Missouri Law Prohibiting Minors from Undergoing Sex-Change Treatments Comes into Force

Two new laws in Missouri went into effect on Monday, restricting the access of transgender youth to sex-change health care and school sports. One law prohibits minors from starting puberty blockers and hormones, as well as gender-changing surgeries. The other law requires student athletes from kindergarten through college to participate in sports teams that align with their assigned sex at birth. These laws were signed by Republican Governor Mike Parson in June and will expire in 2027.

Advocates for LGBTQ+ rights who sued to overturn the health care law were dealt a setback last week when a judge allowed the law to take effect while the court challenge is ongoing. Under the health care law, physicians are prohibited from providing gender-changing health care to minors, but those who were prescribed puberty blockers or hormones before August 28 can still receive the treatments. However, Medicaid will no longer cover transgender health care, and prisoners’ access to surgeries will be limited.

Missouri’s Planned Parenthood clinics have been increasing available appointments and holding pop-up clinics to start patients on treatments before the law takes full effect. Physicians who violate the law may have their licenses revoked and can be sued by patients. Dr. Colleen McNicholas, the chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri, expressed concern that transgender individuals in Missouri who are already receiving care will now be denied coverage under public insurance.

Last month, the ACLU of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner filed a lawsuit seeking to overturn Missouri’s transgender health care law on behalf of doctors, LGBTQ+ organizations, and three families of transgender minors. They argued that the law is discriminatory and requested that it be temporarily blocked during the court challenge. However, a judge ruled against the request, allowing the law to take effect throughout the lawsuit. The next hearing in the case is scheduled for September 22.

Starting Monday, student athletes in Missouri will only be allowed to participate in sports teams that align with their sex assigned at birth. This means transgender girls and women will not be allowed on girls’ and women’s teams, and transgender boys and men can only compete on those teams. Girls and women can play on boys’ and men’s teams only if there is no corresponding sports program available for them.

The law requires compliance based on students’ birth certificates or other government documents, with only records created shortly after birth being considered acceptable. Modified birth certificates are allowed only in cases of typos and other mistakes. The state education department is responsible for creating additional rules for enforcing the law, which is not currently facing a challenge.

Schools, including private institutions, may lose all state funding if they violate the law. Parents, adult students, and former students have the right to sue if they believe a violation of the law led to the loss of an “athletic opportunity” for them. At least 22 states have enacted laws banning or restricting gender-changing care for minors, and many of these bans are being challenged in court.

It is worth noting that every major medical organization, including the American Medical Association, opposes bans on gender-changing care for minors and supports appropriate medical care for youth. The American Academy of Pediatrics recently reaffirmed its support for these treatments and voted to conduct an external review of research regarding the care.