Transgender minors in the US state of Missouri will no longer will have access to puberty blockers, hormones or gender-affirming surgery under legislation passed by the Republican-led legislature on Wednesday.
The ban also affects some adults — Medicaid health care will not cover any gender-affirming care in the state – and surgery will no longer be available to prisoners.
Missouri politicians also sent the Republican governor legislation to ban transgender girls and women from playing on female sports teams from kindergarten through to college, both at public and private schools.
Governor Mike Parson is expected to sign the legislation. He had threatened to keep members working beyond the normal end of their session if they did not approve the ban, which would take effect on August 28 and expire in August 2027. The ban includes exceptions for minors already getting such treatments.
Some democrats wept during the debate.
“To deny these children care is to deny them their very existence,” Democrat Joe Adams said.
Missouri’s ban comes amid a national push by conservatives to put restrictions on transgender and nonbinary people that has become, alongside abortion, a major theme running through legislative sessions across the country in 2023.
At least 16 states have now enacted laws restricting or banning gender-affirming care for minors, and several states are still considering Bills this year to restrict or ban care, creating uncertainty for many families.
Florida and Texas have banned or restricted the care via regulations or administrative orders, and a Bill to restrict care is on Republican Florida Governor Ron DeSantis’s desk.
Missouri’s legislative leaders vowed to stop minors from accessing puberty blockers, hormones and surgeries. And Missouri’s Republican attorney general, Andrew Bailey, took up the charge after Mr Parson appointed him to fill the vacant position in January.
In response, the Kansas City Council was considering a resolution on Wednesday to make Missouri’s largest city a sanctuary for people seeking such medical care.
Mr Bailey, now campaigning to keep the job in 2024, launched an investigation in February into St Louis’ Washington University Transgender Centre following a former staffer’s complaints that doctors were prescribing hormones too quickly and without enough mental health wraparound services.
An internal Washington University review found no malpractice.
Mr 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 healthcare.
In April, Mr Bailey took the 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.
Under Mr Bailey’s rules, before gender-affirming medical treatments can be provided by physicians, people would have to document that they experienced an “intense pattern” of gender dysphoria for at least three years and undergo at least 15 hourly sessions with a therapist for at least 18 months.
Screening for autism and “social media addiction” would be required, and a treatment provider would have to declare that any mental health issues are resolved.
Some patients could maintain their prescriptions as long as they promptly receive the required assessments.