Missouri judge refuses to halt ban on gender-affirming care

A groundbreaking law in Missouri that prohibits gender-affirming health care for transgender minors and certain adults will officially go into effect on Monday. St. Louis Circuit Court Judge Steven Ohmer declined to block the law, stating that there was not sufficient evidence of irreparable harm to justify a temporary injunction.

Last month, the American Civil Liberties Union of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner filed a lawsuit against the law on behalf of three Missouri families, three LGBTQ health organizations, and two physicians. They argued that the law would cause severe and irreversible harm to transgender youth in the state.

The lawsuit stated, “Withholding or restricting gender-affirming medical care from individuals with gender dysphoria when it is medically indicated puts them at risk of severe, irreversible harm to their health and well-being. Adolescents with gender dysphoria… if untreated, can suffer serious medical consequences, including possible self-harm and suicidal ideation.”

In his order, Judge Ohmer expressed doubts about the constitutionality of the law but noted that the scientific and medical evidence regarding gender-affirming care is conflicting. He stated that the evidence did not clearly justify granting a preliminary injunction to block the law.

The ACLU of Missouri remains committed to fighting for transgender rights, with spokesman Tom Bastian stating, “While we are disappointed in and disagree with the court’s ruling, we will not stop fighting to protect the rights of transgender people in Missouri. The case is not over and will go to a full trial on the merits.”

Lambda Legal did not immediately respond to a request for comment.

The law, known as Senate Bill 49, prohibits health care providers from administering gender-affirming treatments to minors, including puberty blockers and hormone replacement therapy. There is a limited exception for transgender youth who began treatment before August 28. The law also restricts transgender individuals under 18 from receiving gender-affirming surgeries and prevents Missouri’s Medicaid program from covering transition-related procedures. Additionally, the law prohibits gender-affirming medical care for transgender inmates in prisons, jails, and correctional centers, regardless of age.

The law, which faced challenges during its passage, will expire after four years due to a “sunset” provision. Missouri Senator Mike Moon, the bill’s sponsor, intends to advocate for the removal of the sunset clause before it expires.

Groups advocating for LGBTQ rights strongly criticized Judge Ohmer’s decision not to block the law’s enforcement.

Aro Royston, board secretary for PROMO Missouri, an LGBTQ rights group, expressed anger and disappointment, stating, “We are enraged — not only has our government and elected officials failed us, but now our justice system has failed to do its job in protecting the most vulnerable of our population.” Royston, who is transgender, emphasized that those in favor of the law do not understand the impact it has on the transgender community and the significance of gender-affirming healthcare.

“They cannot fathom the best part of gender-affirming healthcare, which is being able to look into the mirror and see in the reflection the person you always knew yourself to be,” Royston added.