Judge Upholds Missouri’s Ban on Transgender Procedures for Children

A view of the Missouri State Capitol building's south entrance in Jefferson City, Missouri. Austin Alonzo/The Epoch Times

A Missouri judge has upheld the state’s law that bans transgender procedures for children.

In a ruling handed down on Monday, Judge R. Craig Carter of the Circuit Court of Cole County, Missouri, said the challenge failed to substantiate multiple arguments, including that there exists a medical consensus on whether using drugs and surgeries to treat adolescent gender dysphoria is ethical.

“Regarding the ethics of adolescent gender-affirming treatment, it would seem that the medical profession stands in the middle of an ethical minefield, with scant evidence to lead it out,” Carter wrote.

“States do have abiding interest in protecting the integrity and ethics of the medical profession.”

The law in question, officially known as the Save Adolescents from Experimentation (SAFE) Act, forbids health care providers from prescribing puberty blockers and cross-sex hormones or performing transgender surgeries for individuals younger than 18. Those who were already prescribed the so-called “gender-affirming” medications prior to Aug. 28, 2023, may continue to receive them.

The law also gives patients 15 years after their treatment ends or 15 years after their 21st birthday, whichever is later, to file a civil lawsuit against the medical provider. Patients who are harmed—defined as infertility caused by transgender procedures—may be awarded a minimum of $500,000 with no maximum, and the burden of proof is on the medical provider.

Missouri Gov. Mike Parson signed the law in June 2023, saying that children lack the capacity to provide informed consent for irreversible treatments they might regret later in their lives.

“These decisions have permanent consequences for life and should not be made by impressionable children who may be in crisis or influenced by the political persuasions of others,” Parson said at the time.

The Challenge

The law faced a legal challenge in July 2023, just before it took effect in August. A coalition of LGBT activists, health care providers, and three Missouri families of gender-dysphoric children sued the state, arguing that the SAFE Act violates parental autonomy—the fundamental right of parents to seek and follow medical advice to safeguard their children’s health and well-being.

“The Act’s prohibition on providing evidence-based and medically necessary care for transgender adolescents with gender dysphoria stands directly at odds with parents’ fundamental right to make decisions concerning the care of their children, particularly when it aligns with the adolescent’s liberty interests and right to autonomy in healthcare,” their complaint read.

Carter rejected that argument, saying that the state is acting reasonably to shield children from treatments that could severely disrupt their natural growth, even if the treatments are initiated by parents.

“There is a good reason that state and federal law does not allow minors to make certain decisions, and it stands to reason that parents might be statutorily prevented from taking a child to a care clinic and having a son or daughter undergo these medical and surgical treatments,” he wrote.

The case went through a nine-day trial in September. Among the witnesses testifying for the states were Chloe Cole, a California woman who had her breasts removed at the age of 15 and has since spoken publicly about her regrets; and Jamie Reed, who testified that a St. Louis children’s gender clinic treated many patients without first giving them proper mental health evaluations.

“Her testimony does not arise from any ideological or other bias,” Carter wrote of Reed. “In fact, she is married to a transgender individual.”

The Missouri chapter of the American Civil Liberties Union (ACLU) and Lambda Legal, which argued the case against the state, said in a joint statement that they are “extremely disappointed” in this decision and will appeal.

“The court’s findings signal a troubling acceptance of discrimination, ignore an extensive trial record and the voices of transgender Missourians and those who care for them,” they said in a joint statement.

Missouri Attorney General Andrew Bailey welcomed the ruling.

“The state has a role to play to determine what systems need to be in place to protect the kids and ensure that the adults and the patients understand the lack of science and medicine behind certain recommended procedures,” he said on X.