North Dakota
Ruling in North Dakota transgender health care case likely months out as trial wraps
BISMARCK — A seven-day trial over North Dakota’s ban on gender-affirming care for minors concluded Tuesday, though a final decision on the case is still months away.
The state in 2023 made it a crime for health care professionals to provide the treatments to anyone under 18.
A lawsuit brought by North Dakota pediatric endocrinologist Luis Casas alleges that the ban is an unconstitutional infringement of personal autonomy and equal protection rights.
South Central District Court Judge Jackson Lofgren took the case under advisement Tuesday. He asked the plaintiffs and defense to present their closing arguments in legal briefs to be filed at a later date.
The state of North Dakota wrapped up its side earlier that day with testimony from Stephen Levine, an adult psychiatrist.
Levine has been a psychiatrist since about 1970, and was a committee chair of a group that would later become the World Professional Association for Transgender Health — the leading professional organization for transgender health care. Like the other three expert witnesses called by the state, Levine has spoken in court in defense of several laws similar to North Dakota’s.
Levine said adolescents cannot consent to gender-affirming care, so it should be limited to adults. He also said therapy is the superior course of action for treating gender dysphoria.
Levine said he knows of many adults who have received gender-affirming care but do not appear to have benefited from it.
“I’ve had the occasional adult who I think has prospered from trans-affirmative care,” he said.
Levine also said he believes that most adolescents who believe they have gender dysphoria are really suffering from other psychiatric conditions. He said this explains the sharp increase in young people who are seeking gender-affirming care over the last 15 years.
Jan Conlin, an attorney for the plaintiffs, indicated Tuesday there are fewer than a dozen kids in North Dakota who have sought gender-affirming medical care.
“Would that surprise you?” Conlin asked Levine.
“I guess it would,” Levine replied.
Levine, like the other three witnesses who testified for the state, stressed that the medical research on gender-affirming care is nascent and unsettled.
He said that most children who believe they’re transgender later come to identify with the sex they were assigned at birth. He said he acknowledges that the North Dakota transgender health care ban may be a source of distress for adolescents who depend on the treatment, but that he’s skeptical that it would cause them to suffer significantly.
“Every crisis doesn’t necessarily harm somebody,” he said. “It’s not necessarily the end of the world for that child. It may, in fact, be the beginning of a chance to rethink this whole matter.”
Casas, the pediatric endocrinologist, last week testified that one of his patients attempted suicide after learning of the health care ban.
The plaintiffs on Tuesday brought back Gabriela Balf, a psychiatrist with experience treating adolescents with gender dysphoria, as a rebuttal witness.
Balf acknowledged that there is limited research exploring the use of transgender health care for minors. She said it is very difficult to conduct top-tier studies like randomized control trials on children because it’s unethical.
“We simply cannot do these kinds of trials with kids,” she said. “I would like to put to rest once and forever this idea that we’re not doing this because we’re lazy.”
Still, Balf said the bulk of research suggests that transgender adolescents have benefited from gender-affirming care. She also said that some of the research cited by the defense’s witnesses has been discredited.
Balf questioned why the state thought it necessary to adopt the health care law when it’s never bothered to regulate other areas of medicine.
“I find it so discriminatory to have so much scrutiny of this condition and others, they are just swept under the rug,” she said.
She said a couple years ago, a scientific review noted that more than 600 medications are prescribed off-label to children.
“And yet, they’re given to kids,” Balf said. “And nobody seems to be very bothered about it.”
Mary Steurer / North Dakota Monitor
Over the course of the trial, Casas, Balf and two other doctors with personal experience treating transgender adolescents testified that in some cases, gender-affirming medication is necessary for patients’ health and happiness.
Two teenage patients of Casas testified last week that the treatment turned their lives around. Both said they also receive therapy, but that the therapy would not be enough to effectively treat their gender dysphoria.
