In some cases, they may receive hormone treatment, usually in the form of estrogen pills or testosterone injections.

More than a half-dozen Republican-led states, including South Dakota, have passed bans on gender-affirming care for minors, though several of the laws have been blocked by judges.

Sports participation

The Senate passed two bills that would restrict transgender girls and women in K-12 and collegiate sports, House Bills 1249 and 1489, respectively, by Rep. Ben Koppelman, R-West Fargo.

House Bill 1249 passed 38-9. House Bill 1489 passed 40-7. Supporters said the bills would ensure no sex-based physiological advantages in sports. Opponents said the bills discriminate against transgender people, with no evidence of transgender athletes in North Dakota.


The two bills go to Burgum, who in 2021 vetoed a bill similar to 1249.

The North Dakota High School Activities Association’s Executive Board last year altered a rule applying to transgender students after the NCAA made a similar change to its policy.

The revised policy essentially bans transgender girls who have undergone hormone treatment from participating in girls sports, but the association’s director may allow a trans student to participate in girls sports if the school demonstrates through medical evidence that the athlete has no physical competitive advantage.

The previous rule allowed trans girls to play girls sports after completing one year of hormone treatment.

The association has taken no stance on the proposed legislation.

Nineteen states, including South Dakota, have passed bills restricting transgender girls’ participation in sports.

Bathroom access

The Senate by a 42-5 vote approved House Bill 1473 by Rep. SuAnn Olson, R-Baldwin, which would require jails, prisons and public college dorms to designate bathrooms and showers “for use exclusively for males or exclusively for females.”

The legislation would require the public facilities to make special restroom and shower accommodations for transgender people “as deemed appropriate by the administrator.”


Proponents of the bill say it protects vulnerable women from biological men entering restrooms. Opponents see the legislation as another attempt to deny transgender people basic rights.

The amended bill will go back to the House, which previously approved a different version of it.

A separate proposal, House Bill 1522, would prohibit transgender K-12 students from using bathrooms that align with their gender identity. The Senate voted 37-10 to approve the bill Monday, sending it back to the House to agree on amendments.

The legislation brought by Rep. Scott Dyk, R-Williston, also would bar a school from adopting a policy that “requires or prohibits any individual from using a student's preferred gender pronoun.”

An amendment tacked onto the bill Monday would bar school districts and their governing boards from creating policies to accommodate transgender students unless parents give explicit permission. Teachers also would be prohibited from withholding information about students’ “transgender status” from parents.

The amendment brought by Sen. Larry Luick, R-Fairmount, mirrors language in his Senate Bill 2231, which Burgum rejected. The House sustained the veto Monday.

Birth records

House Bill 1297 by Rep. Jim Kasper, R-Fargo, passed 41-6. The state House of Representatives passed the bill 81-11 in February.

The bill would ban amendment of sex designation on birth records “due to a gender identity change,” with a few exceptions, such as a data entry or if “the sex of the individual was changed with anatomically correct genitalia for the identified sex as certified by a medical provider.”


The bill essentially would make law the current practice of the state Vital Records Division.

The bill goes back to the House for concurrence on amendments, which essentially changed the bill’s title, not its intent.


Olson’s House Bill 1474 passed the Senate 35-12. The House passed the bill 74-18 in February.

The House-passed version defined “father,” “female,” “mother,” “male” and “sex,” and sought to mandate school districts and vital statistics agencies identify people based solely on their sex assigned at birth.

The Senate Human Services Committee removed that provision, leaving the bill only with definitions for “female,” “male,” “sex” and the addition of the definition of a scrap metal dealer to correct a cross-reference to the definition of a person in state law.

The bill goes back to the House for concurrence on amendments.

‘Women’s bill of rights’

The Senate also adopted by voice vote Olson’s House Concurrent Resolution 3010 , which urges public schools and vital statistics agencies "to protect women's rights by distinguishing between the sexes according to biological sex at birth for the purpose of providing equal opportunities and ensuring the privacy and safety of women and girls."

Eight House Republican women brought the resolution, which the secretary of state will send to the state superintendent, superintendents of each school district and the state Department of Health and Human Services commissioner.


Olson has called the resolution “a women’s bill of rights.”

Jeremy Turley is a reporter for Forum News Service. Jack Dura is a reporter for The Bismarck Tribune.

Jeremy Turley is a Bismarck-based reporter for Forum News Service, which provides news coverage to publications owned by Forum Communications Company.
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