The uproar surrounding James Younger, the 7-year-old Texan caught in a parental dispute over whether he should be raised as a girl or a boy, has spilled over into state legislative sessions across the U.S., fueling bills that aim to prevent doctors from using drugs or operations to change the sex of minors.
The first state to wrestle with the issue is South Dakota, where the House State Affairs Committee passed a proposal by a vote of 8-5 last week that would make it a criminal offense for doctors to treat children younger than 16 with hormones or gender-reassignment surgery.
South Dakota state Rep. Fred Deutsch, a Republican and the bill’s sponsor, testified that HB 1057 was needed as a “pause button” to stop life-altering, potentially irreversible medical treatments based not on blood tests or brain scans, but on “a child’s self-assertion.”
“A child’s belief that he or she is of the opposite sex, and the South Dakota doctor’s decision to provide the procedures banned in this bill, are based solely on a child’s feelings,” Mr. Deutsch said. “There’s no blood test, there’s no brain scan, nor any objective medical test to detect it. It’s feelings, and as you all know, feelings change, especially in children.”
The bill is expected to advance to the House floor this week for a vote in the Republican-controlled chamber over the protests of the American Civil Liberties Union, which has vowed to challenge the legislation in court if it becomes law.
South Dakota may be ahead of the curve, but similar bills have been introduced in a half-dozen states in what Chase Strangio, deputy director of the ACLU’s LGBT & HIV Project, called “one of the most hostile starts to a legislative session that we’ve seen.”
“By blocking medical care supported by every major medical association, this legislation represents a callous disregard for the health and wellness of South Dakota’s transgender youth, some of the most vulnerable people in our state,” Heather Smith, executive director of the ACLU of South Dakota, said in a statement. “We want South Dakotans to know that we are investigating all of our legal options. If this bill becomes law, it will be challenged. We will see you in court.”
Democrats have warned that South Dakota could lose business opportunities if the bill passes and triggers a boycott driven by the LGBTQ movement. Critics point to North Carolina, which lost the NBA All-Star Game after the 2016 passage of a “bathroom bill,” although the game wound up in Charlotte after the law was overhauled under a newly elected Democratic governor.
“There will be blowback,” said House Minority Leader Jamie Smith, a Sioux Falls Democrat. “We’ll be labeled as a state that is not welcoming and is not inclusive.”
South Dakota Gov. Kristi Noem, a Republican, said Saturday she had concerns about the bill, even though the committee rolled back the legislation by lowering the age from “under 18” to “under 16” and changed the penalty for doctors who violate the measure from a class 4 felony to a class 1 misdemeanor.
Mr. Deutsch, who recommended the amendments, said children who “suffer from not knowing if they’re a boy or a girl deserve love and compassion, but the drugs and surgeries listed in this bill are in most cases a one-way street.”
“As you all know in South Dakota, we don’t allow children to smoke, play video lottery, buy a South Dakota lottery ticket, gamble in Deadwood, or buy, serve or consume alcohol,” he said. “Why is that? It’s because children aren’t prepared or qualified to make the decisions of this magnitude, even though they believe they may be.”
Opponents of the legislation argued that the parents, not the child, make the final decision for such drugs and procedures.
“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,” said Dean Krogman, chief lobbyist for the South Dakota State Medical Association. “They are complicit because they are the ones who are allowing this to happen, not a 12-year-old child.”
Other medical organizations have opposed the bill, warning that refusing to provide medical treatment such as puberty blockers could increase depression and other mental health problems, leading to a potential increase in suicides.
“This law really would interfere with careful medical practice,” said Dr. Sarah Flynn, a psychiatrist. “There’s evidence to show that when there’s appropriate medical care for people with gender dysphoria, there’s a reduction in depression and possibly suicide. This law makes it difficult for doctors to treat their patients.”
On the other side was Dr. Glenn Ritter, a family practitioner who has worked in Nebraska and South Dakota. He said studies show that a majority of adolescents left to their own devices or provided with counseling will eventually embrace their biological sex.
“Instead, they are being chemically castrated, sterilized, surgically mutilated by physicians, according only to ideology, no science, which in any other situation would be considered criminal,” Dr. Ritter said.
In the Younger case, the dispute centers on efforts by the child’s mother to call James by a girl’s name, “Luna,” and dress him in girls’ clothes, which the father has fought in court, leading to fears by opponents that the child could be treated later with puberty blockers during adolescence.
Texas Gov. Greg Abbott, a Republican, said in October that state agencies are looking into the matter.
In South Dakota, Mr. Deutsch said he introduced the bill after discussing the issue with children on social media.
“I listened to their stories, and the next thing I did was check if there’s any doctors in South Dakota that provide these mutilating or sterilizing procedures,” he told Keloland Media Group. “I found there were a number of them and decided to draft a bill to protect our children from these doctors.”
• This article is based in part on wire service reports.