There are only two pediatric endocrinologists in North Dakota: Casas and Amanda Dahl, who is Casas’ clinical practice partner. Casas said he and Dahl both follow the same standards for administering gender-affirming treatment care. No adolescent can receive gender-affirming care without a diagnosis of gender dysphoria, he said. Patients and their families are also informed of what to expect and the risks of the treatment.
The gender-affirming care ban passed North Dakota’s Republican-dominated Legislature with more than two-thirds approval in each chamber.
The ban contains an exemption for children who were receiving treatment before it went into effect. However, even adolescents who fall under the exemption are no longer receiving the care in North Dakota.
Casas testified he no longer provides gender-affirming care to any minors in North Dakota, including patients he saw before the law was enacted, for fear of prosecution. Those patients must travel to Moorhead, Minnesota, to see him for treatment.
The law makes it a Class A misdemeanor to administer gender-affirming treatments like puberty blockers or hormone therapy to a minor. Anyone found guilty of doing so could face up to 360 days in jail, fines of up to $3,000 or both. Medical professionals also fear a violation of the ban could jeopardize their medical licenses, according to records filed in court.
The law also makes it a Class B felony to perform transition-related surgery on a minor. Experts have testified in the case that medical professionals do not perform such surgeries on minors in North Dakota, and did not before the ban.
This story was originally published on NorthDakotaMonitor.com
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This story was written by one of our partner news agencies. Forum Communications Company uses content from agencies such as Reuters, Kaiser Health News, Tribune News Service and others to provide a wider range of news to our readers. Learn more about the news services FCC uses here.
FARGO — Drivers can expect to see a slight uptick in gas prices as a result of the Iran conflict.
As of Monday, March 2, the average for North Dakota is $2.65 a gallon. While that is a $0.13 increase from a month ago, it is significantly lower than prices a year ago.
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GRAND FORKS – The Study ND, formerly Humanities North Dakota, has received $15,000 from the National Endowment for the Arts for a statewide theater and humanities initiative in recognition of the 250th anniversary of the founding of the United States.
This commemorative investment is meant to bring historical events and figures – such as the framers of the U.S. Constitution – to life through virtual and live performances that celebrate the nation’s history.
The grant, along with funding from private sources, has made it possible for The Study ND to host “America 250” activities after the organization sustained a considerable cut in funding from the National Endowment for the Humanities last year, according to Brenna Gerhardt, The Study ND executive director.
“We absorbed a 50% budget cut, resulting in a loss of $467,645 in funding,” Gerhardt said. “As a result, we had to significantly scale back our American 250 initiatives focused on American history and civics education.”
Funds received from the National Endowment for the Arts will be used to present public readings, theatrical portrayals and guided discussions to encourage audience members to reflect on the nation’s founding in 1776 and on its democratic ideals, while engaging in contemporary conversations about civic life.
All of the programming in the series organized by The Study ND, titled “American Heroes,” will be livestreamed statewide.
In the grant application submitted to the National Endowment for the Arts, “we framed the project around a simple idea: democracy requires more than information, it requires citizens who can think historically, listen well, and argue in good faith,” Gerhardt said.
“This series uses living history performances to bring consequential figures into the room, then turns the room into a civic space through moderated dialogue and related public events. We define ‘heroism’ as civic courage under pressure, the willingness to contend with hard truths, and the capacity to enlarge a community’s moral imagination,” she said.
“The project does not ask audiences to agree on a single interpretation of a figure. It invites them to grapple with complexity together, and to connect the past to the responsibilities of the present.”
When Gerhardt and her colleagues received the application for grant proposals from the National Endowment for the Arts, “we were already planning a line-up of America 250 events and it fit perfectly with what we were already planning, so then we just wrote the grant,” she said.
Private funds, including matching funds from the Bismarck-based Tom and Frances Leach Foundation, have also been provided for this project.
Details about all the events will probably be posted on the website
www.TheStudyND.org
in March, Gerhardt said.
