The Statute: North Dakota Century Code 12.1-36.1
12.1-36.1-01. Definitions.
This chapter defines key terms as follows:
- “Health care provider”: A licensed physician, physician assistant, nurse, or certified medical assistant.
- “Minor”: An individual under the age of eighteen, including emancipated individuals.
- “Sex”: The biological state of being female or male, determined by nonambiguous sex organs, chromosomes, or endogenous hormone profiles at birth.
12.1-36.1-02. Perception of a minor’s sex – Prohibited practices – Penalty.
- It is prohibited for health care providers to perform certain medical interventions if a minor’s perception of their sex does not align with their biological sex. Prohibited practices include:
- Performing surgeries such as castration, hysterectomy, or mastectomy.
- Administering drugs to align a minor’s sex with their perception, including puberty blockers and supraphysiologic doses of hormones.
- Removing healthy or nondiseased body parts or tissues, excluding male circumcision.
- Violations result in criminal penalties:
- Class B felony for performing prohibited surgeries.
- Class A misdemeanor for prescribing or administering drugs.
12.1-36.1-03. Exceptions.
Exceptions apply to:
- Good-faith medical decisions for minors with verified genetic or developmental disorders affecting sexual development.
- Medical procedures initiated before April 21, 2023.
12.1-36.1-04. Statutory limitation.
Prosecution for violations must commence within three years of the offense or its reporting to law enforcement, whichever is later.
Overview of Minor Sex Change Treatment Restrictions
North Dakota law strictly prohibits medical practices aimed at aligning a minor’s perception of their sex with their biological sex. This includes both surgical and pharmaceutical interventions. Exceptions are narrowly tailored to medically verified genetic disorders or ongoing treatments initiated prior to the law’s enactment.
Prohibited Practices and Penalties
The law distinguishes between two categories of violations:
- Class B Felony: Performing surgeries such as mastectomy or phalloplasty on minors for the purpose of changing or affirming their sex perception.
- Class A Misdemeanor: Prescribing or administering puberty blockers or hormone treatments.
Statutory Limitations
The statute includes a three-year limitation period for prosecutions, with the clock starting at the time of the offense or when it is reported.
Penalties for Violating 12.1-36.1
Class B Felony Penalties
| Penalty Category | Details |
|---|---|
| Maximum Period of Incarceration | 10 years |
| Minimum Period of Incarceration | None specified |
| Maximum Fines | $20,000 |
| Minimum Fines | None specified |
| Court Administration Fees | $900 |
| Minimum Length of Probation | None specified |
| Maximum Length of Probation | Up to 5 years supervised probation |
| Supervised Probation Required | Yes |
| 85% Rule Applies | No |
| Offender Registration Requirements | Not applicable |
| Offender Against Children Requirements | Not applicable |
Class A Misdemeanor Penalties
| Penalty Category | Details |
|---|---|
| Maximum Period of Incarceration | 360 days |
| Minimum Period of Incarceration | None specified |
| Maximum Fines | $3,000 |
| Minimum Fines | None specified |
| Court Administration Fees | $200 |
| Minimum Length of Probation | None specified |
| Maximum Length of Probation | 2 years supervised probation |
| Supervised Probation Required | Yes |
| 85% Rule Applies | No |
| Offender Registration Requirements | Not applicable |
| Offender Against Children Requirements | Not applicable |
Real-Life Examples of Prohibited Minor Sex Change Treatments
Surgical Interventions: A physician performs a mastectomy on a 17-year-old to align their physical appearance with their perceived sex, violating the law.
Puberty Blockers: A healthcare provider prescribes puberty-blocking medication to a minor experiencing gender dysphoria.
Hormonal Treatments: A doctor administers supraphysiologic doses of testosterone to a female minor for the purpose of affirming a male identity.
Unnecessary Surgeries: Removal of non-diseased reproductive organs in a minor for gender affirmation purposes.
Cross-State Treatment: A minor receives hormone treatments while residing in North Dakota under a provider from another state.
