South Dakota Republicans introduced a bill this week that would make it a felony for medical professionals to provide transgender health care to minors — including the prescription of puberty blockers.

State Rep. Fred Deutsch, who represents a northeast swath of the state, introduced the bill in the Republican-dominated legislature on Tuesday, the first day of the legislative session, with more than 40 co-sponsors. He said the proposal, House Bill 1057, is a way to hit the “pause button” on an “overwhelming and life-changing” decision.

“Children need to wait until they’re mature to do it,” he said. The “it,” according to the bill, includes gender-related surgeries, such as a vasectomy or vaginoplasty, as well as nonsurgical practices, like the prescription of puberty blockers or hormones.

Deutsch, a chiropractor, called these practices “dangerous” because of the psychological and physical toll they take on minors. He said the bill would not interfere with children’s ability to “socially transition,” which may include a name change or a different style of clothing to match their gender identity. The bill would not apply to intersex minors, or those with ambiguous sex characteristics.

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Physicians, nurses and medical assistants are among the health care professionals who could face a Class 4 felony for providing gender-transition treatment to a minor. A Class 4 felony in South Dakota carries a penalty of up to 10 years in prison.

Democratic legislative leaders said they would oppose the bill. Democrats, however, make up just 16 percent of the state House and 14 percent of the Senate.

Rep. Kelly Sullivan, a Sioux Falls Democrat, said that the measure would interfere in the doctor-patient relationship, and that doctors, patients and families should make decisions for treatment. She also said she’s not aware of any medical centers in South Dakota that provide gender-transition treatments for minors and called the bill a waste of time.

Deutsch — who in 2016 co-sponsored an unsuccessful transgender “bathroom bill” — said he has found several instances of doctors administering gender-transition treatment in Sioux Falls.

Dr. Jack Turban, a resident physician in psychiatry at Harvard Medical School who researches the mental health of trans youth, said it’s “unsettling to see state legislators proposing that standard medical care, as outlined by The American Academy of Pediatrics, The American Academy of Child & Adolescent Psychiatry and The Endocrine Society, should be a felony.”

The Endocrine Society and the World Professional Association of Transgender Health both include puberty blockers and gender-affirming hormone treatments among their recommendations for some transgender adolescents. Both organizations recommend deferring genital surgery until a person is at least 18. But even then, only 25 percent of trans and gender-nonconforming adults in the U.S. reported undergoing some form of transition-related surgery, according to a 2015 U.S. Transgender Survey.

In a statement shared with Dakota News Now, the ACLU of South Dakota says HB 1057 is continuing a streak of discrimination of transgender youth in the state.

“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,” Libby Skarin, policy director for the ACLU of South Dakota, said. “When the government proposes laws that would stigmatize them and undermine their care, they lose those opportunities.”

Conservative lawmakers in several states including Texas, Georgia and Kentucky have introduced bills similar to that of South Dakota’s.

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