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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JAMESTOWN, N.D. — The No. 2 seed Thompson Tommies survived an upset scare by defeating the No. 7 seed Rugby Panthers 39-36 on Thursday, March 5, in the quarterfinals of the North Dakota Division A girls basketball state tournament at the Jamestown Civic Center.
With 16 seconds left in the game and down 39-36, Panthers coach Jen Brossart drew up one final play in an attempt to send the game to overtime. Strong defense from the Tommies formed a cluster of players at the top of the arc, and as time expired, Panthers guard Avery Santjer put up a falling-away 3-point attempt that came up short, giving the quarterfinal victory to Thompson.
Addison Sage had 15 points to lead Thompson with Kya Hurst chipping in 11. Santjer led Rugby with 13.
Burchill’s double-double leads Valley City to win
Valley City junior forward Katie Burchill scored a 23-point double-double with 18 rebounds to lead the Hi-Liners to a 64-44 quarterfinal victory over Devils Lake on Thursday.
Valley City outscored Devils Lake 21-6 in the third quarter to take a commanding lead.
Presley Brown and Tylie Brodina each scored 12 for the Firebirds.
Burchill and sophomore forward Skye Nelson also recorded nine of Valley City’s 12 blocks.
John M. Steiner / The Jamestown Sun
South Prairie-Max runs past Watford City
South Prairie-Max scored a 50-point victory over Watford City, winning 75-25 on Thursday in the quarterfinals behind 19 points from Skotti Beck.
Mya Gunville added 12 points and Brianna Rose 11 for South Prairie-Max.
Lohgan Hanna led Watford City with nine points.
Trenbeath, Kindred squeak by Hazen
Liza Trenbeath’s 27 points paced No. 4 seed Kindred to a 56-54 win over No. 5 Hazen in Thursday’s quarterfinals.
Siera Nipstad chipped in 19 points and six rebounds as the Vikings (20-5) advanced to Friday’s state semifinals against top-seeded South Prairie-Max (24-1). Tipoff is set for 8:15 p.m. at the Jamestown Civic Center.
Kindred shot 22 of 51 (43.1%) from the field to Hazen’s 19 of 41 (46.3%)
Our newsroom occasionally reports stories under a byline of “staff.” Often, the “staff” byline is used when rewriting basic news briefs that originate from official sources, such as a city press release about a road closure, and which require little or no reporting. At times, this byline is used when a news story includes numerous authors or when the story is formed by aggregating previously reported news from various sources. If outside sources are used, it is noted within the story.
Greg Power, fisheries division chief with the North Dakota Game and Fish Department, shares information about the new 2026-2028 Fishing Guide and a few new regulations starting April 1, 2026.
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SIOUX FALLS — Ali Stephens had 17 points and 13 rebounds and 8th-seeded Omaha defeated 9th-seeded North Dakota 49-39 in the first round of the Summit League women’s tournament.
The Fighting Hawks had a tough time putting the ball in the hoop all night long, scoring just three points in the first quarter and having only marginally better luck from there.
UND (7-24) shot just 23.5 percent from the floor (12-for-51) and made 1-of-20 shots from outside the arc. Walker Demers and Mackenzie Hughes had 10 points each to lead the Hawks, with Demers adding eight rebounds.
Matt Zimmer/Sioux Falls Live
Regan Juenemann had 10 points and five rebounds for the Mavericks while Avril Smith had seven points and 16 rebounds and Sarai Estupinan eight points, five assists and three rebounds. Omaha (6-26) shot the ball slightly better than the Hawks, going 16-of-53 from the field (30 percent) and 8-of-23 (35 percent) on 3-pointers.
With the win, the Mavs earn a date with top-seed North Dakota State on Thursday at 2:30 p.m.
The Bison won both regular season matchups by more than 50 points.
Matt Zimmer/Sioux Falls Live
Oral Roberts 84, Kansas City 62 — Don’t look now but the team that started the conference season 0-10 and at one point lost 15 of 16 games might be the hottest in the Summit League.
Oral Roberts picked up their fourth straight victory on Wednesday night in the conference tournament opener, routing Kansas City at the Premier Center in the 8/9 “play-in” game.
Ty Harper had 22 points to lead the Golden Eagles (10-22), who took a 44-21 lead by halftime and never looked back. ORU shot 50 percent from the floor and made 13-of-27 3-pointers while the Kangaroos shot just 34 percent and made 6-of-24 from deep. Martins Kilups had 17 points for the Eagles and Connor Dow added 14.
Jayson Petty had 14 points to lead the Kagaroos, who finish the season 4-27. It was their final game under coach Marvin Menzies, whom the school announced earlier this season would not return next year.
With the win ORU advances to face top-seed North Dakota State on Thursday at 6 p.m.
The Golden Eagles lost to NDSU 86-58 in Tulsa on Jan. 24 but they took the Bison to overtime in Fargo on Jan. 3 in a 79-77 loss.
Matt Zimmer is a Sioux Falls native and longtime sports writer. He graduated from Washington High School where he played football, legion baseball and developed his lifelong love of the Minnesota Twins and Vikings. After graduating from St. Cloud State University, he returned to Sioux Falls, and began a long career in amateur baseball and sports reporting. Email Matt at mzimmer@siouxfallslive.com.
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