Defenses Against Charges Under 12.1-36.1
Several defenses may be applicable for healthcare providers accused of violating these restrictions:
Exceptions for Genetic Disorders
If the treatment was part of a good-faith decision for a minor with a medically verified disorder of sex development, it may be exempt.
Ongoing Treatments
Procedures or medications that began before April 21, 2023, are excluded from this law’s prohibitions.
Lack of Intent
The prosecution must prove willfulness. Demonstrating that the treatment was accidental or not intended to align the minor’s sex perception can negate this element.
Statutory Limitations
Charges cannot be brought if the statute of limitations has expired.
How a Lawyer Can Help
Legal counsel is critical for navigating accusations under this law. A lawyer can:
- Analyze Evidence: Review the details of the case to identify potential defenses.
- Challenge Charges: Argue lack of intent or applicability of exceptions.
- Advocate in Court: Represent the accused in hearings and trial.
- Negotiate: Seek reduced charges or alternative resolutions where applicable.
- Protect Rights: Ensure procedural fairness and constitutional protections.
Frequently Asked Questions About Minor Sex Change Treatment Restrictions
What is prohibited under Chapter 12.1-36.1?
The law prohibits surgeries, hormone treatments, and puberty blockers intended to align a minor’s perception of their sex with their biological sex.
Are any exceptions allowed?
Yes. Exceptions include treatments for medically verified genetic disorders or ongoing treatments started before April 21, 2023.
What are the penalties for performing prohibited surgeries?
Violations involving surgeries are classified as a Class B felony, punishable by up to 10 years in prison and fines of up to $20,000.
Can healthcare providers prescribe puberty blockers to minors?
No. Prescribing puberty blockers for gender affirmation purposes is classified as a Class A misdemeanor.
What should I do if accused of violating this law?
Consult a lawyer immediately to review the specifics of your case and develop a defense strategy.
Is there a time limit for bringing charges?
Yes. Prosecution must commence within three years of the offense or its reporting to law enforcement.
Does this law apply to emancipated minors?
Yes. Emancipated minors are still included under the definition of “minor” in this statute.
Are treatments for intersex conditions prohibited?
No. Treatments for verified genetic disorders or ambiguous sex characteristics are exempt from this law.
Can parents authorize prohibited treatments?
No. Parental consent does not override the prohibitions in this law.
How can a lawyer help if charged?
A lawyer can evaluate the evidence, identify defenses, and represent you in court to ensure the best possible outcome.
What is the difference between prohibited and allowed treatments?
Prohibited treatments aim to align a minor’s sex with their perception, while allowed treatments address genetic or developmental disorders of sexual development.
Can penalties vary by the type of violation?
Yes. Surgeries carry Class B felony penalties, while administering drugs results in Class A misdemeanor charges.
Are there reporting requirements for healthcare providers?
Yes. Healthcare providers must ensure compliance with the law and may face reporting obligations for violations.
Can a minor sue for unauthorized treatments?
Yes. Legal recourse may be available for minors subjected to prohibited treatments, depending on the circumstances.
Are there any federal laws that conflict with this statute?
No current federal laws explicitly conflict with this state statute, but legal challenges may arise.
What role do medical ethics play in this law?
Medical ethics require adherence to state law and protection of patient welfare, which aligns with this statute’s restrictions.
Can criminal charges be combined with civil lawsuits?
Yes. Criminal charges for violations can coexist with civil lawsuits for damages.
Are there penalties for parents seeking prohibited treatments?
While the law targets healthcare providers, parents may face legal scrutiny in certain situations.
How can compliance with this law be ensured?
Healthcare providers must review the statute, update policies, and consult legal counsel to ensure adherence.
What are the long-term implications of this law?
The law may affect medical practices, patient access to care, and legal precedents regarding treatment restrictions.
Are healthcare providers trained on this law?
Healthcare providers are encouraged to seek training and legal guidance to fully understand and comply with this statute.
How does this law interact with existing child welfare laws?
This statute complements child welfare laws by protecting minors from medical interventions deemed inappropriate under state law.