Getting prescribed testosterone before the age of 18 was a “very lucky” experience for Andrew C. in terms of his mental health, but that does not mean it was a simple process.
Andrew is a 17-year-old trans high schooler who lives outside of Sioux Falls, South Dakota and told The Daily Beast the many steps he had to take to be prescribed testosterone for hormone replacement therapy. First, he needed to complete eight sessions with a psychiatrist to be evaluated for a reference letter recommending HRT. Next, he had to wait around a month to get an appointment with the only endocrinologist in Sioux Falls that would prescribe testosterone to minors.
Once Andrew met with the endocrinologist he had to undergo blood-work, discuss the changes that would come from undergoing HRT and learn how to properly self-administer testosterone injections. During every step of the process, Andrew’s parents needed to provide consent. From start to finish it took around six months to get a prescription for testosterone to begin medically transitioning.
“It is not a simple process by any means,” Andrew said. “Doctors aren’t prescribing HRT to little kids.”
For Andrew and other transgender youth across South Dakota if HB 1057 becomes law, medical providers across the state could face criminal charges for prescribing puberty blockers or hormone injections “when such procedures are done to cause the minor to feel or appear as the opposite sex.”
The bill was introduced Jan. 14, and first read in the State House Jan. 15. It is up for a hearing today, Jan. 22, and could be voted on in committee today too. After the committee vote, the bill could go to the full legislature as soon as Jan. 23, but this won't be conclusively known until after the hearing.
HB 1057 is one of the many anti-trans bills being introduced at the start of the 2020 legislative session in states across the United States. It also is a continuation of a trend in anti-transgender legislation introduced in South Dakota yearly since 2015. What makes this bill different is it would make prescribing gender affirming treatment recognized by the Endocrine Society as illegal for doctors in the state.
Andrew said that he has been very lucky that his family and school have been supportive during his transition and have worked to help speak out against HB 1057. However, the bill’s introduction has him worried about his mental health if he ever had to stop taking testosterone.
Some of Andrew’s friends are not yet out of the closet, and this bill could make it harder for them to take any next steps in transitioning, being it socially or medically.
“I think in general South Dakota is kind of an unsafe place to be out in, if you don’t pass,” Andrew said. “I was personally terrified about coming out to the public, but I knew in the end it would be what was best for me and I’ve been so lucky. The legislation only adds to aggression that people feel towards trans people, which makes South Dakota much more unsafe.”
For Anne Dilenschneider, a licensed professional mental health counselor and WPATH (World Professional Association for Transgender Health)-certified gender specialist in Sioux Falls, South Dakota, the latest bill in the history of anti-trans legislation is another instance of political grandstanding and fear-mongering.
She told The Daily Beast the bill fails to even acknowledge the 120-page Standards of Care that are followed by medical and mental health professionals working with trans youth. As a result, the bill spreads disinformation about the care trans youth need, and the options available.
More importantly, Dilenschneider says that whenever anti-trans bills are introduced, it provides an opportunity to educate legislators and the wider public. It is also an opportunity to build relationships and dispel myths.
Empowering trans youth to educate and build relationships with legislators, healthcare system administrators and providers, educators, and businesses around the state is one way she hopes to make a difference fighting the bill. Advocacy work promoted by trans youth in the state is already having an effect in hospitals and schools.
“Every year we know [anti-trans bills being introduced] is coming up,” Dilenschneider said. “We all need to remember what is actually happening day in and day out—how much good, evidence-based care is going on, and how many lives are being saved.”
The fear-mongering effect of HB 1057 is, unfortunately, already apparent to some kids and parents, no matter if the bill is defeated.
Aerin, a non-binary 15-year-old high school student outside Sioux Falls, told The Daily Beast how “exhausting” coming out to their friends and school, but is glad for the support system it has given them. Socially transitioning took years before they were fully out, and now Aerin and their family are beginning the process of looking into medically transitioning.
The threat from HB 1057 is so real, Aerin’s father even told The Daily Beat that the family has even entertained the thought of moving out of state if it passes.
“I think [South Dakota] can be safe if you have a supportive family and school,” Aerin said. “If you don't, it could be quite dangerous. I've had friends fearing that they'll get kicked out of the house. Most of my friends have been quite horrified by the idea of this bill, and they should be. Even if it doesn't affect you personally, it's still a very harmful, hope-stealing bill.”
The site urges South Dakotans to get involved and download a “parents resource guide” from the Minnesota Family Council, a Christian organization aligned with the Family Research Council, which has been designated a “hate group” by the Southern Poverty Law Center.
The website is full of quotes from people who have de-transitioned and features videos from the Heritage Foundation and right-wing website PragerU. However, buried at the bottom of the site is a disclaimer saying “The above statements were not made in connection with HB1057, and do not serve as official endorsements of the legislation.”
HB 1057 was introduced by South Dakotan Representative Fred Deutsch, who in the months before drafting the legislation travelled to the “Summit for Protecting Children from Sexualization,” put on by the right-wing Heritage Foundation “to establish legislation to criminalize doctors that provide sex change operations in children,” according to a copy of the South Dakota Legislator Update provided to The Daily Beast.
Representative Deutsch did not respond to multiple requests for comment about HB 1057.
Libby Skarin, ACLU South Dakota Policy Director, told The Daily Beast that the content of HB 1057 and website promoting it is a “tactical shift,” from proponents of this type of legislation, showing how serious they are about passing it.
The bill was introduced early in the session and will be up for a hearing just over a week after its introduction, leaving grassroots organizations little time to drum up opposition.
Much anti-trans legislation has been defeated in South Dakota before being passed, unlike HB 1008 in 2016, which would have made it illegal for trans people to use the bathroom aligning with the gender they identify as. That bill was defeated only with a veto from then Governor Dennis Daugaard.
A spokesperson for current Governor Kristi Noem declined to comment to The Daily Beast about whether Governor Noem would veto HB 1057 saying, “The Governor does not comment on draft legislation.”
Skarin and the ACLU are working to defeat this bill quickly, but are worried about the effect it could have on other states across the country.
“We know that once one of these bills passes anywhere it is easier to pass elsewhere, so I think the real threat is compounded because not only will this harm kids in our state, it will be the first bill of its kind to be passed, which is very dangerous for this kind of legislation spreading,” Skarin said. “I think we would be better off if we didn’t have to do this every single year.”
UPDATE, January 22, 2020: South Dakota lawmakers voted 8-5 Wednesday, to advance HB 1057 out of committee to the main floor of the legislature. The bill could be heard as soon as Thursday, Jan. 23, with a vote to follow soon after. Republicans have a 59-11 supermajority in the South Dakota legislature.