South Dakota Gov. Kristi Noem signed legislation that will prohibit doctors from prescribing drugs or performing surgeries on minors that are intended to transition the child into a gender that is different from his or her sex. 

“South Dakota’s kids are our future,” Noem said in a statement. “With this legislation, we are protecting kids from harmful, permanent medical procedures. I will always stand up for the next generation of South Dakotans.”

House Bill 1080, which passed the House 60-10 and the Senate 30-4, will take effect on July 1. In addition to banning the drugs and surgeries, it sets penalties for doctors who refuse to follow the law and allows minors who are subjected to the drugs or procedures to recover civil damages. 

With some exceptions, the new law will ban the administration of drugs to minors that halt the normal puberty process. It also bans the prescription of testosterone, estrogen, or progesterone at levels greater than what would normally be produced in a child of the same age and sex. It also prohibits sterilization or altering sexual organs to artificially make them appear like the sexual organs of the opposite sex. It would further ban the removal of any healthy or non-diseased part of the body. 

While most states do not have bans on transgender surgery or drugs for children, lawmakers throughout the country have begun introducing such bills amid a growing conversation about the effects these measures could have on minors. 

Two weeks ago, Utah Gov. Spencer Cox signed legislation that bans transgender surgery for minors and pauses the allowance of transgender drugs for minors until further research is conducted on the long-term effects. Four states — Texas, Arizona, Alabama, and Arkansas — imposed rules to restrict transgender health care for minors last year, but judges in Alabama and Arkansas have prevented those bills from going into effect. Lawmakers in nearly a dozen states are considering similar legislation.

The South Dakota law includes exceptions for medically necessary procedures used to treat an injury, infection, disease, or disorder. It also makes exceptions for children who are born with both male and female sexual organs, as well as any child who is born with a disorder related to sexual development. 

Doctors will be banned from providing these drugs or surgeries to new patients. If a patient is already receiving certain drugs or hormones before the ban goes into effect, the doctor must either terminate those treatments or, if an immediate termination could cause harm to the child’s health, systematically reduce those treatments. The systematic reduction must end by Dec. 31.

If a certified or licensed health care professional violates the law, his or her certification or license will be revoked. Any person who receives these surgeries or drugs as a minor, in violation of the law, will also have legal recourse through civil litigation. Damages can be sought up to the day of the person’s 25th birthday or within three years of the time the person discovered or should have reasonably discovered that the violation caused injury or damages, whichever is later. 

“Denying the truth that we are either male or female hurts real people, especially vulnerable children,” Matt Sharp, a senior counsel for the conservative legal advocacy group Alliance Defending Freedom, said in a statement. 

“By enacting this legislation, South Dakota has taken critical steps to protect children from radical activists that peddle gender ideology and pressure children into life-altering, experimental procedures and drugs,” Sharp continued.

“Science and common sense tell us that children aren’t mature enough to properly evaluate the serious ramifications of making certain decisions; the decision to undergo dangerous and likely sterilizing gender transition procedures is no exception. We commend Gov. Noem and the South Dakota Legislature for standing up for the truth by enacting these vital protections for our children.”

The legislation received opposition from Democratic leadership. Senate Democratic leader Reynold Nesiba and House Democratic leader Oren Lesmeister released a joint statement calling the bill “unconstitutional.”

“We were incredibly disappointed to see HB 1080, a bill putting the government in the middle of medical decisions between parents and their children, pass with so much support through the House of Representatives,” the lawmakers said. “This bill is unconstitutional and seeks to intervene in the decisions made between patients, parents, and medical providers.”