T.D. v. Wrigley:
Physician appeals ruling allowing criminal ban on gender-affirming care for youth, citing state constitutional freedom protections
FOR IMMEDIATE RELEASE
February 26, 2026
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Noah Parrish, Communications Director
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Today a North Dakota-based pediatric endocrinologist asked the North Dakota Supreme Court to overrule a 2025 district court order upholding the state’s ban on gender-affirming care for transgender youth. Represented by Gender Justice and the Lawyering Project in the case T.D. v. Wrigley, Dr. Luis Casas is challenging a measure that criminalizes proven, often life-saving health care by imposing severe penalties on the doctors who provide it.
Under the law, doctors like Dr. Casas face up to 360 days in prison and $3,000 in fines for providing care that every major medical association in the country, including the American Academy of Pediatrics and the American Medical Association, recognizes as safe, effective, and often medically necessary.
“Every family I work with is trying to do the right thing for their child. They come to me, they ask questions and we make decisions together based on the best medical evidence available,” said Dr. Casas. “This law takes that away; instead putting the government between me and my patients and tells North Dakota families that their private medical decisions are no longer their own. These families deserve the same freedom as any other family in this state to work with their doctor and do what’s best for their child.”
North Dakota’s founders enshrined in the very first words of their Constitution a commitment to personal freedom that remains among the broadest in the nation: that all individuals are “by nature equally free and independent.” The appeal argues that the ban on gender-affirming care for youth violates these fundamental protections.
At its core, the law strips families of the ability to make deeply personal medical decisions in consultation with qualified doctors. Transgender youth are the immediate targets, but the precedent reaches far beyond any single group of patients. When the government can criminalize the care a doctor provides based on political disapproval rather than medical evidence, the question is not just who is affected today, but who could be next.
“This case is about a principle every North Dakotan understands: politicians have no business telling families what medical decisions they can make for their own children,” said Jess Braverman, Legal Director at Gender Justice. “North Dakota’s Constitution was written to safeguard against government overreach into the personal autonomy and self-determination of North Dakota families. It’s time for the courts to enforce that promise.”
T.D. v. Wrigley is one of several cases nationwide challenging politically motivated bans on established medical care. Just last year, a Montana court ruled that a similar ban violated that state’s constitution.
“When the government can criminalize health care based on political disapproval rather than medical evidence, the question is not just who is affected today, but who could be next,” said Tanya Pellegrini, Co-Director, Litigation, at the Lawyering Project. “North Dakota’s ban on established health care sets a dangerous precedent for every North Dakotan who believes the government should stay out of their personal medical decisions.”
North Dakotans themselves have made clear where they stand: a 2024 statewide survey found that 91% of North Dakota adults agree the government has no business in the private lives of transgender and nonbinary people, and 71% say parents of trans and nonbinary kids should be able to access the health care and counseling they need. This appeal asks the Court to uphold the values North Dakotans already hold: that personal medical decisions belong to families and their doctors, not politicians.
“The question before the Court is not whether some politicians dislike this care,” added Braverman. “It’s whether North Dakota’s Constitution means what it says—that every North Dakotan has the right to liberty, safety, and the freedom to live their life without unnecessary government intrusion. We believe the district court got that wrong, and we believe the Supreme Court will see this case for what it is: a test of whether our most fundamental freedoms will hold.”
A recording of the virtual press conference announcing this appeal can be found here shortly after 11 am CT.
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Gender Justice is a legal and policy advocacy organization dedicated to advancing gender equity through the law. Our vision is a world where people of all genders, gender identities and expressions, and sexual orientations have the opportunity to thrive. We work toward our vision through impact litigation, advocacy, movement building, and public education.
The Lawyering Project uses the law to improve abortion access and uphold the rights and dignity of people seeking and providing abortion care. Our goal is a legal system that enables each of us to make decisions about intensely personal matters like sex, pregnancy, family, and health care based on our own beliefs and values—and ensures that we all have the resources we need to carry those decisions out.
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