Missouri Attorney General Andrew Bailey on Thursday announced an “emergency regulation” that will severely curtail access to transgender health care, making the state one of the most hostile in the country for trans minors and adults.
The set of rules, scheduled to go into effect April 27 and remain in place until Feb. 6, introduces a three-year waiting period for any trans person seeking to receive gender-affirming care, during which time the patient must have a “medically documented, long-lasting, persistent and intense pattern of gender dysphoria.”
The patient must also undergo at least 15 sessions with psychological or psychiatric professionals over the course of 18 months to determine if they have any mental health conditions, and be screened for autism. Gender-affirming care cannot be administered until “existing mental health comorbidities of the patient have been treated and resolved.”
Bailey has described these restrictions, which carry the “emergency” label to allow for rapid implementation, as necessary to protect kids — but as written, the rules do not only apply to minors.
“The attorney general’s order is not designed to protect children. It is not designed with medical guidelines or best practices in mind,” Democratic state Rep. Eric Woods tweeted. “It is designed to be cruel. It will bring nothing but harm to the people it actually impacts. All around shameful day in Missouri.”
Bailey’s order claims that hormone treatments and gender-affirming surgeries are “experimental.” However, every major medical association in the U.S. has said that such forms of gender-affirming care are acceptable and necessary for transgender youth and adults.
The emergency regulation was introduced after the Missouri House separately passed a ban on gender-affirming care for trans youth; that legislation now moves to the state Senate for consideration.
Missouri is also currently considering a bill to ban transgender athletes from playing on teams that align with their gender identity, starting in sixth grade and continuing to the college level.
The state’s gambit to limit access to trans health care is a part of a wave of anti-LGBTQ+ bills that have swept GOP-controlled legislatures since 2021. Some aim to restrict children from receiving gender-affirming care or using the bathroom that matches their gender identity, while others are wrapped up in a similar moral panic about drag performers.
LGBTQ+ advocates fear that transphobic legislation and restrictions could negatively impact the mental health of those in the community. Transgender youth are at higher risk for suicidal ideation because of stigma and discrimination, according to the Trevor Project nonprofit.
The American Civil Liberties Union of Missouri and the LGBTQ+ rights group Lambda Legal have promised to sue Missouri over its actions.
“This rule is a shocking attempt to exploit Missouri’s consumer protection laws in order to play politics with life-saving medical care. Transgender people in Missouri deserve the support and care necessary to give them the same chance to thrive as their peers,” the groups said in a joint statement.
“We will defend the rights of transgender people through any necessary legal action, just as we have done in other states engaging in this anti-science and discriminatory fearmongering.”
If you or someone you know needs help, dial 988 or call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also get support via text by visiting suicidepreventionlifeline.org/chat. Additionally, you can find local mental health and crisis resources at dontcallthepolice.com. Outside of the U.S., please visit the International Association for Suicide Prevention.