Missouri House passes ban on gender-affirming care for minors as AG Bailey releases new rules

The Missouri House on Thursday approved a Republican-led bill that would ban gender-affirming care for minors.

The bill, filed by state Rep. Brad Hudson, a Cape Fair Republican, would ban all gender transition surgeries, hormone therapy and puberty blockers for anyone under the age of 18.

“Sex changes and little kids are two things that should never go together,” Hudson said on the floor Thursday. “I know that, you know that. The majority of the members of this body know that. And we’ve got constituents all across this great state that know that as well.”

Zora Williams, a 41-year-old transgender woman from St. Louis, said she was furious about the vote.

“Transgender people under the age of 18 are not going to be able to get the gender-affirming care that they need and that is not acceptable,” she said in a phone call. “Pretty much everyone in this community has lost someone they care about by suicide… I think we’re going to see more of that.”

Thursday’s vote sets up a potential fight between the House and Senate over legislation aimed at limiting transgender health care. Hudson’s legislation, which passed 103-52, is more strict than the legislation passed by the Missouri Senate last month and does not include two key concessions added by Senate Democrats.

The Senate version allows minors to continue hormone therapy or puberty blockers if they were already prescribed them and the restrictions on hormone therapy and puberty blockers expire in 2027.

The House’s legislation will now head to the Missouri Senate. It’s unclear whether the Senate will take up the bill after it passed its own version last month after hours of filibuster by Democrats. The House could ultimately take up the Senate’s version, which passed out of the House General Laws Committee later on Thursday.

House Democrats on Thursday lambasted Republicans for bringing the bill to a vote Thursday, saying that they were focusing on culture war issues instead of policies that help Missourians.

“You’re letting the culture wars take over your souls,” House Minority Leader Crystal Quade, a Springfield Democrat and potential candidate for governor, told Republicans Thursday. “I am tired of standing at this microphone trying to shame you into paying attention to what actually matters.”

Missouri Republicans have argued that minors should not be able to undergo gender-affirming care until they turn 18. The bill is part of an onslaught of legislation nationally that targets procedures that assist minors in transitioning genders and ban transgender girls from women’s sports.

“A yes vote is a vote to protect kids from sex change drugs and surgeries,” Hudson said. “A no vote is to not offer that protection.”

But LGBTQ rights advocates have said the legislation targets both transgender kids and doctors. They say the bills are part of a national attack on the LGBTQ community by Republicans. LGBTQ rights advocates were scheduled to hold a rally Thursday in response to similar legislation passed by the Kansas Legislature last week.

Shortly after the Missouri House vote, Missouri Attorney General Andrew Bailey, a Republican, filed a set of emergency rules aimed at restricting how doctors provide gender-affirming care to minors.

The rules take effect on April 27 and expire on Feb. 6, 2024. They include strict psychological therapy requirements for doctors providing care as well as banning care until all of a patient’s other mental health issues have been treated and resolved.

PROMO Missouri, an LGBTQ advocacy group, criticized Bailey in a statement Thursday, saying his rules would also affect transgender adults seeking gender-affirming care.

“His actions today fanned the flames of hate by including transgender adults’ ability to access care in his culture war,” the statement said. “We are living through an all out attack on transgender Missourian’s lives and very ability to exist.”

Madeline Sieren, Bailey’s spokesperson, did not push back when asked if the rules would affect adults seeking transgender health care.

“We have serious concerns about how children are being treated throughout the state, but we believe everyone is entitled to evidence-based medicine and adequate mental health care,” Sieren said in an email.

Doctors and LGBTQ advocates previously told The Star that Bailey’s rules would be difficult to enforce but may create a chilling effect for both patients and doctors providing care.

“Wouldn’t surprise me if this effectively halts any gender affirming care on minors in the state of Missouri,” Brandon Barthel, a Kansas City-based endocrinologist who provides care for transgender adults told The Star when Bailey’s rules were first announced last month.