Judge rules Missouri’s ban on gender-affirming health care for minors to be enforceable from next week

On Friday, a judge in Missouri made a ruling that allows a ban on gender-affirming health care for minors to go into effect starting Monday. This means that health care providers will be prohibited from offering gender-affirming surgeries to children. However, minors who have already begun puberty blockers or hormones prior to Monday will be allowed to continue their treatment. Other minors will no longer have access to these medications.

Furthermore, some adults will also lose access to gender-affirming care. Medicaid will no longer cover treatments for adults, and the state will not provide these surgeries to prisoners.

Physicians who violate the law may have their licenses revoked and can be sued by patients. The law also makes it easier for former patients to sue by giving them 15 years to take legal action and promising a minimum of $500,000 in damages if they succeed.

The ACLU of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner filed a lawsuit last month to challenge the law on behalf of doctors, LGBTQ+ organizations, and three families of transgender minors. They argued that the law is discriminatory and requested a temporary block while the case is ongoing. The next hearing is scheduled for September 22.

Judge Steven Ohmer, however, deemed the plaintiffs’ arguments “unpersuasive and not likely to succeed.” He stated in his ruling that the scientific and medical evidence is conflicting and unclear, raising more questions than answers. Therefore, he did not see sufficient grounds to justify a preliminary injunction.

One of the plaintiffs is a 10-year-old transgender boy who has not yet started puberty and taking puberty blockers. His family is concerned that he will begin puberty after the law takes effect, leaving him without access to puberty blockers for the next four years until the law expires in 2027.

Supporters of the law believe that gender-affirming medical treatments are unsafe and untested. Republican Attorney General Andrew Bailey’s office argued in a court brief that blocking the law could lead to potentially harmful interventions. They cited restrictions on gender-affirming treatments for minors in countries like England and Norway, although these nations have not implemented outright bans.

The major medical organizations in the U.S., including the American Medical Association, have opposed bans on gender-affirming care for minors and supported proper medical care for young individuals. Lawsuits have been filed in multiple states where similar bans have been enacted this year.

“We will work with patients to ensure they receive the care they need in Missouri, or, if necessary, in Illinois where gender-affirming care is protected under state law,” said Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, in a statement following the ruling.

Although the FDA has not specifically approved puberty blockers and hormone treatments for gender-questioning youth, they have been used “off label” for many years, which is a common and accepted practice in medicine. Doctors who treat transgender patients argue that these treatments are not experimental based on decades of use.

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