Elected as an ally of Donald Trump, Noem consistently backed his agenda. She took a hands-off approach to the COVID-19 pandemic in South Dakota, with her response and rhetoric mirroring the Trump administration's handling of the pandemic. Noem did not implement face mask mandates and frequently raised doubts about the efficacy of mask-wearing, encouraged large gatherings without social distancing or mask-wearing, and rejected the advice of public health experts She backed the Trump administration's allegations of voter fraud in the 2020 United States presidential election without evidence, and has signed socially conservative laws such as banning transgender athletes from competing in women's school and collegiate sports.