‘Medical experiments’ or ‘criminalizing’ care? House to weigh transgender treatment bill

PIERRE — Legislation making it a crime to treat transgender children younger than 16 with hormones and gender confirmation surgery is moving forward.

The House State Affairs Committee passed House Bill 1057, which makes the treatment a Class 1 misdemeanor, in an 8-5 vote after a meeting that lasted for nearly three hours on Wednesday morning. The bill will now go to the House floor for a full chamber vote, but that hasn't yet been scheduled. 

The penalty for a Class 1 misdemeanor is one year in jail and a maximum fine of $2,000.

Supporters told the committee that the medical practices described in the bill aren't based on objective science, while opponents, many of them doctors, warned that the bill could negatively affect transgender children in South Dakota and force doctors to decide between treating a patient and going to jail.

More:Why some fear South Dakota's transgender bill will hurt kids

Bill sponsor Rep. Fred Deutsch, and many of the bill's supporters, told the committee that a diagnosis of gender dysphoria is based on a person's feelings rather than objective science. Bill supporters also referred repeatedly to the medical practices the bill would prohibit as "medical experiments." 

Deutsch, R-Florence, said bill supporters believe the medical practices aren't health care, but are "criminal acts." His bill wouldn't prevent transgender children from socially transitioning their gender or seeking mental health treatment, he said. But subjecting transgender children to the medical procedures is "deeply harmful," he said.

Dean Krogman, lobbyist for the South Dakota Medical Association, warned the committee that HB1057 is "very risky" and could have national implications for South Dakota. The association, as well as many medical associations, agree that gender dysphoria is a science-backed medical diagnosis, and the medical procedures can't be done without parental consent. 

"If you want to criminalize this, the only state in the nation that would criminalize the doctor-patient relationship, you are also criminalizing that parent who is in charge of that minor," Krogman said.

What was the reaction to the vote?

Deutsch said he was grateful for the committee's vote. He said he had liberal Democrats, a former American Civil Liberties Union attorney and transgender adults testify in favor of the bill to show the diversity of the support.

"One of my intentions was to show that this is a human rights issue, not a political issue," he said.

But Quinncy Parke, a 17-year-old from Sioux Falls who identifies as non-binary, was disappointed in Wednesday's vote and said they will continue talking with legislators ahead of the full House vote. They said they're worried about the legislation.

"I think there was a lot of confusion. ... I think there are some fundamental problems with our representatives' understanding of this," Parke said.

Fears of a Supreme Court litmus test

Rep. Jon Hansen, R-Dell Rapids, urged his colleagues to support the bill on Wednesday. The bill isn't about hate, but rather about protecting children, he said. 

"None of (the committee members) are filled with hatred or malice," he said. "None of them are mean-spirited or bigoted. The same can be said of the South Dakota Legislature ... We respect the dignity of all human persons."

However, some legislators on the committee were skeptical about whether there was a problem in South Dakota that they needed to fix with the bill or how the state would enforce the law.

All but one of the those who testified in favor of the bill were from out of state, and legislators questioned whether gender confirmation surgeries were occurring on children in South Dakota. Deutsch said four doctors in South Dakota are advertising those services. 

Rep. Jamie Smith, D-Sioux Falls, questioned how an identical bill was introduced in Florida last week. Deutsch said the bill is "homegrown" and is expected to be introduced in about a dozen states, all of which will be based on his bill after he was contacted by interested legislators in other states.

South Dakota legislators are assuming that they know better than medical professionals, Smith said, and while the bill's supporters were from around the country, the opponents were South Dakotans showing up at the Capitol to testify. 

"I do not want to be a court case at the federal level, a litmus test for our country. We don't need to fund a Supreme Court case," he said.

'Criminalizing medicine': Doctors speak out

Doctors, psychiatrists and attorneys testified on both sides of the issue on Wednesday. 

Two dozen doctors sat in the audience in opposition to the bill, wearing their white lab coats and buttons stating, "Every child counts." Lobbyists for the South Dakota Medical Association and Sanford Health said their organizations oppose the bill. 

One million patients were seen in the Sanford Health system in 2019. Fewer than 20 of those million were patients younger than 18 being treated for gender dysphoria, and not all of them were patients in South Dakota, according to Sanford lobbyist Mitch Rave.

The bill "criminalizes medicine" and goes against medical associations' best practices, said Sanford pediatrician Michelle Schimelpfenig, the president of the South Dakota chapter of the American Academy of Pediatrics. 

"It is far reaching and sets a bold precedent of big government," she said.

However, Sioux Falls family physician Glenn Ridder supported the bill. He said it's "medically impossible" to change a person's gender and that children are prescribed "dangerous" medications and surgeries to do so. Many transgender children are depressed and traumatized about what's going on in their bodies during puberty, but they can embrace their biological sex if given time, he said.

"Instead they're being chemically castrated and sterilized surgically, mutilated by surgeons, according to only ideology, no science, which in any other situation would be considered criminal," he said.

Families of transgender kids speak up

Parke was in disbelief when they heard legislators wanted to block the puberty blockers they've been on since age 15.

"You are actively denying medical treatment to children who have such strong feelings of disconnect from their bodies that over half of them are or have been suicidal at some point in their lives," they said.

More:What is it like to come out as transgender in South Dakota?

Parke's mother Kim Parke said their journey hasn't been easy, involving numerous medical professionals, and decisions should be made between families and doctors, not legislators. A diagnosis of gender dysphoria takes months and many doctor's appointments, she said. 

"If you support this bill, you are telling me that you know what's best for my child and, frankly, you do not," she said. 

Lynn Meagher, a mother of two transgender children who spoke on behalf of the national Kelsey Coalition, said there may be "other trauma" fueling children's "feelings" that they're transgender. She asked legislators to listen to the parents and children who have changed their minds after medically transitioning their gender.

"This is not health care," she said. "This is a medical experiment on children."