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Missouri Senate endorses transgender health restrictions

The Missouri Senate advanced a pair of bills to prohibit gender-transitioning health care treatments for minors and restrict them from competing in sports, a hard-fought GOP win Tuesday following intense pressure from protesters to act.

The Senate votes came after an all-night session of closed-door negotiations and only after Republican lawmakers agreed not to prohibit transitions already in process and to let the measures expire in 2027.

“What we got is a good start,” said Republican Sen. Mike Moon, who sponsored the health care ban. “The result is that children will be protected, and I hope that will continue.”

The measures reflect a national push led by Republicans to restrict transgender health care, drag shows, bathroom access and how LGBTQ topics are discussed in schools.

Wyoming on Monday became the 19th state to ban transgender athletes from playing on girls’ or women’s sports teams after the Republican governor opted not to veto the legislation.

Democratic Gov. Laura Kelly last week vetoed a Kansas bill to ban gender-affirming care for transgender minors, setting up a hotly contested fight in the Republican-controlled Legislature to override her. Georgia lawmakers passed a ban on Tuesday.

At least seven states have already enacted restrictions or bans on such care: Alabama, Arkansas, Arizona, Mississippi, Tennessee, Utah and South Dakota. Federal judges have blocked enforcement of laws in Alabama and Arkansas, and more than 20 states are considering bills this year to restrict or ban care.

Iowa and Arkansas lawmakers last week also passed bills to ban transgender people at public schools from using restrooms that correspond with their gender identity.

Missouri's GOP senators compromised by agreeing to allow minors already receiving hormone treatments or puberty-blocking drugs to continue to do so, applying that ban only to those who had not yet started them.

Health care providers who perform a gender-transition surgery or otherwise prescribe “cross-sex hormones or puberty-blocking drugs” to minors could have their medical licenses revoked and face potential lawsuits from their patients until they reach age 36. Republicans initially proposed a 30-year window for lawsuits.

Although they are now due to expire in four years, the limits on competing for transgender athletes are more restrictive than Republican Sen. Holly Rehder’s original plan.

Initially, she proposed limits for only K-12 public school students. The version approved by the Senate also applies to private K-12 schools and public and private universities, a sweeping expansion that could mean some adults also will be impacted.

Schools that violate the rule would lose all state funding.

Moon said the expiration date was necessary to win initial approval. Democrats agreed to stop stalling before voting against the measures. The bills still need final Senate votes to move to the House, where Republican Speaker Dean Plocher has said he plans to follow the Senate’s lead. Similar bills passed out of House committees earlier this year.

The Senate votes came a day after hundreds of activists rallied at Missouri's Capitol to push lawmakers to approve the legislation.

Katy Erker-Lynch, executive director of the LGBTQ rights group PROMO, had encouraged the bills' opponents to stay away from the rally but vowed to "fight every step of the way” against the measures.

During Senate debate Monday, Democratic Sen. Lauren Arthur described the treatments ban as "an example of pretty serious government overreach.”

"You may have your opinions about this, but that doesn’t necessarily mean you have to impose your opinions or regulate someone else’s kids,” she said.

Also Monday, Missouri Attorney General Andrew Bailey announced an emergency regulation limiting access to gender-affirming treatments for minors.

The Republican attorney general said his administrative rule would require an 18-month waiting period, 15 hour-long therapy sessions and treatment of any mental illnesses before Missouri doctors can provide gender-affirming treatments to children younger than 18.

Once that rule takes effect, it can last no more than 180 days, so it would essentially serve as a bridge to any law passed by the Legislature, which would take effect Aug. 28.

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