MISSOURI IMPOSES SWEEPING PROHIBITIONS ON GENDER-AFFIRMING HEALTHCARE
The state of Missouri has enacted one of the most restrictive regulations regarding gender-affirming healthcare in the United States. On Thursday, attorney general Andrew Bailey passed an emergency rule that imposes significant limitations on medical treatments, such as puberty blockers, hormones, and surgeries, which are critical for transgender people. The new restrictions apply to both adults and minors, making Missouri the first state to effectively ban gender-affirming care for adults. The policy imposes arduous hurdles for patients, such as requiring at least 15 years of monitoring and mental health counseling, as well as prohibiting the provision of gender-affirming care to anyone with an “existing mental health comorbidity,” such as depression or autism.
The emergency rule of the Missouri attorney general mandates that healthcare providers give deceptive information to trans patients about gender-affirming care. This move seems to reflect the anti-trans rhetoric that has been spreading across the United States, fueling an upsurge in legislation controlling gender-affirming care. At least 12 states, mostly under Republican leadership, have recently imposed new restrictions on gender-affirming care, primarily for minors. However, AG Bailey’s move goes further, effectively banning the treatment altogether for those adults who do not fully comply with the new restrictions.
Many respected institutions, including the American Medical Association, endorse gender-affirming care as crucial to transgender individuals’ health and well-being. Psychiatric professionals argue that gender-affirming care saves lives. However, these arguments have not deterred the GOP from seeking to eliminate gender-affirming healthcare in their ongoing attacks on “transgenderism.”
In recent months, several states, including Kansas, Indiana, Kentucky, Texas, Oklahoma, and Missouri, have introduced bills to restrict trans healthcare for adults, but none have yet become law. Missouri’s attorney general has acted unilaterally, imposing the new regulations under the Missouri Merchandising Practices Act, which is designed to protect customers from abusive corporate practices.
The emergency rule, while not explicitly banning gender-affirming care, implies an effective ban on treatment for people diagnosed with mental illnesses or autism, as well as those lacking the resources or means to navigate the strict requirements. The regulation references various far-right conspiracy theories and requires medical providers to repeat them. One such theory claims that puberty blockers and hormone therapy are dangerous and unapproved by the Food and Drug Administration. In reality, these treatments are FDA-approved for multiple medical conditions and are considered safe.
Gender-affirming surgeries are also safe and provide significant benefits for trans people seeking them. By imposing this new rule, Attorney General Bailey is denying trans people the benefits of gender-affirming healthcare, such as improving their mental health condition, reducing suicide risk, and enhancing their quality of life. The emergency regulation also increases the risk of harassment and discrimination against trans people in Missouri. The American Civil Liberties Union (ACLU) in Missouri has expressed its intention to defend transgender individuals’ rights and will take whatever legal action it deems necessary against the new regulations.