COLUMBIA, Mo.
— A court in Missouri confirmed on Monday the state’s new law that prohibits certain gender-affirming health care for minors, marking a significant win for proponents of the regulation while similar legal battles unfold in various jurisdictions across the country.
Missouri’s Republican Attorney General, Andrew Bailey, announced that the state is the first in the U.S. to uphold such a law at the trial court level. Bailey, who previously sought to restrict minors’ access to gender-affirming care through regulatory means before the law was passed, is tasked with defending it in court.
“I take great pride in the extensive work my office has undertaken to highlight the absence of supporting evidence for these irreversible medical procedures,” Bailey stated. “Our fight will persist to ensure that Missouri remains the safest state for children.”
Opposition to the bans has been voiced by all major medical organizations, including the American Medical Association, which advocate for the appropriate medical treatment of youth.
Lambda Legal and the ACLU of Missouri, representing the challengers aiming to overturn the law, expressed their intentions to appeal the decision shortly after the ruling was issued.
Missouri joins at least 26 other states that have enacted laws limiting or outlawing gender-affirming medical services for transgender minors. While federal courts have previously deemed the bans in Arkansas and Florida unconstitutional, a federal appeals court has temporarily paused the enforcement of the Florida ruling, and Montana currently has a temporary injunction in place against its own ban. Additionally, restrictions in New Hampshire are scheduled to begin in January 2025.
The law in Missouri specifically prohibits gender-affirming surgeries for individuals under 18, as well as access to hormones and puberty blockers for minors not already undergoing such treatments as of August 2023. This law is set to expire in August 2027.
Major medical organizations endorse these treatments as essential care that should be available to transgender individuals. Under the new Missouri law, adults will still have access to gender-affirming health care, albeit without Medicaid coverage.
Several families of transgender adolescents are among the plaintiffs, asserting that the law denies necessary medical treatments to minors while still permitting access to similar interventions for other children. However, Judge Craig Carter of the Wright County Circuit Court disagreed, stating in his ruling that he perceives “an almost total lack of consensus on the ethical considerations surrounding adolescent gender dysphoria treatment.”
“The evidence presented during the trial revealed significant disagreement regarding the ethics of drug and surgical treatments for adolescent gender dysphoria, along with uncertainty regarding the extent of permissible treatment,” Judge Carter remarked.
In response, Lambda Legal and the ACLU of Missouri declared that the ruling reflects a concerning acceptance of discrimination, disregarding extensive trial records and the testimonies of transgender Missourians and their advocates. They argued that the ruling denies transgender adolescents and Medicaid recipients their right to access necessary, evidence-based, and often life-saving health care.
States that have implemented laws restricting or banning gender-affirming treatments for transgender minors now include Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wyoming.