North Dakota Judge Upholds State's Ban on Gender-Affirming Care for Minors

Court Upholds Ban on Care for Minors

A North Dakota judge has upheld the state's ban on gender-affirming care for minors, a decision that allows the controversial law to remain in effect. On Wednesday, October 9, 2025, District Judge Jackson J. Lofgren of the North Dakota District Court, Burleigh County, ruled that the state's prohibition on certain medical treatments for transgender youth does not violate the North Dakota Constitution.

Legal Challenge and Judge's Reasoning

The lawsuit challenging the ban was brought by families of transgender children and a pediatric endocrinologist, arguing the law infringed upon constitutional rights. Judge Lofgren, however, dismissed the families and children as plaintiffs, leaving pediatric endocrinologist Luis Casas as the sole plaintiff in the case. In his ruling, Judge Lofgren stated that the law does not discriminate based on sex and was not shown to be motivated by anti-transgender animus. He further noted that transgender status is not a suspect classification warranting heightened scrutiny under the state's constitution. The judge concluded that the provision was reasonably related to legitimate state interests and therefore did not violate the equal protection guarantee. He also cited an 'ongoing international debate regarding the safety and effectiveness of the medical procedures prohibited' and that 'deference is given to the Legislature to decide where the line should be drawn,' referencing a U.S. Supreme Court ruling from June that upheld a similar ban in Tennessee.

Details of the North Dakota Law

The North Dakota law, signed by Republican Gov. Doug Burgum in April 2023 and effective immediately, prohibits the use of puberty-blocking drugs and cross-sex hormones to treat gender dysphoria in minors. It classifies providing such care as a misdemeanor for healthcare providers who prescribe or give hormone treatments or puberty blockers to a transgender child. The law also makes it a felony to perform gender-affirming surgery on a minor, though reports indicate such surgeries were not performed on minors in the state prior to the ban.

Reactions and Implications

The ruling has drawn strong reactions from both supporters and opponents of the ban. Jess Braverman, legal director for Gender Justice, which represented the plaintiff, described the ruling as 'devastating for transgender youth and their families.' Conversely, Republican state Rep. Bill Tveit, who introduced the legislation, expressed satisfaction with the decision, asserting that the law serves to protect youth. Opponents of the ban contend that it harms transgender children by denying them crucial medical care, leading some families to seek treatment out of state. The judge's ruling did clarify that minors who were receiving gender-affirming care before the law took effect in April 2023 can continue to receive their treatments within North Dakota.