S.D. bill would punish doctors who perform sex reassignment surgeries on children

PIERRE — Rep. Fred Deutsch and 44 other lawmakers are proposing to make it a felony for medical professionals to treat transgender children with hormones and sex reassignment surgery in South Dakota.

Deutsch, R-Florence, filed House Bill 1057, which he's calling the Vulnerable Child Protection Act, on Tuesday that would make it a Class 4 felony for a medical professional to conduct several practices on children, including emancipated children, in an attempt to change or affirm the child's "perception" of their sex "if that perception is inconsistent with the minor's sex."

The House State Affairs Committee is scheduled to hold a hearing on the bill at 7:45 a.m. Wednesday in room 414 at the state Capitol in Pierre. The livestream of the hearing can be found at sdlegislature.gov.

Deutsch said children in South Dakota are being hurt and he's introducing the legislation to protect them.

"To parents, I say, love your kids. Just love them, support them. That's what I'm trying to do with this bill: love South Dakota children. I'm being the grown up in the room," Deutsch said.

Both Democratic legislators and the American Civil Liberties Union of South Dakota said on Wednesday that they plan to fight the bill. The ACLU of South Dakota said in a statement that it's unconstitutional to single out one group of people and categorically ban all care, no matter how medically necessary.

"Every year, South Dakota lawmakers zero in on transgender youth and every year the transgender community is hurt while meaningful problems go unaddressed. The more we legislate solutions in search of problems, the more our communities suffer," said Libby Skarin, policy director of the ACLU of South Dakota.

The bill would prohibit any physician, surgeon, physician assistant, nurse, clinical nurse specialist, nurse practitioner, anesthetist or medical assistant from conducting the following on children:

Surgeries including castration, vasectomy, hysterectomy and vaginoplasty;

Mastectomies

Prescribing, dispensing or administering medications that block normal puberty, give testosterone to females, give estrogen to males;

Remove a healthy or non-diseased body part or tissue.

The bill would exempt good faith decisions by parents or guardians of a child born with a "medically verifiable genetic disorder of sex development," according to the legislation.

Deutsch argues that no studies have shown that the drugs and procedures are safe and that parents are given inaccurate, incomplete and false information about the procedures.

"They are warned that if they do not consent to medical treatment, their child will be at higher risk of suicide. But there's no evidence to support this claim," Deutsch said. "Kids who are contemplating suicide require evaluation and treatment for conditions such as depression and anxiety. Castration, hysterectomies, puberty blockers and high dose hormones are not treatments for psychological conditions."

The Endocrine Society's clinical guidelines don't recommend hormone treatment for pre-pubescent children and calls for children to be treated during puberty and older adolescence by an expert multi-disciplinary team that includes both medical professionals and mental health professionals.

'Homegrown' legislation

Deutsch announced on Twitter in May that he planned to introduce legislation in the 2020 session to make it a felony for doctors to follow the guidelines of the professional medical association, the Endocrine Society.

The bill is "homegrown," and Deutsch said he began working on it nine months ago after he met transgender people via Twitter and Reddit. He said he was so moved by their experiences of being hurt by the transition process that he wanted to see if it was happening in South Dakota. He said he found that doctors are doing those treatments on children as young as 13 years old, and he plans to show documents in the bill's hearing proving that.

"It breaks my heart. These are our kids in South Dakota," he said. "These are good children that need to have a pause button and this bill is a pause button until they're 18."

His bill doesn't impact transgender children who want to socially transition or seek counseling, he said. He said he's found a dozen studies completed in the last 40 years that found that 85% of children will accept their biological gender if they go through puberty, which is a "natural resolution" to the challenges transgender children face.

Deutsch said he worked on the legislation with Kelsey Coalition, which states its goal is to promote "policies and laws to protect young people who identify as transgender."

There are other organizations in the country that are working on the issue, but he said any similarities between his bill and other organizations and legislators' bills in other states is because they copied the language from his bill.

An identical bill was introduced in the Florida Legislature on Monday. Georgia state Rep. Ginny Ehrhart announced in October that she planned to introduce the Vulnerable Children Protection Act to also prohibit medical procedures on transgender children, but the legislation hadn't been introduced as of Wednesday.

A 2019 case in Texas that became national news in October has also fueled the interest in legislation regulating medical treatments for transgender children. The case centers on a custody dispute over a 7-year-old child where the mother, Anne Georgulas, says the child has been diagnosed with gender dysphoria and should be affirmed as a girl and the father, Jeffrey Younger, has opposed the child's gender transition.

Deutsch said that case didn't impact his legislation because it was already well underway, but it put a spotlight on the issue.

"It's an idea whose time has come," he said.

At the Capitol in Pierre, the Family Heritage Alliance Action will be supporting Deutsch's legislation. Executive Director Norman Woods said they recognize that they aren't talking about numbers or data when discussing the topics, but rather are talking about people and their journeys that include "real pain and hurt."

"We recognize that in this journey, adults should be free to chose their path, but children should be protected from sterilization and permanent surgeries," Woods said.

Immediate opposition

Democrats plan to oppose the legislation, according to House Minority Leader Jamie Smith, D-Sioux Falls. The bill is "frustrating" and "not necessary," and it's "disappointing" that House leadership is co-sponsoring it, he said.

Doctors don't perform sex reassignment surgery on children in South Dakota, and other treatments are medical treatments that should be decided between doctors and parents without the state meddling in it, he said.

"This bill is frustrating on many levels. First of which, it's a constant assault on trans people in the state of South Dakota year after year," Smith said. "To think that a doctor doing their job would be a felon is unheard of."

The ACLU of South Dakota said in a statement that health care for transgender children is individualized and based on the needs of the particular person. The bill would take away private health care choices about medical care that is consistent with prevailing medical and scientific standards. Those choices should be made between a doctor and a patient, not politicians, according to the ACLU.

"Transgender kids, like all kids, deserve a chance to experience joy, to learn in a safe environment, to get the health care that they need, and to survive into adulthood," Skarin said. "When the government proposes laws that would stigmatize them and undermine their care, they lose those opportunities."

Follow @LisaKaczke on Twitter for more from Pierre during the 2020 legislative session.

Clarification: An earlier version of this story misstated the group who helped Deutsch write the bill. The group is the Kelsey Coalition.