Missouri Gov. Parson signs bill banning gender-affirming care for minors during Pride month

Transgender Missourians under the age of 18 will be prohibited from receiving gender-affirming care under a sweeping ban signed into law Wednesday by Republican Gov. Mike Parson.

The ban, part of a nationwide push to regulate the lives of transgender people, has stoked fear in Missouri’s transgender community and prompted some to consider fleeing the state. It goes into effect on Aug. 28.

“We support everyone’s right to his or her own pursuit of happiness; 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,” Parson said in a statement.

The Republican governor signed the new law during Pride Month, which commemorates the struggle for LGBTQ rights. His schedule did not say he planned to sign the legislation this week. He told reporters that he privately signed both the ban on gender-affirming care and a ban on transgender student athletes Wednesday morning before a ceremony on separate bills.

“I wanted to do that. I didn’t want to put a lot of attention, any more attention on those two bills, and we really just didn’t want to draw attention to it,” he told reporters.

The law, which passed both chambers of the Missouri General Assembly on mostly party-line votes this year, would ban gender-affirming care, which includes hormone therapy and puberty blockers, for people under 18. However, it would allow minors to continue hormone therapy or puberty blockers if they were already prescribed them before the law takes effect. The restrictions on hormone therapy and puberty blockers expire in 2027. The ban on gender-affirming surgeries does not expire.

Doctors who violate the ban could lose their medical licenses and health care providers could face civil lawsuits for prescribing hormones and puberty blockers to minors. The new law also affects adults, prohibiting Missouri Medicaid dollars from covering gender-affirming care and bans prisons and jails from providing gender-affirming surgeries.

When asked by The Star, Parson defended the Medicaid provision.

“Medicaid don’t cover a lot of costs, you know, for a lot of people sometimes,” he said.

Transgender Missourians, Democrats, LGBTQ advocates and doctors have lambasted the legislation, saying the law was an attack on the transgender community.

“I predict many families of trans kids and licensed professionals will flee this state out of fear. Affirming parents of trans kids are already a minority, and they will only be a greater minority,” said Kale Marie Michael, a 21-year-old trans woman from Kansas City.

“Gender-affirming care for trans kids saves lives, legislative decisions such as this one endangers them.”

The new law comes amid a wave of legislation aimed at restricting transgender health care nationwide. Missouri led the nation in the number of anti-LGBTQ bills filed this year with 48, according to a legislative tracker from the ACLU. Parson signed the ban on gender-affirming care the same day he signed a law restricting transgender athletes from participating in women’s sports.

Transgender Kansas Citians are now straddling two states where Republicans are pushing to regulate their lives. Missouri Attorney General Andrew Bailey had attempted to make Missouri the first state in the nation to ban gender-affirming care for both adults and minors. Bailey withdrew his attempt this month after lawmakers approved the ban on minors.

And, in Kansas, a new law requiring trans people to use restrooms and other public accommodations based on their sex at birth will go into effect in July.

House Minority Leader Crystal Quade, a Springfield Democrat, said the law’s restrictions were “cruel and medically inaccurate and already are forcing many families to flee Missouri in order to keep receiving the care they need.”

“Politicians need to get out of the doctor’s offices, stop with this continued government overreach, and quit attacking Missouri’s freedoms,” she said.

Republicans touted familiar talking points about how the legislation protects kids. They have argued that minors should not be able to undergo gender-affirming care until they turn 18. Several pointed to a need to stop gender-affirming surgeries, which are relatively rare in Missouri.

The World Professional Association for Transgender Health updated its guidelines in 2022 to allow for hormone treatment beginning at age 14 and some surgeries as early as 15 or 17, according to an Associated Press report from last June.

State Sen. Denny Hoskins, a Warrensburg Republican, thanked Parson for signing the bill.

“Kids that aren’t old enough to get a tattoo, ride the big rides at Worlds of Fun, see an R rated movie, go to a tanning bed, buy cigarettes and vote certainly aren’t old enough to have life changing transgender surgeries to cut off their private parts,” he said.

While every Republican state senator voted in favor of the ban, three House Republicans, including House Majority Leader Jonathan Patterson, a doctor from Lee’s Summit, voted against it. State Rep. Chris Sander, an openly gay Republican from Lone Jack, and state Rep. Gary Bonacker from House Springs, also voted against the Republican-led bill.

Emily Wales, president and CEO of Planned Parenthood Great Plains, which provides care in the Kansas City region, criticized the legislation in a statement. She said Parson and lawmakers were putting “politics over life-saving health care.”

On the other side of the state, Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, said the organization would work with patients to get care in Missouri or in Illinois, where gender-affirming care is protected under state law.

“No matter what, our doors remain open and we’ll do all we can to secure the care you want and need to live a dignified and authentic life,” Rodríguez said.

Tom Bastian, a spokesperson for the ACLU of Missouri, said in a statement that his organization would “continue to explore all options to fight these bans and to expand the rights of trans Missourians.”

Doctors who provide gender-affirming care told The Star that they won’t be able to provide ethical, evidence-based care under the new law.

Kris Humphreys, a doctor who provides gender-affirming care for adults in the Kansas City area, said that while the law put trans people in danger, it also had galvanized the trans community.

“This bill is not the end,” Humphreys said. “The governor and his supermajority have fired the opening shots but they will lose this war.”

Michael, the trans woman from Kansas City, said the legislation was based on false narratives about trans people and gender-affirming care. In committee hearings this year, Missouri lawmakers listened to testimony from people who had traveled nationally to advocate for bans on gender-affirming care and argued the care was experimental.

At most, Michael said, gender-affirming care for minors consists of social transition and minimal medical transition. She said Missouri lawmakers had failed the trans community this year.

“This will most likely lead to undue burden for kids as they make an escape plan out of Missouri as soon as they can,” she said.