ST. LOUIS, Missouri — Transgender patients can continue receiving gender-affirming care after a temporary Missouri court ruling came down on Monday morning.
Judge Ellen H. Ribaudo of Missouri's 21st Judicial Circuit issued a restraining order against Attorney General Andrew Bailey's proposed restrictions on transgender care for minors and adults.
Transgender health care providers are scheduled to appear in court again for the next round of hearings on May 11, four days before the court's restraining order is scheduled to expire.
Had the court allowed the emergency rule to go into effect, it would've immediately disrupted plans of care for hundreds of adults and teens who are in varying states of gender transition, treatment or therapy.
Ribaudo wrote that hundreds of transgender patients in Missouri were "at high risk of having their medical care interrupted for an unknown length of time" if Bailey's restrictions were allowed to take effect.
She also said Bailey's legal arguments lacked "specific detail or elaboration" and "leave significant room for interpretation of what would and would not be covered by the Act, creating confusion for those tasked with the enforcement of the Rule and those required to comply."
The judge noted the unprecedented attempt to wield state law in this manner, and said Bailey's maneuver "may impermissibly invade a function reserved to the legislature."
Bailey's critics describe the attorney general's emergency rule to restrict access as an abuse of state power against individual liberty.
Elad Gross, a civil rights lawyer running in the Democratic primary for attorney general, said Bailey is singling out a small group of people in such a high-profile manner in order to get attention for himself.
"The emergency is we've got an attorney general who is not doing his job right now," Gross said. "The guy wants to get elected. He's getting on TV every time this stuff happens. And he understands that. So he's just playing the news cycle and he's spending our taxpayer money to do it. It's ridiculous."
Bailey also faced criticism from within his own party last month when Republican Secretary of State Jay Ashcroft told St. Louis Public Radio that he wouldn't want to defend this rule restricting an adult's freedom to choose.
The campaign for Bailey's Republican primary challenger Will Scharf said, "It's disappointing to see an attorney general's office that used to win important cases like this under [U.S. Senator Josh] Hawley and [U.S. Senator Eric] Schmitt lose under Bailey."
Bailey's office said the rule still has a chance of taking effect, though the next chance for that to occur wouldn't be until after the Missouri legislature is scheduled to dismiss. Various proposals in the House and Senate could alter the law to restrict gender-affirming care for minors and would render much of Bailey's emergency rule moot.
"We remain confident in our position because the Court even acknowledged that it deferred its consideration of the science until a later date," Bailey's government spokeswoman Madeline Sieren said in an emailed statement.
The court decision, however, said that kind of extensive, thorough review of medical expertise and scientific studies "cannot be accomplished" in the timeline they were working with.
Missouri Solicitor General Josh Divine, arguing on Bailey's behalf, told the judge last week that she couldn't possibly consider all the various medical factors at play in such a short matter of time.
The judge herself said the scientific portion of the arguments wasn't a factor.
"The question for this Court is what should occur during the pendency of this legal challenge – to allow the Rule to go into effect as written or to continue with the current practices," the judge wrote.
"Our six pages of endnotes speak for themselves: these procedures are experimental," Sieren said. "We will continue to fight for all patients to have access to adequate health care."
James Thurow, a parent of a 16-and-a-half-year-old transgender teen who started therapy five years ago, said Bailey's restrictions would create new barriers to access and could end up driving his family out of the state.
"To be forced out of this state because they want to tell my kid what health care we and his doctors think he needs and wants is just infuriating," Thurow said. "Parental rights and my kids' bodily autonomy should trump anything that these idiots want to say. They don't go to medical school, they have no knowledge about my kid at all and they're trying to tell my kid what health care he needs?"
Thurow said he and his wife watched their transgender son go through an extensive counseling and therapy process five years ago before a doctor eventually prescribed testosterone. He expressed exasperation and frustration with a lack of general understanding of the barriers that already exist in the health care and insurance industries.
"My child's testosterone is a controlled substance," he said. "I mean, it is tightly restricted. I had a tooth pulled recently, and they're handing me opioids, OK? I can't get my kids' [testosterone] that easily."
Thurow said few people likely understand how long and costly the road to gender-affirming care can be for a family and said it's not a decision anyone does impulsively.
"We have people dying because of opioid addiction, OK? No one is dying because of the dose of testosterone they're receiving in their gender-affirming health care," Thurow said.
Gross, who acknowledged the state could take an interest in regulating transgender medical procedures for minors, said the attorney general's public push to enact emergency rules outside of the legislative process showed an imbalance of priorities.
"I think we've got a lot of other issues we've got to deal with in Missouri that should take a very high priority, including our crime rate, violent crime, all of these other issues before you're starting to take health care away from individuals in Missouri," Gross said.
"This is a small population in the country and in the state of Missouri that he is basically trying to bully. And you've got to wonder, 'Why are we spending so much time and resources on this issue in particular?' And the reason is because these folks want to keep us divided," Gross said. "That is the way the corrupt officials maintain power is by keeping all of us divided on issues that don't go to the core responsibilities of their office.
"As long as we're fighting amongst ourselves, we don't see the crazy stuff that these folks are doing. I think more and more people are waking up to the ridiculousness in our attorney general's office right now," he said.
Bailey's office has not yet responded to invitations for an interview on this topic.