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Missouri House passes restrictions on gender-affirming care

The state’s Republican governor is expected to sign legislation that prohibits transgender minors from getting gender-affirming care and playing on school sports teams that match their gender identity.

JEFFERSON CITY, Mo. (CN) — In a move that will almost certainly draw a legal challenge, the Missouri House of Representatives on Wednesday approved a ban on puberty blockers and hormone therapy for transgender minors.

The state’s Republican-dominated Legislature also signed off on a measure requiring athletes to compete on school sports teams aligned with their sex assigned at birth.

The legislation affects transgender adults by prohibiting Medicaid payments for hormone therapy, puberty blockers and gender surgeries. It also prohibits gender surgeries for prisoners, and blocks surgeries for minors completely. Doctors who treat patients in violation of the law would be subject to professional discipline and civil liability.

Patients being treated with puberty blockers or hormone therapy before the law takes effect would be able to continue treatment through 2027.

The measures have been sent to Governor Mike Parson for his approval. Parson, a Republican, is expected to sign the restrictions after threatening to keep lawmakers in a special session if the measures weren’t passed by Friday.

Once Parson signs the bills, the restrictions will take effect Aug. 28. Most of the restrictions are set to expire in four years.

Missouri will join a wave of other red states including neighboring Arkansas, Kentucky and Oklahoma that have approved limits on gender-affirming care for minors.

Supporters of the restrictions claims minors lack the life experience to make such life-altering decisions and will regret going through transgender treatment later in life.

Opponents claim the bans are nothing but an attack on the transgender community and Republicans are interfering with private medical decisions.

House Republicans originally wanted a more restrictive measure that would immediately block all gender-affirming care for minors, but Democrats were able to work in a four-year window to allow current patients to continue treatment.

Gender-affirming care has become a hot-button topic in Missouri immediately after it became the first state to outlaw abortion just minutes after the U.S. Supreme Court overturned Roe v. Wade last year.

“It just seems unfair to the child,” Representative Lane Roberts, a Republican from Joplin, told Courthouse News during a phone interview in March. “Most parents of either persuasion, whether conservative or liberal, probably want to protect their children. But there are those who, for one reason or another, seem to want to abdicate to the child. I don't understand that.”

Democratic Senator Greg Razer, the only openly gay member of the state’s Senate, has been a vocal opponent of restrictions on gender-affirming care. He said the GOP has been using LGBTQ rights as a wedge issue for decades.

“And that's bad enough, but at least I'm an adult,” Razer said in a March phone interview. “Attack me as an adult and I can defend myself. They're taking children and the health care that children need on an issue that they don't understand, and they will admit they don't understand. So why are we legislating health care decisions over the advice of every major medical organization in the country?”

He also said the issue of transgender sports participation has been blown out of proportion.

“There are 311,000 Missouri students who participate in sanctioned middle and high school sports in Missouri,” Razer said. “Of those 311,000, approximately five are transgender. That means you are four times more likely to be struck by lightning than you are to be a trans kid on a sports team in Missouri.”

Razer and other Democrats worry that the bills are sending a message that transgender people aren’t welcome in Missouri, which could drive people from the state.

Katherine Sasser, a Columbia School District board member who has a transgender daughter, announced Monday that she was resigning and leaving the state due to the restrictions under consideration, the Columbia Daily Tribune reported.

In a separate matter, Attorney General Andrew Bailey, a Republican, became the first state attorney general to attempt to limit gender-affirming care when he announced emergency regulations prohibiting gender-affirming care on March 20. The restrictions, which apply to both minors and adults, include an 18-month waiting period, 15 hourlong psychiatric assessment sessions and a requirement that any mental conditions are “resolved” before Missouri doctors can provide gender-affirming care.

Lambda Legal and the American Civil Liberties Union filed a lawsuit challenging the orders in the St. Louis County. That case is still pending, with a hearing set for June 20 and a temporary restraining order in place until June 24.

“The decision by Missouri's legislature to join in the shameful chorus of anti-trans legislation by advancing two bills that restrict the rights and freedoms of young transgender people on the same day is astonishing and cruel," Lambda Legal Attorney Nora Huppert said in a statement. "SB49 lacks even a whisper of rhyme or reason and endangers the health and wellbeing of Missouri's transgender community. As we continue to fight against Missouri's Attorney General's so-called 'emergency rule,' today's news is a stark reminder that attacks on transgender people continue to grow both in number and in their shamelessness.”

Bailey said he is reviewing his options regarding his pending order in light of the passage of the bills.

“I’m extremely pleased with the legislature’s move to halt the mutilation of children in the state of Missouri," Bailey said in a statement. "As I’ve held all along, there is no scientific evidence supporting these experimental procedures, and I’m proud to have led in the fight to protect Missouri’s children."

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