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Missouri Senate OKs bill to ban gender-affirming care for minors, sends it to House

Republicans called gender-affirming care 'experimental.' Medical experts say the treatments can save lives.

ST. LOUIS, Missouri — The Missouri Senate moved on Thursday to ban gender-affirming care for minors and limit transgender school students from participation in competitive sports.

Medical experts, such as the ones at the Columbia University Department of Psychiatry, have said "gender-affirming care saves lives."

A study published in the Journal of Interpersonal Violence, and shared on the website for the National Institute of Health said, "82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with suicidality highest among transgender youth."

A separate study published in the Journal of Psychiatric Practice found transgender teens consider suicide when they feel they don't belong in society or when they feel their problem is a burden for someone else. 

Republican Senators labeled the bill prohibiting medical procedures the "SAFE Act," an acronym for "Save Adolescents from Experimentation." 

The state's largest LGBTQ+ advocacy group slammed the move as politically motivated and the rhetoric as medically misleading. 

“A certified public accountant, a cattle rancher, and a family-farm operator decided they know better than every major medical association in the country when it comes to gender-affirming healthcare," Executive Director of PROMO, Katy Erker-Lynch said. "Today, the Missouri Senate joined them with the final passage of Senate Bill 49. This action demonstrates their motivations of using transgender bodies as political pawns and their false belief of having the expertise to ban lifesaving healthcare for children in the State of Missouri."

“Over the past 72 hours, egregious and outright lies about surgery on minors have spread while the bill filer and sponsor himself has publicly acknowledged he cannot account for one single surgery having occurred in Missouri," Erker-Lynch said. "The reason is simple — surgery for trans youth is not part of any recommended standards of care or guidance. While these senators purport to act out of concern for children’s health and welfare, they spew lies about what gender-affirming care actually is, willfully ignore and dismiss decades of medical research, and are unwilling to listen to transgender Missourians and their families."

State Senator Holly Thompson-Rehder defended the use of the word "experimentation," even though the language in the bill lists and defines very specific and known medical procedures that have commonly understood outcomes. 

"The outcome is not the same every time, and so it hasn't been done enough that it's consistent," Thompson-Rehder said during a Thursday afternoon interview on The Record. 

"The information that they were given as pre-teens, as teenagers, were that the hormones were reversible, but then they weren't," she said. "And then when they went into the surgeries, that that was exactly how they were feeling. But they really still have that child's mind. And so they weren't able to make that decision. Once they became an adult, they felt very differently. And so when it comes to children, we do feel that this is just experimental."

Medical experts and transgender advocates have stressed that children aren't making medical decisions on their own, but rather doctors are prescribing details treatment plans, and parents are consenting to them after the child goes through counseling and psychiatric care.

"Children are not making these decisions," PROMO said in a statement released earlier this week. "Gender-affirming healthcare is individualized based on the decisions of the child, their parents, and a team of medical professionals from multiple disciplines."

Thompson-Rehder acknowledged the intense counseling that takes place before doctors prescribe any puberty blockers or hormone therapy, but argued the state still has an interest in overriding the medical experts on this issue.

"The child is really driving the care, saying, this is how I feel," she said. "But we've seen examples of grown ups now saying that when they were children, that is how they felt. But their brain was not fully developed. They didn't have the full understanding. And once they became an adult, they realized that's not how I felt."

The Senate proposal threatens to strip doctors of their license or open them up to lawsuits if they treat teens with hormone therapy, puberty blockers, or surgical procedures related to gender transition. It would not, however, outlaw or prohibit any ongoing treatments already underway. 

Thompson-Rehder said she wasn't sure how many transgender patients would be impacted by this prohibition, but suggested the total number of transgender athletes competing in Missouri sports was very low. 

Thompson-Rehder, who is mulling a 2024 primary run for Lieutenant Governor, defended the ban on transgender participation in sports by comparing it to a scenario where an aspiring athlete might get cut from a team "because they're not fast enough or when a kid doesn't make the team because they don't have anyone to take them home after practice and they live way out in the country that they're too poor to afford a ride."

"There are many things that keep kids from being able to make a team," she said. "And so this is... this is just one of those things that makes you not eligible for the team or qualified for the team."

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