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Missouri attorney general withdraws rule limiting trans care for children and adults

Andrew Bailey, newly appointed Missouri Attorney General, gives remarks after being sworn in on Tuesday, Jan. 3, 2023, at the Missouri Supreme Court in Jefferson City.
Brian Munoz
St. Louis Public Radio
Andrew Bailey, newly appointed Missouri attorney general, speaks after being sworn in on Jan. 3 at the Missouri Supreme Court in Jefferson City.

Updated at 9 p.m. May 16 with a response from the ACLU

Missouri Attorney General Andrew Bailey’s office on Tuesday pulled an emergency rule that would have limited care for transgender children and adults.

A spokesman for the secretary of state, which oversees Missouri’s administrative regulations, confirmed that Bailey’s office eliminated the rule.

Although the rule, which would have expired in February, has been terminated, it’s likely transgender minors will soon be barred from accessing hormones and other treatment. The Republican-controlled state legislature earlier this month passed a bill that prohibits gender-affirming treatment for minors but not adults, and Gov. Mike Parson is expected to sign it.

Bailey said because the legislature acted, the rule was no longer necessary.

“We were standing in the gap unless and until the General Assembly decided to take action on this issue,” Bailey said in a statement. “The General Assembly has now filled that gap with a statute.”

The rule was on hold as lawyers for patients and doctors challenged it on the grounds it would have kept transgender people from receiving the treatment they want.

Bailey submitted the rule to the state last month. It would have prohibited providers from offering surgery, hormone therapy and other treatments to transgender people unless they had resolved all mental health issues, undergone at least 15 hours of therapy and displayed three documented years of gender dysphoria.

Bailey often spoke of the need to protect children from what he refers to as experimental treatment. But after announcing the rules, he said they were designed to “protect all patients” regardless of their age.

Transgender people and health care providers said the rules were so onerous that they would effectively prohibit most people from accessing gender-affirming procedures.

Missouri House Minority Leader Crystal Quade, D-Springfield said in a statement that Bailey had "grossly overstepped" his legal authority.

"It isn’t surprising he withdrew his unconstitutional rule knowing another embarrassing court defeat was inevitable. Missourians deserve an attorney general worthy of the office, not one who persecutes innocent Missourians for political gain," Quade said.

A St. Louis County Circuit Court judge put the rule on hold while the ACLU and Lambda Legal challenged it in court. The legal groups filed suit against Bailey on behalf of some providers, transgender patients and their families.

The ACLU called the decision to withdraw the rules a victory for bodily autonomy.

"After weeks of embarrassing Missouri on the national stage, the attorney general has finally joined everyone else in recognizing that his hasty attempt to usurp other branches of government cannot withstand scrutiny," a statement from the organization read. "His transparently faux concern for trans youth could not mask that his willingness to abuse his office in an attempt to erase from public all transgender Missourians."

The statement said major medical organizationssupport gender-affirming care and that the governor should veto the ban on treatment for minors and another bill that states transgender student athletes must participate in sports as the sex they were assigned at birth.

Sarah Fentem is the health reporter at St. Louis Public Radio.