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Ban on gender-affirming care for minors heads to Governor; Care for trans adults remains in limbo

Rebecca Smith
Two young children play with a transgender pride flag on the steps of the capitol in Jefferson City, Missouri, at the "Protest for Trans Rights" on March, 29, 2023.

The Missouri House has passed the “Save Adolescents From Experimentation,” or SAFE bill, which bans gender-affirming care for anyone under the age of 18.

With two days left in the legislative session, the House voted to pass the bill 108 to 50. All Democrats and three Republicans voted against the bill.

It has been a tumultuous few months leading up to Wednesday, and there are still uncertainties about the status of gender-affirming care for trans Missourians.

At the beginning of the legislative session, Gov. Mike Parson gave a speech about what he wanted the legislature to address and transgender issues were never mentioned.

But as gender-affirming care became a hot-button conversation nationwide, this changed and Parson threatened to call a special session on the issue if the bill wasn’t passed.

Missouri Legislature

Senator Mike Moon (R-29) is the sponsor of the bill, which bans gender-affirming care like hormone therapy, drugs that prevent the onset of puberty and gender-affirming surgeries.

And it wasn’t a smooth process getting the bill to the floor. There were arguments on the floor between Moon and Republican Senate leadership.

“We're allowing medical communities to butcher them, to put chemicals in their body that changes them for life, and yet we say the timing’s not right,” Moon said on the floor. “We could pass this bill today if we wanted to.”

Once it made it to the floor, Democrats filibustered the bill for days – the last day going throughout the night.

Finally, the filibuster ended with a compromise made with Democrats. The compromise made it so that minors already receiving care will be able to continue, and it established a “four-year sunset” on the bill. Essentially, the legislature will have to consider this legislation again in four years or it will expire.

The bill then moved to the House.

In the House, there was a delay in taking up the Senate’s bill and it passed its own bill that did not include any of the Senate’s compromises.

But after a month, the House passed Senate Bill 49 today.

Attorney General Andrew Bailey

While this was all happening in the Missouri State Legislature, Missouri Attorney General Andrew Bailey announced in April a set of emergency rules that would ban gender-affirming care – for minors and adults – through a consumer protection law.

This ban would require anyone attempting to receive gender-affirming care to meet requirements like having three years of documented gender dysphoria, a screening for autism and at least 15 hours of mental health care.

Lambda Legal, the American Civil Liberties Union of Missouri and law firm Bryan Cave Leighton Paisner LLP then filed a petition seeking a temporary restraining order to block implementation of the rules on April 27.

A judge granted the restraining order, and Bailey’s rules are now being held up in court. The next scheduled court date is July 20.

Still, these proposed rules have added to the stigma that trans people face every day and some say it has had a cooling effect on gender-affirming care – like at the University of Missouri.

Jools Pulcher is one of the trans adults who could be impacted by these rules.

“The [MU] Student Health Center is currently talking to their legal team because they don't know how the new emergency order is going to affect my ability to get my testosterone and my treatment,” Pulcher said.

For now, MU Health Care said it will continue to provide care, but is also evaluating how these regulations would impact their services – if implemented.

Impacts on trans Missourians

Pulcher said that early in transition – before his voice dropped and he grew facial hair – he faced harassment and physical violence.

“So it took a little getting used to, like, this past summer being able to be out and about with my shirt off and feel safe, and that was something I’m just getting used to,” Pulcher said. “And now that could be something that is just as quickly disappearing for me.”

Pulcher said he and other trans Missourians could be forced to de-transition if the Attorney General's rules end up going into effect. And he added that it frustrates him that Missouri officials use his body, and other trans bodies, as a way to get more votes.

“I and every trans person that walks next to you is going to have more in common with you than a politician who drives a Mercedes and lives in the Capitol and never comes to your neighborhood other than to give you a flier and tell you to vote red or vote blue,’ Pulcher said.

While access to gender-affirming care for adults like Pulcher remains in limbo, Senate Bill 49 now heads to the governor’s desk and if signed – which it is expected to be – it will take effect August 28, ending access to this care for Missourians under the age of 18.

Briana Heaney is a senior at the University of Missouri’s journalism school studying cross-platform editing and producing and minoring in economics.
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