Missouri legislature passes restrictions on transgender health care and sports participation
Missouri lawmakers gave final approval Wednesday to restrictions on transgender minors receiving gender-affirming care and participating on school sports teams that align with their gender identity.
Members of the House voted 108-50 Wednesday to pass the legislation restricting gender-affirming health care and 109-49 to pass restricting sports participation.
Three Republicans joined Democrats in voting against the restrictions on gender-affirming health care. On school sports participation, two Republicans voted against the bill, while one Democrat voted present.
The chamber spent less than an hour discussing both bills, with Republicans voting to end debate twice.
The bills, which now go to Gov. Mike Parson, who is expected to sign them, are less restrictive than those in other Republican-leaning states but still provoked harsh criticism from Democrats who said they’re political ploys at the expense of a vulnerable part of Missouri’s LGBTQ community.
“The intent of everyone in this room is completely irrelevant. What is important to keep in mind is the impact of this legislation,” said Rep. Ian Mackey, D-Clayton. “When I say that I'm hurt as a member of the LGBT community, not nearly to the extent as these little kids are.”
The bill from Sen. Mike Moon, R-Ash Grove, bars transgender youth under the age of 18 from accessing gender-affirming care like puberty blockers, hormone therapy and gender transition surgery.
Gender-affirming care includes medical and mental health care treatments as well as social support.
The practice is supported by multiple medical associations, including the American Academy of Pediatrics and the American Medical Association. Doctors say it’s rare for minors to undergo any form of transition-related surgery before the age of 18.
House Republicans repeated their stance on Wednesday that the bill is about protecting children.
“One thing that is often alleged or insinuated is that we are hypocrites, because we are the party of small government, and yet we are advocating for government involvement in this area,” said Rep. Brad Hudson, R-Cape Fair. “Small government Republicans have never said that it is inappropriate for the government to get involved when it comes to protecting children.”
Legislation by Sen. Holly Rehder, R-Sikeston, bars transgender athletes from participating on school sports teams that correspond with their gender identity through the collegiate level. It also applies to public, charter and private schools.
“This bill is not about limiting anyone's ability to play sports. It's about protecting the fair and competitive balance that we currently have in women's sports,” Rep. Brian Seitz, R-Branson, said.
The Missouri State High School Activities Association already has guidelines on sports participation for transgender athletes, as does the NCAA for college sports.
Rep. Peter Merideth, D-St. Louis, said the discussions on this bill show the ignorance and bigotry of the Republican-run chamber.
“This bill is the epitome of bullying the most vulnerable kids in our state,” Merideth said.
In order to pass the health care restrictions through the Senate, Republicans in the upper chamber included compromise language that exempted minors already receiving gender-affirming care, including puberty blockers and hormone treatment, from the ban.
Additionally, part of the health care restrictions as well as the entirety of the sports participation bill are set to expire in four years, which means that Senate Democrats could filibuster any attempt to reauthorize the legislation.
While some House Republicans wanted to pass their version of the gender-affirming care ban, which did not contain the clause exempting existing patients, Senate Republicans were firm that their version of the bill would be the one that passed.
Hudson spoke on the House version of the bill and its lack of movement while presenting the Senate bills on the floor.
“Because of little to no action over there, that piece of legislation will most likely die at six o'clock on Friday," Hudson said, when the legislative session ends. “It is now up to the Missouri House to finish this job.”
Parson also threatened to call lawmakers into special session if they did not get either the transgender health care or sports legislation completed before Friday.
Missouri follows other GOP-led states
Missouri is one of several Republican-leaning states that have passed restrictions or outright bans on gender-affirming care to minors. For the most part, Republicans contend that treatment is inappropriate for people under 18 — and that anyone seeking hormone therapy or gender transition surgery should wait until they’re adults.
Many GOP lawmakers say they were prodded to pass the gender-affirming care ban by their constituents.
“It's not a hateful thing,” said Rep. Wendy Hausman, R-St. Peters. “We just have very strong passions in what we believe in.”
