Families, providers sue to block Missouri law banning gender-affirming care for minors

Three Missouri families, along with medical providers, are suing the state to block a law banning transgender youth from receiving gender-affirming medication or surgery. The law is set to take effect on Aug. 28.

The lawsuit was filed by Lambda Legal, the ACLU of Missouri and law firm Bryan Cave Leighton Paisner LLP in Cole County Circuit Court. In addition to the families of transgender young people, PFLAG National and GLMA: Health Professionals Advancing LGBTQ+ Equality are also part of the lawsuit.

Gov. Mike Parson signed SB 49 into law on June 7. SB 49, which was sponsored by Sen. Mike Moon of Ash Grove, prevents health care providers from performing gender-affirmation surgery or administering gender-affirmation hormones or drugs to minors. It also bars MO HealthNet, which is Missouri's Medicaid program, from providing payment for gender-affirming surgeries and hormones, and puberty-blocking drugs.

"Governor Parson signed Senate Bill 49 to protect Missouri children and supports efforts by Attorney General Bailey to defend the legislation," said Jonathan Shiflett, Parson's press secretary.

In a statement regarding the lawsuit, Moon maintains that the law "acts as a pause button" and that he has seen no evidence to support the plaintiff's claims that gender-affirming health care such as puberty blockers, hormone and surgery are safe for minors.

"In simple terms, SB 49 acts as a pause button. We must allow children to grow into adulthood, unharmed by these dangerous practices," Moon said.

The bill also stipulates that "elective gender transition surgeries" are not included in the health care services provided to incarcerated individuals in Missouri.

"On its face, the law enshrines discriminatory practices in our health care system by specifically denying transgender Missourians under the age of eighteen access to evidence-based gender-affirming medical care while stripping parents of their fundamental right to make medical decisions for their children," said Gillian Wilcox, deputy director of litigation at the ACLU of Missouri in a press release. "Extreme politicians in Missouri, like the Attorney General, have made known their desire to ban gender-affirming care throughout the state. This legislation targets very specific, vulnerable populations — young people, those who access health care through Medicaid, and incarcerated individuals — to replace private medical decisions with the will of politicians in Jefferson City."

Prior to the bill passing in the Missouri Legislature and the governor signing it into law, Attorney General Andrew Bailey announced an emergency rule on April 13 that put regulations in place for anyone seeking gender-affirming health care. On April 24, legal advocacy groups filed a motion requesting a temporary restraining order that would block the emergency rule from being enforced. A temporary restraining order was granted, but once SB 49 passed in Missouri's Legislature, Bailey terminated the rule.

“We were standing in the gap unless and until the General Assembly decided to take action on this issue. The General Assembly has now filled that gap with a statute," Bailey said in a statement at the time. "I’m proud to have shed light on the experimental nature of these procedures, and will continue to do everything in my power to make Missouri the safest state in the nation for children.”

In response to the lawsuit seeking to halt the law, Bailey said: “There are zero FDA approvals of puberty blockers or cross-sex hormones to treat gender dysphoria in children. We’re not going to let left-wing ideologues experiment on children here in the state of Missouri.”

What other states are suing to block similar laws?

As of 2023, at least 19 states have passed similar laws preventing health care providers from giving minors gender-affirming care. In 11 of those states, families and health care providers have sued to prevent those laws from going into effect.

Alabama

In 2022, Alabama passed a first-of-its-kind law making it a felony, punishable by up to 10 years in prison, to give the medications to assist transgender minors in their transition. Five parents are part of Boe v. Marshall, a lawsuit arguing that the law "intrudes into the right of parents to make medical decisions to ensure the health and wellbeing of their children."

Last year, a district court judge blocked parts of the law, and then state officials appealed that decision. Currently, aspects of the original lawsuit are still being considered by U.S. District Judge Liles Burke, according to AL.com.

Arkansas

In Brandt et al. v. Rutledge et al., four families of transgender youth and two doctors challenged a 2021 Arkansas law prohibiting health care professionals from providing or referring trans youth "for medically necessary" health care, according to the ACLU. The lawsuit was filed in federal court and alleges that the law is a violation of the U.S. Constitution.

On June 20, a federal district court judge struck down and permanently prevented Arkansas from enforcing the law.

Florida

Three Florida families are challenging a May 2023 law that restricts gender-affirming care for children. In early June, a federal judge indicated that the ban will likely be found unconstitutional, but only listed the three families who filed suit when he issued his preliminary injunction.

Idaho

In Poe v. Labrador, two Idaho families are challenging a 2023 law that criminalizes providing gender-affirming medical care to transgender youth. Physicians face up to 10 years in prison and a felony conviction of they provide hormones, puberty blockers or other gender-affirming care to people younger than 18.

The lawsuit is ongoing.

Indiana

In K.C. v. Medical Licensing Board of Indiana, four Indiana families and Dr. Catherine Bast, medical director at Mosaic Health & Healing Arts, challenged a 2023 law that prohibited health care professionals from providing or referring transgender people under 18 for gender-affirming health care.

On June 16, a federal judge temporarily blocked the law.

Kentucky

In Doe v. Thornbury, seven trans children and their parents filed a lawsuit challenging sections of a March 2023 law that would ban puberty blockers and hormone therapy for trans youths. On June 28, a federal judge issued a temporary injunction.

More: Missouri governor signs several laws, including on transgender athletics, health care

Montana

In Van Garderen et al. v. State of Montana, three Montana families and two medical providers are challenging a 2023 law banning gender-affirming care for trans youth. According to the ACLU, the families and medical providers say the law is "violating their rights under the Montana Constitution, including the right to equal protection, the right to access medical care, and the right of parents to direct the upbringing of their children."

The lawsuit is ongoing.

Nebraska

In May 2023, the Nebraska legislature passed a bill that included a provision banning abortion starting at 12 weeks of pregnancy and another provision restricting health care for trans youth. Abortion providers are suing state officials to protect constitutional rights and rights of their patient in PP of the Heartland v. Hilger. The lawsuit argues that the law violates the state's single-subject requirement, which says that no bill can contain more than one subject.

The lawsuit is ongoing.

Oklahoma

In Poe v. Drummond, a group of families and a medical provider sued to challenge a 2023 law imposing criminal penalties on healthcare providers who provide medical care for transgender adolescents.

On May 18, Oklahoma agreed not to enforce the rule, and to give both sides time to file briefs in the case.

More: Missouri AG requests termination of emergency rule restricting gender-affirming care

Tennessee

In L.W. v. Skrmeitti, a family and two anonymous plaintiffs sued to challenge a law that bans gender-affirming care for minors and requires minors currently receiving gender-affirming care to discontinue that care by March 31, 2024. While a federal judge blocked the law on June 28, a federal appeals court temporarily reinstated the law on July 8.

Texas

In Loe v. Texas, five Texas families, three medical professionals and two organizations are suing to challenge a law passed in spring 2023 banning gender-affirming care for trans youth and require the state to revoke the medical licenses of physicians that provide care to minors.

The lawsuit is ongoing.

Susan Szuch is the health and public policy reporter for the Springfield News-Leader. Follow her on Twitter @szuchsm. Story idea? Email her at sszuch@gannett.com.

This article originally appeared on Springfield News-Leader: Advocates sue Missouri over gender-affirming care ban for minors