Missouri attorney general rescinds rule restricting gender-affirming care

Missouri Attorney General Andrew Bailey on Tuesday withdrew an order that would have heavily restricted gender-affirming care for people of all ages in the state.

The order, which his office called an emergency regulation, would have introduced stringent requirements for anyone seeking gender-affirming care in the state. It was intended to go into effect April 27, but was repeatedly stayed by judges. 

Among the requirements in the regulation were mandates that anyone seeking transition-related care have a documented diagnosis of gender dysphoria for at least three consecutive years; receive a “full psychological or psychiatric assessment” consisting of at least 15 separate hour-long sessions over 18 months to explore “whether the person has any mental health comorbidities”; and be screened for autism and “social contagion with respect to the patient’s gender identity.”

While the April 13 statement from Bailey’s office announcing the regulation made repeated references to protecting minors from harm allegedly caused by gender-affirming care, the rule itself applied broadly, with no mentions of age in most of its provisions.

The order kicked off a firestorm of backlash, first in the form of lawsuits filed upon its announcement, and then with a 12-1 vote by city council members in Kansas City, Missouri, to declare their municipality a “sanctuary” for those seeking or providing gender-affirming care.

Bailey’s rescission of the order comes a week after the Missouri Legislature passed a ban on gender-affirming care for minors. That legislation, which has not yet been signed by Gov. Mike Parson, does not apply to adults, unlike Bailey’s emergency regulation.

“The legislature has now passed a ban that exceeds the authority of the rule that we passed, so we will now be prepared to defend the statute in court,” Bailey told Missouri television news station KMOV.

The ACLU of Missouri, which joined Lambda Legal in announcing a lawsuit over the regulation on April 13 after the attorney general’s office first issued it, released a statement Tuesday night after the announcement of the rule’s rescission:

After weeks of embarrassing Missouri on the national stage, the Attorney General has finally joined everyone else in recognizing that his hasty attempt to usurp other branches of government cannot withstand scrutiny. His transparently faux concern for trans youth could not mask that his willingness to abuse his office in an attempt to erase from public all transgender Missourians. Today’s actions are a victory for Missourians’ right to bodily autonomy, but the fight is not over.

The ACLU of Missouri also decried state legislators’ bill that would ban gender-affirming care for minors, along with another recently passed bill that would restrict transgender girls and women from playing on sports teams that align with their gender identity from kindergarten through college, in both public and private schools:

While recently passed legislation is not as extreme as the Attorney General’s unlawful rule, it still rejects the recommendations of every major medical association based on decades of peer-reviewed studies supporting the necessity of life-saving gender-affirming care. If it is allowed to become law, the legislation would substitute the uninformed opinions of politicians for patient and parental consent informed by knowledgeable medical professionals. The Governor should veto Senate Bills 39 and 49 and afford trans youth and their families the dignity of continuing (to) make important medical decisions without interference from the political branches of government.

There’s little indication Parson will reject the bills. Last month, he threatened to call a special legislative session if lawmakers did not pass restrictions on gender-affirming care for minors and trans participation in sports by the end of their current session.

Published with permission of The American Independent Foundation.