North Dakota ND
BanHB 1254 (2023) / N.D.C.C. 12.1-36.1-02 prohibits puberty blockers and listed hormones and surgeries for gender-transition purposes on minors. The North Dakota Supreme Court upheld it on 17 September 2026.
Last verified: 13 Oct 2026
Medical care for minorsBan
HB 1254 (2023) / N.D.C.C. 12.1-36.1-02 prohibits puberty blockers and listed hormones and surgeries for gender-transition purposes on minors. The North Dakota Supreme Court upheld it on 17 September 2026.
North Dakota Legislative Assembly (HB1254)
Medicaid and CHIPFederal funding ended (minors)
State Medicaid policy covers gender-transition procedures; federal funding for minors ended under the 2026 CMS rule. A federal CMS final rule (13 Aug 2026) prohibits federal Medicaid and CHIP funding for these procedures for patients under 18 (Medicaid) and under 19 (CHIP).
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employee coverageExcludes
State employee health plans explicitly exclude coverage of gender-transition procedures.
Health Plan | NDPERS (ndpers.nd.gov)
SportsSex-based
State law requires school athletic teams designated for girls or women to be limited to students of the female sex (K-12 and higher education).
HB1249
FacilitiesSex-based (K-12 schools)
State law requires multiple-occupancy restrooms and changing facilities in K-12 schools to be designated and used by biological sex.
North Dakota HB1522
Pronouns and parent noticeParent access on request
State law bars school staff from withholding information about a student's gender identity from a parent who asks for it.
HB1522
CurriculumNo state law
No state law specifically addresses instruction on sexual orientation or gender identity.
No state law identified (statute review, Oct 2026)
Definition of sexDefined by biology
State law defines "sex", "male" and "female" in biological terms for purposes of state law.
HB 1474
Identity documentsBirth-certificate sex changed only with surgery and court order
Birth-certificate sex changed only with surgery and court order; driver's licence sex change needs a provider form.
North Dakota Century Code t23c02.1 (ndlegis.gov)
Shield lawNone
No shield statute identified.
No shield statute identified
AdultsRestricted (funding)
DetransitionNo state law
No state law provides an extended limitations period or other remedy specific to detransitioners.
No state law identified
PrisonsBy sex at birth, exceptions case-by-case
Inmates are generally housed by birth sex, with case-by-case exceptions. The DOCR does not publish the policy online.
DOCR Policy 4B-07 (as quoted by the National LGBTQ+ Bar)
Pending billsNo active bills
No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.
LegiScan search, checked 13 Oct 2026 (adjourned legislature)
LitigationResolved/ongoing
North Dakota Supreme Court upheld HB 1254 on 17 September 2026.
T.D. v. Wrigley, 2026 ND 162 (N.D. 17 Sep 2026)
Key datesNone upcoming
No upcoming effective dates or court deadlines were identified.
Review, Oct 2026
Sources
- North Dakota Legislative Assembly (HB1254) →
- 42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406) →
- HB1254 →
- Health Plan | NDPERS (ndpers.nd.gov) →
- HB1249 →
- North Dakota HB1522 →
- HB1522 →
- HB 1474 →
- North Dakota Century Code t23c02.1 (ndlegis.gov) →
- DOCR Policy 4B-07 (as quoted by the National LGBTQ+ Bar) →
- LegiScan search, checked 13 Oct 2026 (adjourned legislature) →
- T.D. v. Wrigley, 2026 ND 162 (N.D. 17 Sep 2026) →