North Dakota
Gender-affirming care for minors hangs in balance as North Dakota trial begins
BISMARCK — A court in Bismarck on Monday, Jan. 27 kicked off a trial to decide the fate of North Dakota’s ban on gender-affirming care for minors.
The law, signed by former Gov. Doug Burgum in 2023, makes it a crime for health care professionals to provide gender-affirming treatment to anyone below age 18. The ban contains an exemption for adolescents who had been receiving treatment before it went into effect.
Over the course of the trial, anticipated to take eight days, attorneys will debate whether the law violates personal autonomy and equal protection rights under the state constitution.
The lawsuit is brought by North Dakota pediatric endocrinologist Luis Casas, who is challenging the ban on behalf of himself and his patients.
“This case is not as complicated as it may seem,” Brittany Stewart, an attorney for Gender Justice, said in her opening statement. “All North Dakotans have a right to personal autonomy to make decisions about the health care they need or don’t need to live happy, healthy lives as their authentic selves.”
Previously, the plaintiffs also included three North Dakota families with transgender children. South Central Judicial District Judge Jackson Lofgren
ruled earlier this month
that the families did not have standing to participate in the case because their children were receiving gender-affirming care before the law took effect, and therefore do not fall under the ban.
The families will still testify as witnesses for the plaintiffs.
Doctors and others with expertise providing care to transgender youth, including Casas, also will be called to the witness stand.
The state says the science behind gender-affirming care is not settled and that the ban is needed to protect children.
“The health care law is a constitutional regulation of practice in medicine, in the area of medical uncertainty,” Special Assistant Attorney General Joseph Quinn said in his opening statement for the state. “This is something that the Legislature has the power to do, has the right to do and it has the responsibility to do.”
Experts called by the state will testify that the standards of care are based on emerging, low-quality evidence, Quinn said.
On Monday, one of the children of the three former plaintiff families testified about his experience receiving gender-affirming care in North Dakota. The seventh grader testified under the pseudonym James Doe to protect his identity.
Doe said that today, he lives as a typical 13-year-old. He enjoys spending time with friends, plays football and is a part of the school band.
He knew he was transgender from age 4 or 5, he said.
“I kinda felt more like a boy. I liked Legos more than Barbies, more of my friends were boys,” Doe said.
Though many of his peers accepted him as a boy in elementary school, there were ways his school did not accommodate him. He had accidents because teachers wouldn’t let him use the boys restroom, for example.
After coming out to his family as transgender, he started attending therapy to help with his gender dysphoria, he said.
At age 10, Doe was referred to Casas to discuss gender-affirming treatment. He said that Casas had him wait six months to start puberty blockers.
“He made me go home to think about what I really wanted,” he said.
Doe said he started testosterone treatment at age 13. Similarly, he said Casas urged him and his family to think seriously about the treatment before pursuing it.
“It’s helped me become more comfortable with myself,” Doe said of the treatment. “Medication really makes me who I am today.”
He said he’s had to travel to Moorhead, Minnesota, to receive the treatment from Casas, which has caused him to miss school, extracurriculars and time with friends.
Most of Monday morning and afternoon, the court heard from Daniel Shumer, a pediatric endocrinologist and clinical associate professor of pediatrics for the University of Michigan.
Research indicates that transgender youth who start gender-affirming treatment during the early phases of puberty are happier and healthier than those who start gender-affirming treatment after puberty or during adulthood, he testified.
The way puberty affects the body is significant and irreversible, so being forced to undergo puberty in a way that clashes with their gender identity can be devastating to transgender adolescents, Shumer said.
“It may be nice to say that these are decisions that are best left for adults. The truth of the matter is that puberty happens during adolescence,” he said. “A young person with gender dysphoria is going through a period of time where their body is changing in a permanent way, in a manner that’s opposite to how they know themselves.”
Gender-affirming surgical procedures aren’t performed on adolescents in North Dakota. Shumer also testified that pediatric endocrinologists only prescribe puberty blockers and hormone therapy to adolescents with gender dysphoria, not pre-pubescent minors.
