One of the laws prohibits minors from commencing puberty blockers and hormonal treatments, and it also prohibits gender-affirming surgeries for young individuals. The other law mandates that student athletes from kindergarten through college participate in sports teams that correspond with their sex as identified at birth.
Republican Governor Mike Parson signed these bills into law in June, following pressure from him and other supporters of the legislation on the GOP-led legislature. Both laws have a sunset provision set for 2027.
Advocates of the LGBTQ+ community who sought to challenge the health care law were dealt a setback when a judge permitted the law to take effect as the legal challenge unfolds.
HEALTHCARE
The health care law bars physicians from providing gender-affirming healthcare to minors. However, individuals under 18 years of age who were prescribed puberty blockers or hormones prior to August 28 are allowed to continue receiving those treatments.
Missouri’s Planned Parenthood clinics had ramped up available appointments and held pop-up clinics to initiate patients on treatments before the law’s implementation.
While adults still retain access to transgender health care under this law, Medicaid coverage is not applicable, and access to surgeries for inmates is restricted.
Caitlin Whaley, spokesperson for the Missouri Department of Social Services, stated that the state’s Medicaid program “has not historically paid” for gender-affirming surgeries. Changes have been made to Medicaid to prevent payments for hormones and puberty blockers.
Dr. Colleen McNicholas, Chief Medical Officer of Planned Parenthood of the St. Louis Region and Southwest Missouri, expressed concerns that the ban on Medicaid coverage might necessitate adult patients already receiving treatments to transition to providers accepting out-of-pocket payments.
Republican Attorney General Andrew Bailey addressed a letter to several healthcare providers, including Planned Parenthood, notifying them of the law’s implementation. Bailey had previously attempted to impose restrictions on gender-affirming health care through rulemaking. His office is currently defending the health care law in court. Violation of the law by physicians could result in revoked licenses and lawsuits from patients.
A state board of physicians appointed by the governor oversees licensure and revocation of licenses in Missouri.
LAWSUIT
The ACLU of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner filed a lawsuit last month seeking to overturn Missouri’s transgender health care law on behalf of doctors, LGBTQ+ organizations, and three families of transgender minors. Alleging that the law is discriminatory, they requested that it be temporarily suspended during the course of the legal challenge. A St. Louis judge disagreed, and last week ruled that the law could remain in effect throughout the lawsuit. The next hearing in the case is scheduled for September 22.
SCHOOL SPORTS
Effective immediately, student athletes are only permitted to participate in K-12 and college sports teams consistent with their sex assigned at birth. This means transgender girls and women cannot join girls’ and women’s school teams, and transgender boys and men can only participate in girls’ and women’s teams.
Girls and women can join boys’ and men’s teams if no corresponding sports program exists for them.
Verification is based on birth certificates or other official documents, but only records created shortly after birth are accepted. Amended birth certificates are only permissible in cases of typographical errors and similar mistakes.
The state education department is responsible for establishing additional enforcement rules for this law, which is not currently facing a legal challenge.
Schools, including private institutions, risk losing all state funding for violating the law. Parents, adult students, and former students can file lawsuits if they believe a violation of the law resulted in the loss of an “athletic opportunity.”
OTHER STATES
At least 22 states have enacted laws that ban or restrict gender-affirming care for minors, with many of these bans subject to legal challenges.
North Carolina recently joined this trend, with Republican lawmakers overriding Democratic Governor Roy Cooper’s veto to pass a measure that prohibits medical professionals from providing hormone therapy, puberty-blocking drugs, and surgical gender-transition procedures to those under 18, with limited exceptions. While North Carolina’s law took immediate effect, minors who had started treatment before August 1 can continue if their doctors and parents deem it medically necessary. Opponents of the law have indicated plans to challenge it through a lawsuit.
A federal judge in June invalidated Arkansas’ pioneering ban, and the state has appealed this decision. The judge in the case ruled that the prohibition violated the constitutional rights of transgender youth, families, and medical providers. He also dismissed proponents’ arguments that these treatments were experimental.
Critics of treatments for children argue that they are too young to make decisions about their futures.
All major medical organizations, including the American Medical Association, have opposed bans on gender-affirming care for minors and supported medical care for youth when administered appropriately. The American Academy of Pediatrics recently reiterated its support for these treatments and committed to conducting an external review of research on the topic.