Medical care for minorsBan▾
MedicaidFederal funding ended (minors)▾
State Medicaid pays for sex-change procedures (federal money for minors ended 13 Oct 2026). A federal CMS rule ends federal Medicaid and CHIP money for puberty blockers, cross-sex hormones and surgery for minors.
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employeesExcludes▾
State-employee health plans don't pay for sex-change procedures.
Health Plan | NDPERS (ndpers.nd.gov)
SportsSex-based▾
Girls' sports are protected: state law keeps males out of girls' and women's teams (K-12 and higher education).
HB1249
FacilitiesSex-based (K-12 schools)▾
Bathrooms and changing rooms in K-12 schools are separated by sex, so males stay out of women's and girls' spaces.
North Dakota HB1522
Pronouns and parent noticeParent access on request▾
CurriculumNo state law▾
No state law on gender-identity lessons; local school boards decide.
No state law identified (statute review, Oct 2026)
Sex definitionDefined by biology▾
ID markersBirth-certificate sex changed only with surgery and court order▾
Birth-certificate sex changed only with surgery and court order; licence sex change needs a provider form.
North Dakota Century Code t23c02.1 (ndlegis.gov)
Shield lawNone▾
No shield law.
No shield statute identified
AdultsRestricted (funding)▾
DetransitionNo state law▾
No special right for detransitioners to sue.
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
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 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)
- LegiScan search, checked 13 Oct 2026 (adjourned legislature)
- T.D. v. Wrigley, 2026 ND 162 (N.D. 17 Sep 2026)