Thread by @njhochman

A powerful, well-funded coalition is working to bring the transgender movement to red America.

And it's winning—even in deep-red South Dakota.

This is the story of how one of the most conservative states in the country was conquered by gender ideology.🧵nationalreview.com/2023/01/how-ge…

South Dakota has been governed by Republican supermajorities for decades. In a 2018 Gallup survey, its population was ranked as the third-most conservative in the country.

It's not a state where one would expect to find a major conference for transgender medical specialists.

But next week, just such an event will be hosted in Sioux Falls. The "Midwest Gender Identity Summit" is set to take place on January 13 — co-hosted by Sanford Health, a Sioux Falls-based healthcare company, and the Transformation Project, a local transgender activist group.

Both Sanford and the Transformation Project sit at the crossroads of a variety of factors that have made "cherry-red South Dakota the unlikely epicenter of a transgender uprising on the American Great Plains," as the Washington Post put it in 2020. washingtonpost.com/national/trans…

The first reports of this dynamic came when Sanford—a $7.5-billion medical giant that employs nearly seven times more South Dakotans than any other business in the state—was linked to the death of HB 1217, a 2021 bill that would have banned men from competing in women’s sports.

When Governor @KristiNoem surprised conservatives by vetoing that bill, we looked into it. What we found was that a Sanford lobbyist named Matt McCaulley had worked with Noem’s office to kill HB 1217 — and a number of anti-gender ideology bills, too:

Sanford had publicly lobbied to kill the medical conscience rights and youth sex-change laws. After all, its business interests were implicated in these bills—the healthcare company profits from sex-change surgeries + drugs.

Here's what one state lawmaker told me at the time:

But Sanford's influence pierces much deeper than Noem's office. The company and its activist allies have lobbied increasingly aggressively against conservative bills that threaten its interests.

In the past few sessions, dozens of those bills have died in the state legislature:

How do these bills keep dying in a state controlled by Republicans?

Well, active Sanford employees currently serve as Republicans in the legislature; and the local GOP establishment enjoys generous donations from Sanford-backed healthcare lobbying groups like SDAHO and SDSMA.

SDSMA's political action committee is chaired by a Sanford transgender doctor, Dr. Keith Hansen — who just so happens to be presenting on “Providing Gender Affirming Care” at the upcoming gender identity conference. He's also a top professor at the USD Sanford School of Medicine.

Hansen, who's based at Sanford Sioux Falls, claims to be an "expert on the medical treatment of transgender children." He lobbied against the proposed ban on puberty blockers—which he himself prescribes. (As reported in a local outlet below).

He's treated children as young as 8.

SDSMA, Hansen's/Sanford's lobbying group, continues to push South Dakota left: It's pro-abortion, and boasts about routinely defeating social-conservative bills, including efforts to ban sex-change surgeries for children.

Almost every single bill it's opposed has died.

SDAHO, which is chaired by the president of Sanford Sioux Falls—and includes Sanford lobbyists who helped kill the ban on sex-change surgeries for minors on its board—has lobbied against many of the same bills. It's also helped to defeat numerous efforts to stop vaccine mandates.

Oh yeah, and both SDAHO and SDSMA have also been working closely with Governor Kristi Noem, state senate president Lee Schoenbeck, and various other establishment Republican leaders to primary every single social conservative in the state legislature:
aol.com/news/gov-krist…

In 2022, Noem herself backed primary challengers to the most conservative members of the state legislature, whose names had been placed on a "hit-list" circulated by Schoenbeck.

And Sanford's lobbying groups are spending hundreds of thousands of dollars to help defeat them.

The goal is to "reshape" South Dakota—to stack the legislature with Republicans who will do as they're told, and to neutralize any who might get in their way.

That includes—and I'm not making this up—a number of active Sanford lobbyists simultaneously serving as lawmakers.

Doug Barthel, for example, joined Sanford's lobbying team in 2015—a job he's continued since being elected to the South Dakota House in 2017. The average salary for his position at Sanford is $62,462/year—well upwards of four times that of his $14,000 base pay in the legislature.

Barthel is a Republican. But he's voted to kill dozens of transgender bills—women's sports, medical conscience rights, bans on youth sex changes, etc.

He's joined by numerous other Sanford employees in the legislature—including two Sanford nurses—with similar voting records.

The state senate's Health and Human Services Committee—where many of these bills end up dying—is also dominated by Sanford-backed members. Multiple senators on the committee sued to block a 2016 anti-corruption bill that barred lawmakers from being employed by lobbying interests.

SDSMA gave its annual "Friend of Medicine" aware to R. Blake Curd, a senator on the committee who also actively lobbied against the ban on sex-change surgeries for children.

The current chair of the committee, Wayne Steinhauer, was dubbed "state legislator of 2022” by SDAHO.

Gender ideology continues to gain ground outside the legislature, too. The Noem-appointed prisons director recently signed off on allowing inmates to transfer to prisons that match their “gender identity” rather than biological sex—and attain sex changes on the taxpayer dime.

And last month, SDSU hosted a "kid-friendly" drag show. SDSU is overseen by the state Board of Regents, which is also teeming with Sanford connections.

The head of a local conservative group urged Noem to take action.

So Noem called for him to be fired:

As @RepJonHansen, a conservative lawmaker representing district 25 in the South Dakota house, told me: "This is South Dakota, not California. We’re supposed to be protecting our kids from harmful stuff like this." @NRO
nationalreview.com/2023/01/how-ge…

Here's part of the statement Noem's spokesperson sent me in response to an email I sent asking if they wanted to send a statement for this piece. It's...something: