In February 2023, the North Dakota House enacted legislative protections for minors against gender transition procedures, through the uncommon means of criminal prohibitions. The law makes it a Class A misdemeanor (punishable by up to 360 days in jail and a $3,000 fine) to administer puberty blockers and cross-sex hormones to minors, except for pre-existing courses of treatment grandfathered in. The law also makes it a Class B felony (punishable by up to 10 years in prison or a $20,000 fine) to carry out a gender transition surgery on a minor.

"It's a law that needs to be there," said North Dakota Rep. Bill Tveit (R), who had been the bill's sponsor. "We need to protect our youth, and that's what the whole goal of this thing was from the beginning."

In November 2023, activist lawyers sued to block the law under the North Dakota constitution (they had already obtained a victory in the federal Eighth Circuit Court of Appeals against Arkansas, and chose not to test their fortune). Judge Lofgren denied their motion for a temporary restraining order on November 11, 2023 and their motion for a preliminary injunction on June 5, 2024. In this second ruling, Lofgren found that the plaintiffs' parental rights argument did not apply to gender transition procedures and that transgender status was not a protected class according to North Dakota law.

On January 14, 2025, Lofgren narrowed the case to one plaintiff, a North Dakota doctor, ruling that the families who sued did not have standing since they were grandfathered-in under the law. Lofgren then oversaw a seven-day bench trial that concluded on February 4, 2025.

In a methodical, 85-page ruling (T.D. v. Wrigley), Lofgren ruled that the law protecting minors did not violate the North Dakota constitution. Following the logic of the Supreme Court's Skrmetti ruling, Lofgren found that "North Dakota's Health Care Law discriminates based upon age and medical purpose. It does not discriminate based on sex." Consequently, the law did not violate North Dakota's equal protection clause.

Additionally, he wrote, "The court does not find that the Health Care Law implicates the right to personal autonomy and self-determination. Absent a fundamental or important substantive right, the law is subject to a rational basis standard of review, which the court has determined the Health Care Law satisfies."

Lofgren was struck by evidence presented during the trial that showed increasing dangers from gender transition procedures for minors. "The evidence establishes there is an ongoing international debate regarding the safety and effectiveness of the medical procedures prohibited by the Health Care Law," he said. "Where there is uncertainty, deference is given to the Legislature to decide where the line should be drawn."

Since 2021, 27 US state legislatures plus Puerto Rico have enacted some form of protection for minors against gender transition procedures. Although many of these laws were placed on hold due to legal challenges, the US Supreme Court's Skrmetti ruling in June 2025 set a national precedent that eventually vindicated every law that had been challenged in federal court.

In some states, however, pro-transgender activists had challenged the law under provisions in state constitutions, thereby trying to distinguish these cases from the Supreme Court precedent. Thus, lawsuits against state laws protecting minors from gender transition procedures have continued in Missouri, Montana, Ohio, and also North Dakota.

That North Dakota's law prevailed at the trial court level gives it a good chance of surviving in the likely event of an appeal.

In response to the ruling, Attorney General Drew Wrigley (R) said the court's verdict proves that "The North Dakota legislature considered this matter thoroughly and determined that medical gender transition procedures and protocols cannot be appropriately undertaken for minors." Subscribe for free to Breaking Christian News here

Joshua Arnold is a senior writer at The Washington Stand.

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