Metro Weekly

Missouri Sued Over Ban on Gender-Affirming Care

Lawsuit argues that the ban is unconstitutional because it discriminates against trans youth and usurps parental rights.

Illustration: Todd Franson.

Two prominent legal groups have sued the state of Missouri on behalf of three families of transgender youth, medical providers, and two prominent LGBTQ organizations, asking a state judge to block the state’s ban on gender-affirming care from being enforced.

The law, SB 49, which is scheduled to take effect on August 28, prohibits health care providers in Missouri from prescribing puberty blockers, hormones, or gender confirmation surgery — the latter of which rarely is prescribed for those under 18 — to minors suffering from gender dysphoria.

The law contains an exception for those who have already begun gender-affirming care that will allow them to continue receiving it if their doctors believe that stopping treatment would do more harm.

The law also prohibits Medicaid from covering the cost of any transition-related treatments or procedures, regardless of the age of the patient — meaning low-income transgender adults are effectively barred from accessing gender-affirming care, and prohibits incarcerated individuals from obtaining gender confirmation surgery.

The lawsuit argues that the ban is unconstitutional, violating the rights of transgender youth by discriminating against them on the basis of both sex and gender identity, and violating parents’ fundamental right to make decisions they believe to be in the best interest of their children.

The lawsuit also claims that, unless the court issues an injunction to block Missouri from enforcing the law, all the plaintiffs will be irreparably harmed. By banning the transgender youth from accessing gender-affirming care, the state is likely to exacerbate the youths’ feelings of anxiety and gender dysphoria, as well as lead to potential mental health issues. 

The lawsuit claims that parents, including members of PFLAG, will have their parental decision-making usurped by the state, and will either be forced to watch their children suffer, or will have to uproot their lives and spend significant amounts of money to travel or relocate out of state to ensure their children can receive gender-affirming care.

The suit also argues that, without an injunction, the law puts providers, including plaintiff Southampton Healthcare, at risk of violating their professional obligations and personal relationships with their patients by refusing to prescribe gender-affirming care to their patients, or, if they do prescribe it, at risk of losing their medical licenses and livelihoods.

“SB 49 is the latest chapter in Missouri’s relentless attacks on transgender people, and the stories of the families challenging the law demonstrate the immense, devastating harm it is already inflicting on their lives,” Nora Huppert, a staff attorney at Lambda Legal, said in a statement. “SB 49 would deny adolescent transgender Missourians access to evidence-based treatment supported by the overwhelming medical consensus. This law is not just harmful and cruel; it is life-threatening.”

“On its face, the law enshrines discriminatory practices in our health care system by specifically denying transgender Missourians under the age of eighteen access to evidence-based gender-affirming medical care while stripping parents of their fundamental right to make medical decisions for their children,” Gillian Wilcox, the deputy director of litigation at the American Civil Liberties Union of Missouri, said in a statement.

“Extreme politicians in Missouri, like the Attorney General, have made known their desire to ban gender-affirming care throughout the State. This legislation targets very specific, vulnerable populations — young people, those who access health care through Medicaid, and incarcerated individuals — to replace private medical decisions with the will of politicians in Jefferson City,” added Wilcox.

“Doctors, nurses, and all health professionals play a crucial role in promoting healthier and happier communities in Missouri and beyond,” Alex Sheldon, the executive director of GLMA:Health Professionals Advancing LGBTQ+ Equality, one of the two advocacy groups that is a plaintiff in the case.

“SB 49 blatantly undermines the extensive expertise and life-saving work of health professionals by placing unnecessary constraints on their ability to provide essential care for transgender patients,” Sheldon added. “By suing the State of Missouri, GLMA is advocating for the rights of our health professional members to practice medicine without facing discriminatory restrictions.”

The three families — all of whom are referred to by initials or pseudonyms in order to protect their identity — expressed fear and outrage over the law and how the state might seek to enforce it. Already, Missouri Attorney General has sought to coerce local police departments into helping enforce the law by arresting violators — despite the fact that the law imposes no criminal penalties, only civil penalties, for violations.

“SB 49 is an attempt to interfere in our family relationships and it places the health and well-being of our children at great risk,” the families said in a joint statement. “It must be stopped.”

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