But primarily Democratic critics of the idea say that prohibiting gender-affirming care runs counter to the advice of medical organizations and doctors. They’ve also pushed back against contentions that puberty blockers or hormone therapy are dangerous or experimental, adding that it can often help alleviate depression or anxiety among transgender youth.
“It is not the terrible things that the gentleman [Hudson] is saying like the mutilation of children,” said House Minority Leader Crystal Quade, D-Springfield. “We're talking about keeping kids from killing themselves by being able to go see a doctor.”
They also contend that the issue is essentially a solution in search of a problem, adding that it’s only reaching critical mass among Republican voters due to conservative media outlets and social media influencers amplifying negative coverage of gender-affirming care.
Rep. Barbara Phifer, D-Kirkwood, who has a transgender grandson, said she doubted that Wednesday would be the last time lawmakers would go after Missouri’s transgender community.
“Anytime you start persecuting one group of people, horror follows,” Phifer said. “And we just need to be very aware of that.”
Efforts to pass the gender-affirming care ban faced complications in April when Attorney General Andrew Bailey issued emergency rules that substantially restricted transgender adults and minors from accessing hormone therapy and gender transition surgery. Bailey’s rules clashed with GOP legislator messaging that they should pass Moon’s bill to protect children.
Some Republican legislators, including Senate President Pro Tem Caleb Rowden, said they do not support restrictions on transgender adults. And Secretary of State Jay Ashcroft, a candidate for governor, also said that transgender adults should be able to make their own decisions.
“If you're an adult, you can make all kinds of decisions where maybe I don't think it's the right decision. But part of freedom is you make decisions I don’t like,” said state Rep. Bill Hardwick, R-Pulaski County. “But children are entirely different.”
Bailey’s rules are on hold while they are being challenged in court in St. Louis County.
PROMO, ACLU slam legislation
Reaction to the legislature's decision from LBGTQ advocates and their allies was swift.
“The lives of transgender people in our state — and in our country — have not only been prioritized as political pawns for elected leaders to advance their careers, but the rhetoric around who transgender Missourians truly are has become [chock]-full of disgusting lies and dangerous misunderstandings," said a statement from PROMO, a group that advocates for LGBTQ rights.
The ACLU of Missouri released a statement that said the bills "attempt to erase transness from Missouri."
"Every person in the state should be alarmed by this weaponization of the government to intimidate people through the denial of basic health care and exclusion from extracurricular activities," the ACLU of Missouri's statement continued. "The ACLU of Missouri will continue to explore all options to fight these bans and to expand the rights of trans Missourians.”
Yamelsie Rodríguez, president and CEO, Planned Parenthood of the St. Louis Region and Southwest Missouri, said in a statement that her organization "will continue to do everything in our power to ensure all patients are supported, seen, and cared for."
"Any patient wanting to continue their gender-affirming care in a state that welcomes people of all identities: Our Fairview Heights, Illinois, health center is open to you, and we are here to help you make plans to get care," Rodríguez said.
Brandon Hill, interim president and CEO of Vivent Health, a leading provider of HIV prevention, care and support, said that the bill "reinforces the prejudices and injustices that lead to poor health outcomes among our LGBTQ+ community, including significant heightened risk for self-harm and suicide.”
“Make no mistake, every time individuals are stigmatized by legislation such as this, they are pushed further away from receiving the life-saving health care they need,” Hill said.
After the vote, Rep. Chris Sander, a Lone Jack Republican who voted against both bills, said he was upset that he didn’t get to speak out against either piece of legislation.
“And on marriage, we've won. There's no taking that back,” Sander said. “So they're picking a new fight on trans people who are kids.”
Sander, one of two openly gay Republicans in the House, said he doubted that his colleagues were finished with pushing transgender-related legislation.
“It's like baby steps,” Sander said. “They're not gonna quit. And that's why I'm not going to quit.”
Quade also expressed doubts that Republicans would cease trying to pass legislation that affect transgender people.
“We're going to continue to stand and fight against government intrusion and overreach in personal freedoms and liberties. And that's exactly what this is,” Quade said. “You can have feelings about being confused about the trans community or something that you don't understand. But it is … our responsibility as lawmakers to do our due diligence and understand something before we legislate it.”