Two side-by-side images compare Kristi Noem's appearance in 2019 and 2025. The 2019 image shows her with natural makeup and a short, layered hairstyle. The 2025 image depicts her with darker, longer hair, heavier makeup, and a more sculpted facial appearance. The tweet above the images asks, "What has happened to Kristi Noem's face? 😳" and the post is captioned "Gender affirming care."
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