Missouri AG rule restricts gender-affirming health care

Republican Missouri Attorney General Andrew Bailey issued an “emergency rule” last week that severely restricts access to guideline-directed gender-affirming healthcare for minors as well as adults in the state.

The rule was made under the Missouri Merchandising Practices Act and is slated to take effect on April 27 after paperwork is filed with the Missouri Secretary of State’s office.

The state’s American Civil Liberties Union chapter and Lambda Legal promised to take “any necessary legal action” in a joint statement released hours after the rule was made public.

“The attorney general’s so-called emergency rule is based on distorted, misleading and debunked claims and ignores the overwhelming body of scientific and medical evidence supporting this care as well as the medical experts and doctors who work with transgender people every day,” the groups wrote.

Bailey’s restrictions go further than most anti-transgender policies that have been implemented in other conservative states, for example by requiring patients of all ages to complete 15 hourly sessions with a mental health professional over the course of 18-months and have a diagnosis of gender dysphoria for three “most recent, consecutive years” before treatment with puberty blockers, hormones or gender-transition surgery.

Trans Missourians with autism would be barred from accessing gender-affirming care, while those diagnosed with anxiety or depression would have to resolve those conditions beforehand. Patients who receive care would be required to complete 15 years of follow-ups.

As activist and legislative researcher Erin Reed pointed out in her newsletter on the rule, “Many transgender people suffer from depression or anxiety before transitioning and gender-affirming care is the most effective treatment.”

Additionally, “To delay gender affirming care for three years for transgender adults is exceptionally cruel,” Reed wrote. “Most gender affirming care in America is done according to WPATH standards via informed consent and no forced waiting period.”

Shannon Minter, legal director of the National Center for Lesbian Rights, urged his followers to call Republican Missouri Gov. Mike Parson to demand a rescission of the attorney general’s order.

Full statement by national LGBTQ Legal Groups condemning Missouri action barring healthcare for transgender people:

“Today, Missouri Attorney General Andrew Bailey issued an Emergency Rule regarding the medical treatment of transgender people. Lambda Legal, the American Civil Liberties Union (ACLU), the National Center for Lesbian Rights (NCLR), Human Rights Campaign (HRC), and GLBTQ Advocates and Defenders (GLAD) issued the following statement.

“As national legal groups who represent LGBTQ people and their families in every state across this country, we condemn the lawless action of Missouri’s Attorney General in purporting to bar essential medical care for both transgender adolescents and adults.

“This action by Missouri’s Attorney General crosses a red line that should strike fear in the heart of every person who values individual liberty and believes that individuals, not government officials, should make health care decisions for their children and themselves.

“This is a dangerous and unprecedented escalation in the assault on evidence-based health care for transgender people. Cutting off treatment for those who need it will create predictable, unnecessary, and serious harm. It is also a blatant attempt to strip transgender people of equal protection under the law and to subject them to intrusive government surveillance and control.

“We wish to make unequivocally clear that we will challenge this and any similar attempt to interfere with the fundamental freedom of transgender people to obtain medically necessary care and to be treated as equal, respected, and participating members of our democracy.

“Lambda Legal and the ACLU of Missouri are prepared to fight back in court and have announced their intention to take legal action against this order.

“At this critical moment for our nation, we call on all freedom-loving people to join us in condemning this dangerous abuse of government power and to affirm that every person in this country is of equal value and worth and has an equal right to freedom from governmental coercion and tyranny. Transgender people are part of our communities, and we will not tolerate this or any other attempt to deny them the freedom to control their own lives and make decisions about their own medical care.”

CHRISTOPHER KANE