Missouri is about to force trans adults & teens to detransition. The ACLU is suing.

The American Civil Liberties Union (ACLU) of Missouri has sued to block severe restrictions on gender-affirming care issued earlier this month by the state’s Attorney General Andrew Bailey (R).

Scheduled to take effect on April 27, Bailey’s “emergency regulation” would require both minors and adults in Missouri to receive 15 hourly sessions with a therapist over at least 18 months before receiving gender-affirming care such as hormone therapy or puberty blockers. They would also have to be screened for autism and “social media addiction,” and any mental health issues would have to be treated and resolved before they would be eligible for treatment for gender dysphoria, the AP reports.

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Notably, Bailey’s messaging around the rule framed it as “protecting” children from what he falsely characterized as “experimental” medical treatment, but the final rule as filed with Missouri’s Secretary of State on April 13 included no age limits and thus applies to trans people of all ages.

While some trans individuals will be allowed to maintain their prescriptions while they attempt to receive the assessments required under the new rule, some transgender Missourians have already reported being notified by their doctors that they will no longer be able to prescribe gender-affirming medication.

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“Trans adults are being pulled from gender-affirming care in Missouri,” journalist and activist Erin Reed tweeted earlier this month. “There will be mass medical detransitioning if this rule takes effect.”

As the Missouri Independent reported earlier this month, the rule cites a Missouri law intended to prosecute fraudulent business practices. In a statement, Gillian Wilcox, Deputy Director for Litigation at the ACLU of Missouri, called the move a “dangerous and unlawful twisting of Missouri’s consumer protection laws.”

“This usurping of power will not only inflict harm on transgender adolescents, but its application will immediately jeopardize the health care of transgender adults throughout the state,” Wilcox said. “This chicanery is the Attorney General’s attempt to legislate and harm transgender Missourians while ignoring evidence-based medical treatment for his own political gain.”

The lawsuit filed by the ACLU along with Lambda Legal and Bryan Cave Leighton LLP on behalf of Southampton Community Healthcare, Kelly Storck, Logan Casey, and the families of two transgender people, accuses Bailey of “usurping authority and powers outside those of his office.”

Bailey’s emergency regulation, the lawsuit states, “targets gender-affirming care with unprecedented and unique restrictions so onerous that it effectively prohibits the provision of this necessary, safe, and effective care for many, if not most, transgender people in Missouri.” It alleges that the rule “interferes with the ability of medical and mental health providers to follow these evidence-based protocols. In so doing, the Emergency Rule denies transgender
adolescents and adults medically necessary treatment and prevents parents from exercising their fundamental rights to obtain medically necessary care for their adolescents. It further regulates doctors and mental health providers and prohibits them from treating their patients in accordance with well-established standards of care.”

As noted in the suit, every major medical organization in the United States recognizes that gender-affirming healthcare is evidence-based, safe, and effective and can be medically necessary to treat gender dysphoria.

Dr. Samuel Tochtrop of Southampton Community Healthcare called the emergency order “a baseless and discriminatory attempt to limit the healthcare options for transgender individuals, who already face several barriers accessing necessary and life-saving medical care.”

“This so-called emergency rule is an outrageous attack on basic healthcare for transgender people of all ages, and by imposing extreme restrictions on care for broad categories of Missouri’s transgender people, including adults, it represents a stunning expansion of efforts to target gender-affirming care,” said Lambda Legal staff attorney Nora Huppert. “It relies on debunked and misleading claims and makes a mockery of the phrase ‘evidence-based medicine.’ This unprecedented attempt to use Missouri’s consumer protection law to go after necessary and often life-saving healthcare must be stopped.”