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Missouri attorney general announces plan to add restrictions to gender-intervention care for youth

Bailey called gender transition "mutilating children for the sake of a woke, leftist agenda" and "inhumane science experiments" in the announcement.

JEFFERSON CITY, Mo. — Missouri's attorney general announced on Monday a plan to use a law governing deceptive business practices to add restrictions on gender transition interventions for transgender children.

In a statement, Republican Attorney General Andrew Bailey said his office would use "existing Missouri law governing unfair, deceptive, and unconscionable business practices" to add strict requirements on gender transition interventions, which the statement called experimental.

Bailey called gender transition "mutilating children for the sake of a woke, leftist agenda" and "inhumane science experiments" in his announcement and on his official Twitter account. The statement said the emergency regulations have not been put into effect at the time of the announcement, but they would last 30 legislative days or 180 days, whichever is longer.

Every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association, has voiced support for gender-affirming care, which can include counseling, social transition, hormone therapy or surgery.

In a statement, PROMO, Missouri’s LGBTQ+ public policy and advocacy organization, called Bailey's announcement a "gross and reprehensible action that puts the health, wellness, and very lives of transgender and gender-expansive youth at risk.”

"It is clear his office does not respect the professional guidelines of every major medical association in our country, who agrees gender-affirming healthcare is the standard of care for transgender Missourians, and instead is abusing his political power by asserting his beliefs by stating access to lifesaving healthcare is part of a ‘woke, leftist agenda,’" the statement said.

The announcement from Bailey's office said the emergency restrictions "must include at least" the following: 

  • Specific informed-consent disclosures informing patients that, among other things,
    • The use of puberty blocker drugs or cross-sex hormones to treat gender identity disorder or gender dysphoria is experimental and is not approved by the Food and Drug Administration (FDA).
    • The FDA has issued a warning that puberty blockers can lead to brain swelling and blindness.
    • Sweden’s National Board of Health and Welfare (“NBHW”) recently declared that, at least for minors, “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits.”
    • One scientific study notes that an individual whose friend identifies as transgender is “more than 70 times” as likely to similarly identify as transgender, suggesting that many individuals “incorrectly believe themselves to be transgender and in need of transition” because of social factors.
    • The Endocrine Society found that “the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/gender incongruent in adolescence.”
  • Prohibiting gender transition interventions when the provider fails to,
    • ensure that the patient has received a full psychological or psychiatric assessment, consisting of not fewer than 15 separate, hourly sessions over the course of not fewer than 18 months to determine, among other things, whether the person has any mental health comorbidities.
    • ensure that any existing mental health comorbidities of the patient have been treated and resolved.
    • adopt and follow a procedure to track all adverse effects that arise from any course of covered gender transition intervention for all patients beginning the first day of intervention and continuing for a period of not fewer than 15 years.
    • obtain and keep on file informed written consent.
    • ensure that the patient has received a comprehensive screening to determine whether the patient has autism.
    • ensure (at least annually) that the patient is not experiencing social contagion with respect to the patient’s gender identity.

PROMO --  a non-profit that advocates for LGBTQ+ rights said this political move will hurt Missourians and their families. 

Gender Affirmative Care is supported by The American Academy of Pediatrics and Bailey's move only stokes misinformation and fear. 

"There are a lot of trans kids when not supported don't feel loved or accepted and don't make it to adulthood," Robert Fischer, a PROMO spokesperson said. "Which is a really dangerous aspect of not being able to access gender affirming healthcare. Gender affirming healthcare is healthcare, plain and simple. It's hard to imagine having these conversations about another form of healthcare. This sets a dangerous precedent."

Fischer said Planned Parenthood is one of the biggest providers of gender affirmative services. 

Washington University Transgender Center at St. Louis Children’s Hospital provided the following statement:

"We are aware of the Attorney General’s press release and will review any proposed regulations when they are filed. We take the care and safety of our patients very seriously. Our focus remains on our commitment to providing compassionate, family-centered care to all of the patients and families we serve."

The center is currently under investigation by the attorney general's office after allegations made by a former employee earlier this year. The center said it is cooperating with that investigation, but refused Bailey's call to place a moratorium on puberty blocker medications last month.

It comes as Missouri lawmakers debate Senate Bill 49, which would ban gender-affirming care for minors. Democrats filibustered for hours before the Missouri Senate's scheduled spring break earlier this month to delay passage of the bill.

A couple hundred people rallied Monday at the Capitol in hopes of pushing lawmakers to pass SB49, while several came in opposition. The rally featured a diverse collection of speakers, including Republican state officials such as Secretary of State Jay Ashcroft, Christian leaders and several gay and transgender activists who said that only adults should be able to access gender-affirming care.

Several Missouri lawmakers this year filed bills to ban gender-affirming treatment for transgender youth, and Senate President Pro Tem Caleb Rowden said that's a priority for Senate Republicans.

Bailey has been outspoken on social issues since he took office in January

Republican Gov. Mike Parson appointed Bailey, the former top lawyer for the Governor's Office, to replace now-U.S. Sen. Eric Schmitt as the state attorney general.

During two months in office so far, Bailey has called on school boards to adopt policies against children attending drag shows and warned CVS and Walgreens not to sell abortion medications.

In a statement responding to Bailey's latest move, Dr. Colleen McNicholas, chief medical officer for Planned Parenthood of the St. Louis Region and Southwest Missouri, said:

“Missouri Attorney General Andrew Bailey’s transphobia is an embarrassment to the Show-Me State. The politically driven claims made in the announcement are medically false and harmful. Scientific evidence shows — and the medical community agrees — that gender-affirming care is safe, effective, and lifesaving. Bailey’s lack of medical expertise shows. His personal moral panic is inappropriately and unlawfully setting harmful policies that will hurt young transgender Missourians and their families. We denounce this government interference in the practice of medicine, and we demand politicians leave health care between providers and their patients. Shame on any politician who uses trans youth for political theatrics.”

In January, Bailey officially launched his campaign for attorney general in 2024.

Transgender medical treatment for children and teens is increasingly under attack in many states, labeled child abuse and subject to criminalizing bans. But it has been available in the United States for more than a decade and is endorsed by major medical associations.

Many clinics use treatment plans pioneered in Amsterdam 30 years ago, according to a recent review in the British Psych Bulletin. Since 2005, the number of youth referred to gender clinics has increased as much as tenfold in the U.S., U.K, Canada and Finland, the review said.

The Associated Press contributed to this report.


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