A South Dakota law prohibiting gender-affirming care for minors is set to take effect next month, joining a growing list of states considering or enacting similar bans across the country.
Meanwhile, a concerned mother is grappling with how her transgender daughter will continue to receive transition-related care, telling ABC News they soon may have to travel up to 200 miles away to get her daughter’s puberty blockers prescribed in Minnesota.
“We’re just putting a pause on [puberty] until we get to a point where her therapist, her medical doctor and her parent all agree she’s mature enough to make a decision how she wants to progress,” said Carrie, whose daughter's name is Willow.
She added, “The most frustrating part of all of those laws for me is that, I’m her parent. I should be able to make decisions regarding my child’s health care.”
Willow began to socially transition in about fifth grade, but kids at her previous school would “deliberately misgender her or deliberately call her by her old name,” Carrie said. The mom and daughter now drive from rural Minnesota to nearby Sioux Falls, South Dakota, for work, school and medical care.
Carrie and Willow's story is part of "The Freedom to Exist - A Soul of a Nation Presentation," airing June 6 on ABC.
South Dakota Gov. Kristi Noem signed HB 1080, known as the “Help Not Harm bill," into law in February. The law bans both surgical and non-surgical gender-affirming care for transgender youth, including hormone replacement therapy and puberty blockers. Supporters of the law believe they are protecting children by prohibiting these treatments until adulthood.
MORE: What is gender dysphoria and what does transgender youth care consist of?Critics say such restrictions infringe on the rights of parents like Carrie to make health decisions on behalf of their children. They also point to research about the risks associated with disallowing transgender children experiencing gender dysphoria to access essential care.
“[Risks] include increased risk for depression and anxiety and, sadly, increased risks for feelings of self-harm, including suicidality,” Dr. Benjamin Hoffman, president-elect of the American Academy of Pediatrics, told ABC News.
“If you’ve got a law in your state that says you are wrong for being who you know you are, that’s going to deeply impact your sense of self,” Hoffman continued.
At least 18 states have passed laws or policies that at least partially restrict gender-affirming care for minors. The laws in Alabama and Arkansas are temporarily blocked, as legal challenges make their way through the courts. At least 14 other states are considering similar laws.
And gender-affirming health care isn’t the only thing under threat, according to the American Civil Liberties Union. The organization is tracking at least 491 anti-LGBTQ bills up for consideration in state legislatures across the country, involving issues like civil rights, free speech and expression.
MORE: Map: Where gender-affirming care is being targeted in the US“There is a lot of anxiety around the increased affirmation and visibility of LGBTQ experiences, and especially trans and nonbinary experiences,” said activist and author Raquel Willis.
Several trans activists told ABC News that a turning point came in 2015, when the Supreme Court struck down the remaining bans on marriage equality for same-sex couples.
“One of the things trans activists absolutely rightly pointed out is that while you might win on gay marriage, where is this huge infrastructure opposing it going to then park all of its energy? And since L-G-B-T — well the T is just sitting right there, they didn’t have to go very far,” said John Hopkins University professor Dr. Jules Gill-Peterson.
ACLU attorney Chase Strangio speculates the anti-trans legislation moving through state legislatures nationwide stems from "an ideological goal of eradicating trans people."
For Willow’s mom, it’s a frightening — and all too real — possibility.
“Passing of these laws, things that are said about the trans community will make them feel even more like they don’t belong, that their existence doesn’t matter. It’s not going to stop there. And that’s what scares me I think the most,” Carrie said.
ABC News' Kiara Alfonseca contributed to this report.