Missouri to Restrict Gender-Transition Care of Adults and Minors; 1st in US

Missouri Attorney General Andrew Bailey speaks to his staff in March 2023. Courtesy of the Missouri Attorney General's Office

Missouri Attorney General Andrew Bailey has put in place emergency restrictions on “gender-affirming care” for adults in addition to minors, believed to be the first of their kind in the nation, to protect patients from “deceptive” business practices surrounding transgender procedures.

However, transgender-rights activists say Bailey has opened a new front in the war over such procedures in the United States.

“This is a nuclear bomb on trans people in Missouri. Its effects will be felt for years if it goes into effect,” activist Erin Reed wrote on Twitter.

More than 3 million people viewed Reed’s tweet that stated, “Missouri AG just essentially banned gender-affirming care for most trans adults via emergency rule.”

While many states have proposed or enacted laws banning or restricting the procedures on minors, the Missouri rule is said to be the first that also affects transgender adults.

The Human Rights Campaign wrote on Twitter, “This isn’t just an overreach of authority—it’s an outright attempt to endanger and ultimately erase transgender people statewide.”

Missouri’s new rule (pdf) clarifies that gender-transitioning medical treatments are illegal under existing consumer-protection laws unless medical providers meet certain informed-consent and patient-screening requirements. The rule takes effect on April 27 and expires on Feb. 6, 2024.

Under the rule, medical providers must give patients specific warnings about risks. They also must ensure that patients have received mental health assessments, undergone 18 months of visits with a mental health therapist, and resolved any psychiatric symptoms.

Activist Chloe Cole participates in a demonstration in Anaheim, Calif., on Oct. 8, 2022. Brad Jones/The Epoch Times

Special Concerns About Youth

The rule covers patients of all ages, however, some provisions are tailored to minors.

According to the rule, providers must assess whether “social contagion” played a role in minors’ gender distress and whether young people suffer from “social media addiction or compulsion” that contributed to discontent over their gender.

Current patients may continue their gender-transitioning procedures as long as the mental-health assessments and treatment prescribed in the rule are promptly followed, the rule states.

The rules are unreasonable and restrict transgender people’s access to “gender-affirming care,” according to a joint statement from Lambda Legal and the Missouri chapter of the American Civil Liberties Union. Calling Bailey’s action “a shocking attempt to exploit Missouri’s consumer protection laws,” the groups stated that they would take legal action against the rule if necessary.

“We look forward to defending our regulation in court if we need to,“ Bailey said in an April 14 email to The Epoch Times. ”This regulation injects an ounce of common sense into gender-transition procedures.”

He said recent revelations about the dangers of these interventions compelled him to act quickly to protect the public, including children.

In an April 14 interview with Fox News, Bailey called the rule “innovative,” saying that it’s the first time an attorney general’s authority has been used to create a rule adding safeguards to gender-transitioning practices.

“I would encourage other states to adopt the same policy,” he said.

Flags representing LGBT social movements are posted outside the Stonewall Monument in New York on June 7, 2022. Angela Weiss/AFP via Getty Images

‘Clandestine Network’ Harming Children

The rule applies to “any puberty-blocking drugs, cross-sex hormones, or surgery, for the purpose of transitioning gender, decreasing gender incongruence, or treating gender dysphoria,” which is persistent distress over one’s gender.

Under the rule, providing such gender-transition interventions without specific patient evaluations and warnings is “unfair, deceptive, fraudulent or otherwise unlawful” under Missouri’s consumer protection laws.

Bailey announced his intention to implement such a rule in March. He said concerns have risen about “an immense increase in the use of these life-altering interventions, which have serious side effects.”

Meanwhile, his office has been investigating a gender clinic whistleblower’s allegations since January.

“An investigation has revealed that some providers in Missouri prescribe gender transition interventions without any individualized assessment, contrary to safeguards established in scientific literature and by medical organizations,” the rule states.

In addition, Bailey asserted in a statement, “My office has uncovered a clandestine network of clinics across the state who are harming children by ignoring the science.”

Critics, however, accused Bailey of relying on “debunked” claims that the procedures are harmful.

In his email, Bailey said, “I would point leftists who are ignoring the science to our six pages of endnotes citing to [sic] clinical studies and medical journals supporting that transition-intervention procedures are dangerous and purely experimental.”