A judge is limiting the scope of a lawsuit challenging North Dakota’s ban on gender-affirming care for minors after concluding three families don’t have standing to participate as plaintiffs.
Luis Casas, a North Dakota pediatric endocrinologist, will be the sole remaining plaintiff in the case, South Central Judicial District Judge Jackson Lofgren said during a pretrial conference Tuesday.
Lofgren found that Casas has standing to represent himself in the lawsuit as well as the interests of his current and future patients.
The law, signed by former Gov. Doug Burgum in 2023, makes it a crime for medical professionals to provide gender-affirming care to anyone under age 18. It includes an exemption for minors who had been receiving treatment before the ban took effect.
Casas and three North Dakota families with transgender children sued the state over the law in September 2023. In their complaint, the group argued the ban violates health care freedoms and discriminates against children with gender dysphoria by denying them treatment available to kids with other medical conditions. The plaintiffs also claimed that the law is unconstitutionally vague and leaves medical providers vulnerable to prosecution because it does not sufficiently explain when its exemptions apply.
Lofgren concluded that the families cannot be plaintiffs in the case because their children all received gender-affirming care before the ban took effect, and therefore fall under the law’s health care exemption.
The judge also found that the plaintiff cannot challenge the part of the law banning gender-affirming surgery for minors, since such procedures “are not approved under the current standard of care” in North Dakota.
Lofgren said he will limit what constitutional arguments may be considered at trial, as well.
The trial will focus on plaintiffs’ claims that the law’s restrictions on gender-affirming treatments like puberty blockers and hormone therapy violate equal protection, personal autonomy and self-determination rights under the state constitution, he said.
Lofgren said he is dismissing the plaintiffs’ arguments that the law infringes on their right to due process and is too vague.
The plaintiffs have argued that even minors who previously received gender affirming care can no longer access treatment in the state, since medical providers are not confident about what kind of care they can legally provide.
This in spite of a June order from Lofgren clarifying that under that the children of the three families that brought the lawsuit qualify for the exemption.
Lofgren said an order outlining his latest findings will be published sometime Tuesday.
The lawsuit is scheduled for an eight-day bench trial — meaning there will be no jury — beginning Jan. 27 in Bismarck.
The three families will still be allowed to testify as witnesses.
The gender-affirming care ban passed North Dakota’s Republican-dominated Legislature with more than two-thirds approval in each chamber.
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. Anyone convicted of doing so could face up to 10 years in prison, a maximum $20,000 fine or both. Experts have testified in the case that medical professionals do not perform such surgeries on minors in North Dakota.