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Missouri judge blocks restrictions on transgender healthcare temporarily

The court decision calls the restrictions "broad" and says people would be "subjected to immediate and irreparable loss, damage or injury" if enacted.

JEFFERSON CITY, Mo. — Doctors who provide gender-affirming care to transgender patients can continue their plans of care without disruption from the state after a Missouri judge issued a restraining order against Attorney General Andrew Bailey’s proposed restrictions on the health care treatments. 

Transgender clinics and advocates with the American Civil Liberties Union sued to block Bailey’s rule from taking effect last Thursday.  

Bailey’s proposed restrictions would have redirected all adult and minor transgender patients in the state to undergo a minimum of 18 months of counseling before they could resume or begin their treatments. 

The court's decision was guided, in part, by concern that Bailey’s restrictions could have the effect of “creating confusion” in hospitals and clinics.  

“The Rule promulgated by the Attorney General states specifically, ‘This rule does not contain an exhaustive list of the practices that violate the Act,’” the judge wrote in her ruling. “This leaves significant room for interpretation of what would and would not be covered by the Act, creating confusion for those tasked with the enforcement of the Rule and those required to comply.”

The rule would also require the patients’ doctors to sign off on documents stating the patients had no underlying mental health conditions. Transgender patients and medical advocates said the restrictions were written so broadly, they would amount to an effective outright ban on care.

The one of plaintiffs in the case, Southampton Community Healthcare, thanked the court for blocking the restrictions.

"Without this halt on the baseless and discriminatory rule, our practice would have been forced to grapple with how to provide ethical medical care to our transgender patients in a way consistent with our obligations under a rule that places illogical barriers to necessary care," said said Plaintiff Southampton Community Healthcare’s Dr. Michael Donovan in an emailed news release.

The ALCU of Missouri called the restrictions a false emergency that was "untruthful and dangerous."

“Today's ruling marks a win for transgender Missourians over an unprecedented attempt by the Attorney General to unilaterally legislate and harm their right to self-expression, bodily autonomy, and access to lifesaving health care,” said Gillian Wilcox, Deputy Director of Litigation for the ACLU of Missouri.

Extensive counseling and therapy are already standard operating procedure for patients seeking gender-affirming care, according to Tawnya Brown with Vivent Health.  

“Counseling or therapy is definitely part of how someone prepares for a gender transition in their affirming care process,” Brown said on The Record last Thursday. “When people are making these decisions, there seems to be an expectation that this is just something they thought of today, and then they go to the doctor and get on these hormones. That's not how it works. They've been dealing with these issues for their lives and have been in and out of mental health therapy for quite some time.” 

Bailey’s office has not yet responded to requests for comment. 

The next court hearing is scheduled for May 11.  

Read the court order here.

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