The America 250 events, which are planned to take place at Bismarck State College, are 5-6 p.m. July 8, “Reading of the Declaration of Independence, with John Adams,” and 6-7:30 p.m. July 9, “Alexander Hamilton Speaks,” both performed by William Chrystal.
The Living History programs are planned for 7-8:15 p.m. Sept. 17, “Thomas Paine,” performed by Doug Mishler, and Oct. 6, 7-8:15 p.m, “Frederick Douglass,” performed by Nathan Richardson. Both will be moderated by Susan Frontczak.
The performers Chrystal and Richardson live in Virginia, Frontczak in Colorado,and Mishler in Nevada.
Another program, “Hemingway and Gellhorn,” is set for Sept. 16-18 at Bismarck State College, Gerhardt said. “It is part of our broader Chautauqua/living history programming connected to America 250 … (and) will feature performances and discussion centered on Ernest Hemingway and Martha Gellhorn, using their lives and writing as a way to explore major questions about American identity, war reporting, public memory, and the stories we tell about freedom, conflict and responsibility.
“What I am excited about with this event is that it gives us a way to approach America 250 beyond founding-era material. In other words, it helps us show the American story is not just about 1776, but also about the generations that followed and how Americans wrestled with democracy, power, truth and moral courage.”
This program “expands the initiative beyond commemoration into reflection, dialogue and interpretation, which is where the humanities are especially valuable,” she said. “It helps us reach audiences who may be drawn in through literature, journalism and performance, not only traditional history events.”
The Hemingway and Gellhorn program fits in with America 250 in that “it broadens the frame and adds depth to the larger effort.”
Gerhardt is hoping that these activities will give participants “a better understanding of all the debates and issues going on when our country was founded, and how those debates are continuing today,” she said, “and just to be more thoughtful and informed citizens.”
College students and members of the general public will also be invited to participate in a workshop aimed at teaching participants how to build a living history performance from primary sources and historical research.
Last year, The Study ND lost a substantial amount of funding – nearly $468,000, about half of its annual budget – from the National Endowment for the Humanities for its fiscal 2025 year.
The loss of that much funding was discouraging, Gerhardt said. “Very much so, because we had a lot of activities planned for America 250 and we had to cancel a lot of them, or – like in this case – seek other funding, which we were lucky to get.”
The Study ND currently has four full-time employees, she said. “We eliminated a part-time marketing position after the cuts.”
A nonprofit organization, The Study ND provides civics, arts and cultural education programming. The organization’s programs – which include online classes, book talks, lectures and more – reached about 24,000 people in 2024, Gerhardt told the North Dakota Monitor in April 2025.
During the summer, the organization hosts a civics education program for high school and middle school social studies teachers, she said.
On this day in 1943, two North Dakota army officers, Second Lieut. Arthur B. Kuntz and First Lieut. Bernard A. Anderson, were killed in separate medium bomber training crashes in Florida and Georgia.
Here is the complete story as it appeared in the paper that day:
Army Plane Crashes Kill Two N. D. Men
Two North Dakota officers in the army air forces were killed Sunday in bomber crashes during training flights, Associated Press dispatches revealed Monday.
Second Lieut. Arthur B. Kuntz of Harvey (Wells county) was killed with 10 others from the Avon Park, Fla., army bomber base when two medium bombers collided during a routine formation flight. Both planes crashed and there were no survivors.
First Lieut. Bernard A. Anderson of Warwick (Benson county) was one of six killed when a medium bomber from MacDill field, Tampa, Fla., crashed near Savannah, Ga. Lieutenant Anderson was co-pilot of the plane.
None of the other victims of either accident was from the Dakotas or Minnesota.
Lieutenant Kuntz, son of Mr. and Mrs. Roy Kuntz of Harvey, was graduated from the army air force navigation school at Hondo, Texas, as a second lieutenant last October, and received his wings as a navigator.
Kate Almquist is the social media manager for InForum. After working as an intern, she joined The Forum full time starting in January 2022. Readers can reach her at kalmquist@forumcomm.com.
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