South Dakota Governor Kristi Noem signed a bill on Monday that prohibits both surgical and non-surgical gender-affirming treatments for transgender youth. The law will take effect on July 1.

H.B. 1080, known as the "Help Not Harm" bill, was first presented to the South Dakota House in January, and has been signed into law less than a month later. South Dakota now joins Utah to become the second state this year to ban gender-affirming care for trans minors.

Health care providers who violate the new law by providing hormone replacement therapy, gender-affirming surgery or other kinds of care to trans youth under the age of 18 risk both civil suits, and the potential to lose their licenses.

"South Dakota's kids are our future. With this legislation, we are protecting kids from harmful, permanent medical procedures," said Noem in a press release on the bill. "I will always stand up for the next generation of South Dakotans."

The state Senate voted 30-4 to send the bill to the governor after the state House advanced it in a 60-10 vote.

While Noem and her supporters have characterized trans healthcare as "harmful," research has shown that access to medical transition can be a major step in improving quality of life for trans people. An analysis of 56 peer-reviewed works by the What We Know Project found that in 93% of the studies, gender transition improved the overall well-being of trans respondents. 

"Early gender affirming care is crucial to overall health and well-being" for trans and nonbinary youth, "as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the healthcare system," according to the U.S. Department of Health and Human Services, 

Experts also say that access to gender-affirming care can be a life-or-death issue for trans youth. A study published in the journal Pediatrics found that nearly 51% of female-to-male respondents had attempted suicide, while the average youth suicide rate in the U.S. is 9%, according to a 2022 study by UCLA.

Opponents of the bill immediately expressed concern at its passing. 

The ACLU of South Dakota wrote on Facebook, "This ban won't stop South Dakotans from being trans, but it will deny them critical support that helps struggling transgender youth grow up to become thriving transgender adults."

"We will never stop fighting for the right of trans youth to the love, support and care that every young person deserves," the ACLU added. "As much as Gov. Noem wants to force these young people to live a lie, we know they are strong enough to live their truth, and we will always fight for communities and policies that protect their freedom to do so."

Susan Williams, executive director of the Transformation Project Advocacy Network, which works to advance the "dignity and well-being of transgender South Dakotans," wrote in a Facebook post after the bill passed the Senate: "Our community is sad. Our community is angry. Worst of all, our community is scared."

"I feel betrayed by the elected officials who are supposed to protect my family that just voted against us," Williams added.

This is not the first time that South Dakota has targeted trans people in the state. In February, 2022, Noem signed S.B. 46, which prohibits trans girls from competing on sports teams concurrent with their gender identities, joining a slew of other U.S. states that recently signed athletics-specific anti-trans legislation. 

More than two dozen states have tried to enact measures that would either heavily restrict or completely ban access to gender-affirming care for trans youth in 2022, according to The Hill, and 20 bills that target trans medical care were pre-filed in at least nine states for 2023, including South Dakota.