In his questioning of Shumer, Quinn sought to establish that experts have different opinions on
the efficacy of gender-affirming care and whether the risks of providing the medical treatment to adolescents outweigh the benefits. Quinn pointed to several articles where researchers urged caution on the administration of gender-affirming treatment to minors, and called for additional study of the topic.
Quinn asked Shumer if he is aware of any discourse over the legitimacy of the use of gender-affirming medical treatments to treat gender dysphoria.
“Certainly in state courtrooms in the last couple of years,” Shumer replied, though he maintained that the field of pediatric endocrinology has accepted the procedures as valid.
Shumer said that there is a consensus among leading medical associations that hormone therapy is safe and effective to treat gender dysphoria. He also said that the standards of care pediatric endocrinologists use to guide the treatment of adolescents with gender dysphoria are developed based on a review of clinical data.
The state before opening statements asked Lofgren to not allow the former plaintiff families to testify at the trial. Special Assistant Attorney General Daniel Gaustad argued the personal testimony of a few families is not relevant to whether the text of the law is constitutional.
Lofgren denied the request.
Prichard spared from subpoena
The plaintiffs initially had subpoenaed former Rep. Brandon Prichard, a sponsor of the ban during the 2023 session, to testify in the trial. Lofgren on Monday granted a request from the state to block the subpoena because the North Dakota Constitution protects lawmakers from being questioned about their legislative work in court.
Prichard, a Republican who represented the Bismarck area in the state Legislature until losing reelection last year, in a statement to the North Dakota Monitor said he is happy he will no longer be appearing in court, and that he hopes the health care law will stand.
“The trial is over a narrow set of facts and my testimony wouldn’t have provided anything new from what I already discussed in the deposition,” Prichard said. “My expectation was for the plaintiff’s legal team to treat me hostile and try to dig into my time as a legislator, which is privileged.”
Court records show that in a deposition, Prichard said he believes transgender people are “choosing against God.” He also said he suspects scientific research that suggested gender-affirming care is a safe and effective treatment for adolescents with gender dysphoria is fabricated by LGBTQ rights groups.
Attorneys for the plaintiffs have
told the court previously
that even minors who fall under the law’s exemption cannot access gender-affirming care in North Dakota, since medical providers are uncertain how to interpret the law.
The trial is a bench trial, which means Lofgren will issue a verdict.
This story was originally published on NorthDakotaMonitor.com
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GRAND FORKS — A North Dakota composer’s dream is turning into a statewide invitation.
Williston-based musician Emily Black-Driscoll was chosen as the North Dakota Music Teachers Association’s commissioned composer for 2026. She’s preparing an original composition that will premiere in August.
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North Dakota
Challengers declare victory after ND Supreme Court rules against Legislature’s attempt to alter term limits
BISMARCK — A constitutional ballot measure to amend the state’s term limits law as proposed by the Legislature will not appear on November’s ballot, the North Dakota Supreme Court ruled Thursday, siding with petitioners who argued the Legislature exceeded its authority and violated the state constitution in proposing the changes.
“The people’s voice was heard,” Grand Forks County Commissioner Terry Bjerke said in reaction to the news.
Bjerke was a member of the sponsoring committee behind the successful 2022 effort to pass a term limits initiative, which amended the state constitution by capping legislative term limits to eight years in the House and eight years in the Senate. The amendment, which became article XV of the state constitution, also included a clause barring the Legislature from making constitutional changes to term limits.
During the 2025 session, however, lawmakers narrowly approved Senate Concurrent Resolution 4008, in which the legislature proposed Constitutional Measure 1, a ballot measure to amend the term limits language to allow legislators to decide in which chamber they want to serve their 16 years, and to repeal the clause limiting the legislative assembly’s authority to propose an amendment to alter or repeal term limits.
Bjerke and former Minot legislator Oley Larsen brought the lawsuit challenging the validity of the Legislature’s action in January, and the state Supreme Court
heard oral arguments in the case
this spring.
