Missouri AG announces rule to restrict gender-affirming care for minors
March 20, 2023
Jack Suntrup
JEFFERSON CITY — Missouri Attorney General Andrew Bailey said Monday his office will file an emergency regulation to limit access to gender-related care for minors.
The new rules will require an 18-month waiting period, 15 hourlong therapy sessions and treatment of any mental illnesses before Missouri doctors can provide that kind of care to transgender children, Bailey’s office said.
The move appeared to sidestep the Republican-led Legislature, which has debated, but not passed, legislation to restrict transgender health care for minors, including puberty blockers, hormone therapy and surgeries.
As of late Monday, the attorney general’s emergency regulation had yet to be filed with the secretary of state’s office, said JoDonn Chaney, spokesman for Secretary of State Jay Ashcroft.
Bailey’s announcement came as state lawmakers returned to work Monday after a one-week spring break and hundreds of supporters of anti-transgender health care legislation gathered in the Capitol Rotunda for a rally.
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The rules, which are likely to face a court challenge, were met with derision from a statewide group advocating for LGBTQ people and from parents of children receiving care at the Washington University Transgender Center at St. Louis Children’s Hospital, which has come under fire after a report last month by a former employee, Jamie Reed, alleged substandard care at the clinic.
“We consider this regulation a gross and reprehensible action that puts the health, wellness, and very lives of transgender and gender-expansive youth at risk,” PROMO, a Missouri organization advocating for LGTBQ rights, said in a statement.
Alison Maclean of Kirkwood, whose 12-year-old son is being treated at the Transgender Center, said, “This is completely based in ignorance,” and said the regulation is “perpetuating misinformation.”
A news release from Bailey’s office describes “gender transition interventions” as “experimental.”
Sen. Greg Razer, D-Kansas City, spoke during floor debate on a bill that would end medical care for transgender children who are transitioning. Video courtesy of the Senate media office, editing by Beth O’Malley
Among other things, the emergency regulation would require the patient to receive “a full psychological or psychiatric assessment, consisting of not fewer than 15 separate, hourly sessions over the course of not fewer than 18 months to determine, among other things, whether the person has any mental health comorbidities.”
The regulation would require “any existing mental health comorbidities of the patient” to “have been treated and resolved” prior to gender transition interventions.
Patients would also need to be screened for autism and would need to be evaluated at least annually to make sure “the patient is not experiencing social contagion with respect to the patient’s gender identity.”
Bailey, in a statement, said he was sticking up for children: “I am dedicated to using every legal tool at my disposal to stand in the gap and protect children from being subject to inhumane science experiments.”
In response, PROMO said, “Gender-affirming care is not experimental but a lifesaving and lifegiving standardized path of health care backed by every major medical association in the United States.”
“Bailey’s lack of medical expertise shows,” said Dr. Colleen McNicholas, chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri. “Scientific evidence shows — and the medical community agrees — that gender-affirming care is safe, effective and life-saving.”
Politifact, in a fact-check published in January, called “mostly false” a claim that “all ‘gender affirming care’ for children is 100% experimental. There are zero long-term studies on the effects the drugs and surgeries will have on them.”
Other St. Louis-area parents with transgender children sharply criticized Bailey’s action.
“It’s absolutely horrifying that the attorney general would think he is better informed than medical professionals and parents who absolutely have the best interest of their children in mind,” said Jennifer Goldring of St. Louis County, the mother of a 16-year-old son on testosterone. “I’m terrified of what this means for my child and his mental health if he cannot get the gender-affirming care he needs.”
Goldring said she was unsure whether the order would affect her son, as he is already on testosterone, but would consider moving if that meant getting him the care he requires.
“We would have to figure it out,” she said.
Susan Halla, national board president of TransParent, said she wasn’t surprised by Bailey’s action.
“I think they’re threatened that they’re not going to get these bills through,” she said.
Halla, who lives in south St. Louis and is the mother of a 22-year-old son who was treated by the Transgender Center, accused Bailey of “fearmongering and using misleading and false information.”
“We will continue to fight this,” she said. “It’s disappointing that they continue to rely on lies and false information to garner votes for their reelection campaign.”
Bailey, a Republican, took office in January after his appointment by Gov. Mike Parson. He said he is running for a four-year term in 2024.
Chuck Hatfield, a Jefferson City attorney and former aide to former Attorney General Jay Nixon, a Democrat, cast doubt on Bailey’s action.
“It’s a creative strategy, and I don’t know that it’s going to hold if somebody takes him to court,” he said.
He called doing an emergency regulation “unusual” and said “that’s supposed to be reserved for, you know, actual emergencies — immediate threat to public health or safety.”
Julie Flory, vice chancellor of marketing and communications for Washington U., said the university will review the regulation once it is filed.
“We take the care and safety of our patients very seriously,” Flory said in an email. “Our focus remains on our commitment to providing compassionate, family-centered care to all of the patients and families we serve.”
After convening after 4 p.m., senators returned to debate on health care for transgender minors.
Instead of debating legislation sponsored by Republican Sen. Mike Moon, R-Ash Grove, who has feuded with GOP leadership, senators were debating legislation by Sen. Holly Rehder, R-Sikeston, that would also restrict transgender athletes and health care.
Debate stretched late into the evening.
Post-Dispatch reporter Colleen Schrappen and The Associated Press contributed to this report.
Updated at 8 p.m.
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