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Lawsuit seeks to halt Missouri attorney general’s rules on gender-affirming care

Andrew Bailey, newly appointed Missouri Attorney General, speaks to the media on Tuesday, Jan. 3, 2023, after being sworn in as the state’s 44th attorney general at the Missouri Supreme Court in Jefferson City.
Brian Munoz
St. Louis Public Radio
Andrew Bailey, shown in January, says he believes his transgender care restrictions will stand up in court.

Missouri Attorney General Andrew Bailey’s rules restricting gender-affirming care for transgender minors and adults are facing a legal challenge.

The ACLU of Missouri, Lambda Legal and the Bryan Cave Leighton Paisner law firm filed a suit in St. Louis County Court on Monday to prevent the emergency guidelines from going into effect Thursday. Among other arguments, the suit says Bailey is going well beyond his power to regulate consumer protection matters in pushing for the rules.

“He is sort of taking a law that is about refrigerators and using it to go after trans people and tell doctors and other medical providers how they can practice,” said Nora Huppert, a staff attorney with Lambda Legal.

LGBTQ advocates say the rules represent the broadest restrictions on transgender adults having access to hormone therapy or gender transition surgery. Among other provisions, the rules state that transgender minors and adults cannot obtain gender-affirming care unless they receive 15 separate hourly sessions of therapy over at least 18 months, have three years of documented gender dysphoria and are screened for autism. They also state that people must have mental health conditions “treated” and “resolved.”

“This is really unprecedented, in that the policy targets access to gender-affirming care for huge categories of trans adults throughout the state,” Huppert said. “It is really a first of its kind for an effort to administratively tell medical providers how they can and cannot practice.”

Bailey has said the rules are aimed at making people more informed before they embark on gender-affirming care. He reiterated that position in a statement reacting to the lawsuit.

“Rather than ensure that patients are protected by common-sense safeguards, these organizations are racing to court in an effort to continue their ideologically based procedures masquerading as medicine,” Bailey said.

He said in an interview last week he was confident his rules could hold up in court, adding that he’s “standing up to make sure that patients have the information they need to make informed health care decisions.”

Since the rules were released earlier this month, some people have sought gender-affirming carebecause the guidelines have a clause exempting those who are already receiving care. But some health care experts said the rules are so onerous that providers may be hesitant to provide care for anyone, including existing patients.

Huppert said it’s important to fight Bailey’s rules in court not only to ensure Missourians still have access to treatments, but also to provide a disincentive for other states to enact similar guidelines.

“There have been attempts to imitate what other states are doing and build off and expand and become even crueler and even less rational in the way that they go after gender-affirming care,” Huppert said.

Jason is the politics correspondent for St. Louis Public Radio.