Transgender minors and some adults in Missouri will soon be banned from accessing puberty blockers, hormones and gender-affirming surgeries under a bill signed Wednesday by the state's Republican governor.
Beginning Aug. 28, Missouri health care providers won't be able to prescribe those gender-affirming treatments for teens and children. Most adults will still have access to transgender health care under the law, but Medicaid won't cover it.
Gender-affirming surgeries for inmates and prisoners will be outlawed.
The law is set to expire in 2027 as part of a Republican compromise with Senate Democrats.
The FDA has not approved the medications specifically to treat gender-questioning youth. But they have been used for many years for that purpose “off label,” a common and accepted practice for many medical conditions. Doctors who treat transgender patients say those decades of use are proof the treatments are not experimental.
Gov. Mike Parson also on Wednesday signed legislation that would ban transgender girls and women from playing on female sports teams from kindergarten through college. Both public and private schools face losing all state funding for violating the law.
"I think the idea of trying to say that ‘Hey, Missouri is not transgender friendly, or that we're trying to drive people out state’ is really a false narrative. What we're trying to do is protect children,” Parsons said.
The St. Louis County Health department sent out a health advisory saying if you know someone in Missouri who needs gender affirming care, have them act right away.
"The community is rightfully upset and very angry,” said Robert Fischer of LGBTQ advocacy group PROMO. "It was even more impactful for our community because he signed it during pride month."
Michael Walk of West County has a teenager transgender daughter.
"She knows how much having access to gender-affirming healthcare have meant to her. Her emotional state has lifted so much … It's a shame that for several years now, kids will not be allowed to access the same healthcare,” he said.
Youth who are already receiving gender-affirming care before the new law kicks in can continue doing so in Missouri.
Fischer says some families are packing up for other states.
"Many people are leaving now. There are people that are leaving at the end of this month … to protect their children,” he said.
"It creates waves of anxiety for all the trans kids because although most of them may not play sports, they feel like they are being put in the position of someone who is an outsider, and they are already a lot of them feel that way. They don't need to be made to feel more outside. They need to be included more,” Walk added.
Parson called on the Republican-led legislature to pass the bills in the final weeks of its session and threatened to keep them working past their May 12 end date if they don't.
Republican leaders of the House and Senate pledged months ago to pass the bills, but the chambers disagreed on how restrictive the bans should be.
The House ultimately took up the Senate’s toned-down version of the health care bill, which includes an exception that allows transgender minors to continue receiving gender-affirming health care if they have already started treatment.
Missouri’s bans come amid a national push by conservatives to put restrictions on transgender and nonbinary people, which alongside abortion has become a major theme of state legislative sessions this year.
A legal challenge to the laws is possible. When the legislature first passed the bills, the ACLU of Missouri said it “will continue to explore all options to fight these bans and to expand the rights of trans Missourians.”
The state’s Planned Parenthood clinics have been ramping up available appointments and holding pop-up clinics to start patients on treatments ahead of the law taking effect.
“We will continue to do everything in our power to ensure all patients are supported, seen, and cared for,” said Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, in a statement. “Any patient wanting to continue their gender-affirming care in a state that welcomes people of all identities: our Fairview Heights, Illinois, health center is open to you and we are here to help you make plans to get care.”
Missouri Attorney General Andrew Bailey, a Republican now campaigning for reelection, launched an investigation in February into St. Louis’ Washington University Transgender Center. A former staffer had complained that doctors were prescribing hormones too quickly and without enough mental health wraparound services. An internal Washington University review found no malpractice.
Bailey has since expanded his investigation to any clinic offering pediatric gender-affirming care in Missouri and demanded records from a St. Louis Planned Parenthood where doctors provide such health care.
In April, Bailey took the novel step of imposing restrictions on adults as well as children under Missouri’s consumer-protection law. A judge temporarily blocked the limits from taking effect as she considers a legal challenge.
"The Department of Public Health firmly believes in the right to access life-saving healthcare. Our department stands in solidarity with transgender and gender diverse communities and LGBTQ+ advocates," said St. Louis County Department of Health Director Dr. Kanika Cunningham said. "As a physician, I am disappointed with this bill. I support the wellbeing of our transgender youth and their families. Transgender Missourians deserve to live free of fear and oppression, and we will not stop working and advocating alongside LGBTQ+ partners until that is a reality."
The Department of Health is sharing the following resources to those impacted:
- The SPOT with Washington University School of Medicine at 314-535-0413. The SPOT provides gender-affirming health services to youth ages 13–24.
- Planned Parenthood Illinois provides gender-affirming healthcare services, in-person and virtually. Call 1-800-230-7526 to book an appointment.
- Planned Parenthood of the St. Louis Region at 314-531-7526.
- Trans Parent St. Louis Chapter at stlouis.mo@transparentusa.org. Trans Parent offers support, resources, and guidance to parents of trans youth.
- For transgender individuals who may need financial assistance for gender-affirming care, please be aware of the resources assembled by the Campaign for Southern Equality:
- Metro Trans Umbrella Group (MTUG) for local services and resources available to transgender individuals. MTUG maintains a list of inclusive therapists and medical providers.
- Trans Lifeline at 877-565-8860 or the St. Louis Queer+ Support Helpline at 314-380-7774 for emotional, identity-affirming support.