“Those term limits may only be altered by a measure proposed by the people rather than the Legislative Assembly. And yet a few years later, the Legislative Assembly is doing what they are prohibited from doing,” attorney Zachary Wallen argued on Bjerke and Larsen’s behalf.
Tanner Ecker / The Bismarck Tribune
The Legislature’s attorneys argued the clause prohibiting legislative proposals to alter the constitutional term limits language “infringes on our republican form of government” by “limiting the people’s ability to vote on amendments proposed by their elected officials.”
Justice Jon Jensen seemed skeptical of that argument during the April 2 hearing, questioning whether a second vote was appropriate.
“The public did speak on this. The public spoke on it when it passed the original constitutional amendment and they said, ‘Legislature, you don’t even get to propose a change.’ They have already spoken on it,” Jensen said. “You want a second shot, or a second bite at the apple, not a first one, a second.”
In Thursday’s ruling, all five justices sided with Bjerke and Larsen.
“We … conclude the Legislative Assembly’s adoption of S.C.R. 4008 violated N.D. Const. art. XV … and declare S.C.R. 4008 and Constitutional Measure 1 void … We enjoin the Secretary of State from placing Constitutional Measure 1 on the November 2026 general election ballot,” the ruling said.
Bjerke thanked the legal team that worked on behalf of their lawsuit, and said he was grateful the court reached the conclusion it did.
“I’m thrilled that what the people voted on and approved has been validated,” Bjerke said.
He added that the Legislature had “multiple opportunities” to address term limits prior to 2022’s initiated measure and chose not to, and gave a nod to the country’s coming milestone and the process by which voters expressed their support for term limits.
“We’ve lasted 250 years,” Bjerke said. “I have two words for those elected leaders who think they aren’t: everyone’s replaceable.”
North Dakota
Fargo woman convicted in North Dakota fraud case now faces charges in Minnesota: A deeper dive
FARGO, N.D. (Valley News Live) – A North Dakota woman who was sentenced to 180 days in jail in Cass County for defrauding healthcare providers and Medicaid programs is now facing additional fraud charges in Minnesota.
Christine Marie Pryor, 55, pleaded guilty in November 2024 to theft by deception involving more than $50,000. She was sentenced to first serve 180 days with a 3-year sentence suspended. She received credit for 44 days already served.
Pryor was ordered to pay $82,584.78 in restitution to Southeast Human Services in Fargo, where she worked between 2018 and 2019.
How the scheme unfolded
According to court documents, Pryor worked at multiple healthcare facilities in North Dakota and Minnesota between 2018 and 2023, using the identities and credentials of three licensed professionals without their knowledge. She submitted fraudulent Capella University diplomas and transcripts to gain employment.
Investigators say Pryor admitted she searched state licensing websites for therapists who shared her first name, then used those therapists’ last names and license numbers when applying for jobs.
At Southeast Human Services, where she worked as a Licensed Addiction Counselor, Pryor earned $55,584.82 while providing therapy services to approximately 150 patients. She also opened her own counseling center, NIAM Brain Injury Center, in Fargo between 2020 and 2021, and worked at The Lotus Center in Moorhead, Minnesota, from 2021 to 2023.
Court documents say the three licensed professionals whose identities were used told investigators they had no knowledge of Pryor’s actions and did not give her permission to use their information.
Two additional charges against Pryor in North Dakota, unauthorized use of personal identifying information, were dismissed on motion of the state.
Additional charges in Minnesota
Pryor is also facing charges in Minnesota. Minnesota Attorney General Keith Ellison announced on Tuesday charges against Pryor in Clay County District Court for six theft offenses and six identity theft offenses related to defrauding Minnesota’s Medicaid program of more than $150,000.
According to the Minnesota complaint, Pryor claimed to provide psychotherapy and alcohol and drug counseling services to Medicaid recipients despite having no license or credentials to do so. Prosecutors allege she used the credentials and identities of three licensed professionals while claiming to provide Medicaid-funded services to 169 clients.
The Minnesota charges were filed as part of National Health Care Fraud Takedown Day, a joint effort involving the Department of Justice and more than 40 state Medicaid Fraud Control Units.
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