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Missouri lawmakers pass bill to ban gender-affirming care for transgender kids

Missouri lawmakers passed a bill on Wednesday to ban gender-affirming health care for transgender minors and another bill that would prevent transgender girls and women from competing on girls' and women's sports teams. The bills were sent to Republican Governor Mike Parson to sign.

Transgender minors in Missouri no longer would have access to puberty blockers, hormones or gender-affirming surgery under one bill passed by the GOP-led House on Wednesday, although minors who already receive puberty-blockers and hormone treatments would be exempt from the new restrictions. The ban also affects some adults — Medicaid health care won't cover any gender-affirming care in the state, and surgery will no longer be available to adult prisoners and inmates.

Another bill, to ban transgender girls and women from participating in female sports teams, would apply from kindergarten through college, both at public and private schools. Schools that allow transgender girls and women to play on such teams would lose state funding.

Both measures would expire in 2027, thanks to concessions made through Republican negotiations with Senate Democrats.

Parson is expected to sign both bills. He threatened to keep lawmakers working beyond the normal end of their session if they didn't approve the gender-affirming care ban, which would take effect Aug. 28.

Transgender Ban-Missouri
Glenda Starke wears a transgender flag as a counter protest during a rally in favor of a ban on gender-affirming health care legislation, March 20, 2023, at the Missouri Statehouse in Jefferson City, Mo. Charlie Riedel / AP

"When you have kids being surgically and or chemically altered for life for no good reason, yes, it's time for the government to get involved," Republican Rep. Brad Hudson told colleagues on the House floor Wednesday.

Democrats wept during debate.

"To deny these children care is to deny them their very existence," Democratic Rep. Joe Adams said.

Missouri's ban comes amid a national push by conservatives to put restrictions on transgender and nonbinary people that has become, alongside abortion, a major theme running through legislative sessions across the country in 2023.

"Every person in the state should be alarmed by this weaponization of the government to intimidate people through the denial of basic health care and exclusion from extracurricular activities," the ACLU of Missouri said in a statement after the bills passed.  

At least 16 states have now enacted laws restricting or banning gender-affirming care for minors, and several states are still considering bills this year to restrict or ban care, creating uncertainty for many families. Florida and Texas have banned or restricted the care via regulations or administrative orders, and a bill to restrict care is on Republican Florida Gov. Ron DeSantis' desk.

At least 21 other states have passed restrictions on transgender athletes' participation in sports.

Missouri's legislative leaders vowed to stop minors from accessing puberty blockers, hormones and surgeries this year. And Missouri's Republican attorney general, Andrew Bailey, took up the charge after Parson appointed him to fill the vacant position in January.

In response, the Kansas City Council was considering a resolution Wednesday to make Missouri's largest city a sanctuary for people seeking gender-affirming care.

Bailey, now campaigning to keep the job in 2024, launched an investigation in February into St. Louis' Washington University Transgender Center following a former staffer's complaints that doctors were prescribing hormones too quickly and without enough mental health wraparound services. An internal Washington University review found no malpractice.

Bailey has since expanded his investigation to any clinic offering pediatric gender-affirming care in Missouri, and demanded records from a St. Louis Planned Parenthood where doctors provide such health care.

In April, Bailey took the novel step of imposing restrictions on adults as well as children under Missouri's consumer-protection law. A judge temporarily blocked the limits from taking effect as she considers a legal challenge.

Under Bailey's rules, before gender-affirming medical treatments can be provided by physicians, people would have to document that they experienced an "intense pattern" of gender dysphoria for at least three years and undergo at least 15 hourly sessions with a therapist for at least 18 months. Screening for autism and "social media addiction" would be required, and a treatment provider would have to declare that any mental health issues are resolved. Some patients could maintain their prescriptions as long as they promptly receive the required assessments.

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