The North Dakota Supreme Court upheld a state ban on gender-affirming medical care for transgender youth on September 17, 2026. The high court affirmed the lower court’s ruling in T.D. v. Wrigley, rejecting constitutional challenges to the legislation.
The decision confirms that North Dakota’s state constitution offers limited protection against government restrictions on healthcare decisions for minors. A concurring opinion noted that residents may not possess the same equality rights under the state charter as they do under federal equal protection guarantees.
Jess Braverman of Gender Justice criticized the outcome, stating, “This ruling is devastating for transgender youth and their families in North Dakota.” Dr. Luis Casas added that the decision keeps government interference between him and his patients.
Major medical organizations, including the American Academy of Pediatrics and the American Medical Association, maintain that gender-affirming care is safe and evidence-based. The ruling leaves the prohibition in effect for providers across the state.