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Missouri governor signs ban on transgender health care and school sports

Beginning August 28, Missouri health care providers won’t be able to prescribe those gender-affirming treatments for teens and children

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

Transgender minors and some adults in Missouri will soon be limited from accessing puberty blockers, hormones and gender-affirming surgeries — as well as some school sports teams — under bills signed Wednesday by the state’s Republican governor.

Beginning Aug. 28, Missouri health care providers won’t be able to prescribe those gender-affirming treatments for teens and children. Most adults will still have access to transgender health care under the law, but Medicaid won’t cover it. Prisoners in the state must pay for gender-affirming surgeries out-of-pocket under the law, the governor’s spokesperson Kelli Jones said.

Gov. Mike Parson called hormones, puberty blockers and gender-affirming surgeries “harmful, irreversible treatments and procedures” for minors.

“We support everyone’s right to his or her own pursuit of happiness,” Parson said in a statement Wednesday. “However, we must protect children from making life-altering decisions that they could come to regret in adulthood once they have physically and emotionally matured.”

Every major medical organization, including the American Medical Association, has opposed the bans on gender-affirming care for minors and supported the medical care for youth when administered appropriately. Lawsuits have been filed in several states where bans have been enacted this year.

Parson also signed legislation Wednesday to ban transgender girls and women from playing on female sports teams from kindergarten through college. Both public and private schools face losing all state funding for violating the law.

“Today, Governor Parson showed just how little Missouri’s state government values LGBTQ+ lives and, in particular, transgender and gender-expansive youth,” said Shira Berkowitz, of the state’s LGBTQ+ advocacy group PROMO.

The laws are set to expire in 2027 as part of a Republican compromise with Senate Democrats.

Parson called on the Republican-led Legislature to pass the bills in the final weeks of its session and threatened to keep them working past their May 12 end date if they did not.

Republican leaders of the House and Senate pledged at the beginning of session to pass the bills, but the chambers disagreed on how restrictive the bans should be.

The House ultimately took up the Senate’s toned-down version of the health care bill, which includes an exception that allows transgender minors to continue receiving gender-affirming health care if they have already started treatment.

“The governor could have said ‘no’ to bigotry and hate,” Missouri House Democratic Minority Leader Crystal Quade said in a statement. “Instead he embraced it.”

Missouri’s bans come amid a national push by conservatives to put restrictions on transgender and nonbinary people, which alongside abortion has become a major theme of state legislative sessions this year.

At least 20 states, including Missouri, have now enacted laws restricting or banning gender-affirming medical care for transgender minors.

A legal challenge to Missouri’s laws is possible. When the Legislature first passed the bills, the ACLU of Missouri said it “will continue to explore all options to fight these bans and to expand the rights of trans Missourians.”

Federal judges have blocked enforcement of laws in Alabama and Arkansas, and Oklahoma has agreed to not enforce its ban while opponents seek a temporary court order blocking it.

Missouri’s Planned Parenthood clinics had been ramping up available appointments and holding pop-up clinics to start patients on treatments ahead of the law taking effect.

In April, Missouri’s Republican Attorney General Andrew Bailey took the novel step of imposing restrictions on adults as well as children under Missouri’s consumer-protection law. He pulled the rule in May after the GOP-led Legislature sent the bills to Parson.

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