[A Missouri judge has upheld the state’s ban on gender-affirming care for minors, including the use of puberty blockers, cross-sex hormones, and surgery, for treating gender dysphoria. The 2023 law, known as Senate Bill 49, was a victory for opponents of gender-affirming care.
The law, which was signed by Governor Mike Parson in January 2023, prohibits the use of such treatments for individuals under the age of 18, with the exception of those who were already receiving treatment prior to August 2023.
The ruling came after a nine-day trial in a lawsuit filed by three transgender children and their parents, who argued that the ban was unconstitutional and denying them access to necessary medical care.
The judge, R. Craig Carter, cited the “remarkably weak evidence” and “no good evidence on the long-term outcomes of interventions” in his decision, as well as the World Health Organization’s decision not to “craft guidelines for treating gender dysphoria in adolescents because ‘the evidence base for children and adolescents is limited and variable’.”
The American Medical Association, the American Academy of Pediatrics, and other major medical organizations have opposed the ban, saying that treatment for gender dysphoria is “medically necessary” and should be “determined by shared decision making between the patient and physician.”
Lambda Legal and the American Civil Liberties Union, which have been providing legal counsel to the plaintiffs, have pledged to appeal the decision, calling it a “chilling message that, for some, compassion and equal access to health care are still out of reach.”
Doctors who defy the law could face having their licenses to practice medicine in Missouri revoked, and could also be sued by patients up to 15 years after receiving treatment. The law also prohibits the use of state Medicaid funds to pay for gender-affirming care for patients of any age.
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