Rep. Leigh Finke, DFL-St. Paul, is the sponsor of the bill and Minnesota’s first transgender legislator. (Richard Tsong-Taatarii, Star Tribune/The Minnesota Star Tribune)

Minnesota could become a refuge for transgender people from other states seeking health care that affirms their gender identity, under a bill passed in the House early Friday morning.

The proposal, which passed on a 68-62 vote after debate stretched more than five hours in the middle of the night, would protect transgender people, their families and medical practitioners from extradition orders and legal repercussions for traveling to Minnesota to receive gender-affirming care.

The vote comes as GOP-led states across the country are proposing bans on gender-affirming medical services for minors, including recently signed laws in neighboring Iowa and South Dakota.

"We've seen a wave of legislation targeting trans folks over the past couple of years, including efforts to restrict and criminalize lifesaving, gender-affirming care," said Rep. Leigh Finke, DFL-St. Paul, the bill's sponsor and Minnesota's first transgender legislator.

House Republicans preemptively pushed back on the bill before the debate Thursday, arguing it undermines parental rights and puts children at risk because it doesn't include an age limit on who can receive the care.

"These treatments can be dangerous and permanent, this bill denies that science," said Rep. Peggy Scott, R-Andover. "We want to protect the kids and make sure every child is able to receive the help, love and support they need to flourish in life. This bill is not the way to do that."

The proposal, called by supporters the "trans refuge bill," still needs to clear the Senate before it heads to DFL Gov. Tim Walz, who recently signed a symbolic executive order to protect patients and providers of gender-affirming care from extradition orders while keeping their data private.

Finke said that passing the bill into law is stronger than issuing an executive order, which could be rescinded by a future governor.

Medical practitioners who provide gender-affirming care in Minnesota said they've already seen a spike in calls and people traveling from other states that have passed bans to receive such care. That care often includes support for families, counseling and medication such as hormone blockers to prevent puberty from happening.

Gender-affirming related surgeries for children under 18 are rare, said Dr. Angela Kade Goepferd, chief medical director of the gender health program at Children's Minnesota. They don't perform surgeries on patients under 18.

"It is a very rare for a thing for a child to access," she said. "The vast majority of gender-affirming care is medication-based or supportive services."

But Republican House Minority Leader Lisa Demuth said the proposal is an overreach from Democrats who swept control of government in the last election.

"Democrats are going to tell you that this is what Minnesota voted for, but it is not," she said. "The vast majority of parents in Minnesota do not put these issues as a top concern for their children."

Medical organizations like the American Academy of Child and Adolescent Psychiatry and the Centers for Disease Control and Prevention have said that access to gender-affirming care is essential. The American Medical Association recently sent a letter to the National Governors Association urging state leaders to oppose restrictions on gender-affirming care, calling it "medically necessary" for transgender people "who face increased risk of anxiety, stress, substance use disorder and suicide."

Finke said the situation in the region is "rapidly evolving" with more states banning gender-affirming care. North Dakota's Legislature is also considering legislation to criminalize health care providers who give gender-affirming care to minors.

"To all those families across the United States that are afraid and wondering where they can go for help," Finke said, "Minnesota is saying: 'We see you, we love you and you belong here.' "