Missouri bill would ban gender-affirming care for minors, strip doctors of licenses

A Missouri House bill seeks to block access to gender-affirming care for transgender and nonbinary youth, effectively ending health insurance coverage for gender-affirming treatments and putting the medical licenses of affirming providers in jeopardy.

The bill, officially titled the Save Adolescents from Experimentation (SAFE) Act, stipulates that physicians or other health care providers in Missouri may not provide “gender transition procedures” like puberty blockers or hormones to any person under 18 years old.

Doctors who continue providing or recommending gender-affirming care to trans or nonbinary minors would be subject to disciplinary action and could potentially have their medical licenses revoked.

“Any referral for or provision of gender transition procedures to an individual under eighteen years of age is unprofessional conduct and shall be subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state,” the bill reads.

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Notably, providers under the bill are not prohibited from performing surgeries or prescribing medications like puberty blockers or hormones to young patients who do not intend to use them for a “gender transition” and require treatment for a “medically verifiable disorder of sex development.”

The bill’s sponsor, Rep. Suzie Pollock (R), has been a determined adversary of the transgender community, and last year voted in favor of a bill with an amendment barring transgender women and girls from competing on sports teams that match their gender identity. The bill itself bore no similarities to the amendment, and was introduced as a measure to protect the grade averages of students adversely affected by the COVID-19 pandemic.

Pollock earlier this month spoke on a panel about “transgenderism” at an event held by the conservative organization Concerned Women for America, which in March filed a Title IX complaint against the University of Pennsylvania for allowing Lia Thomas, a transgender swimmer, to compete on the university’s women’s team.

The group wrote in a statement announcing the lawsuit that the university was “forcing women to compete against athletes who are biologically male.”

Pollock’s bill also prohibits the state’s Medicaid program from reimbursing or providing coverage for gender-affirming care to transgender or nonbinary minors. According to the bill, public funds “shall not be directly or indirectly used, granted, paid, or distributed to any individual, entity, or organization that provides gender transition procedures to an individual under eighteen years of age.”

On top of that, payments made for gender-affirming treatments – even as premiums for health care coverage that includes coverage for gender-affirming care – would not be tax deductible.

A second bill sponsored by Pollock this year would require physicians to provide those seeking gender-affirming care with “the most recent available studies on detransitioners,” or individuals who sought gender-affirming care and “later regretted doing so.”

Detransitioning is exceedingly rare, and just 8 percent of respondents in the 2015 National Transgender Survey said they had at some point gone back to living as their sex assigned at birth. Importantly, the majority of those who did detransition did so only temporarily, and 62 percent of trans people who had detransitioned reported that they were currently living as a gender different from their gender assigned at birth.

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