Missouri judge declines to block ban on gender-affirming care

A Missouri law banning gender-affirming health care for transgender minors and some adults will take effect Monday after a circuit court judge on Friday declined to block it.

St. Louis Circuit Court Judge Steven Ohmer on Friday rejected a request to temporarily block the enforcement of Missouri’s gender-affirming care ban, writing in an order that “petitioners have not clearly shown a sufficient threat of irreparable injury absent injunctive relief.”

In a lawsuit filed last month on behalf of three Missouri families with transgender children, three LGBTQ health organizations and two physicians, the American Civil Liberties Union (ACLU) of Missouri, Lambda Legal and Bryan Cave Leighton Paisner argued that the measure will “cause severe and irreparable harm” to transgender young people in Missouri if it is allowed to take effect.

“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,” the groups wrote in the lawsuit. “

Adolescents with gender dysphoria … if untreated, can suffer serious medical consequences, including possible self-harm and suicidal ideation,” they said.

Ohmer in Friday’s order wrote that plaintiffs in the case are unlikely to succeed on their claim that Missouri’s law is unconstitutional. He added that scientific and medical evidence in support of gender-affirming care “is conflicting and unclear,” despite being considered medically necessary by every major medical organization.

“As a result, it has not clearly been shown with sufficient possibility of success on the merits to justify the grant of a preliminary injunction,” Ohmer wrote.

The ACLU of Missouri vowed to keep fighting in wake of the ruling.

“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,” ACLU of Missouri spokesman Tom Bastian said in a statement. “The case is not over and will go to a full trial on the merits.”

Lambda Legal immediately responded to a request for comment.

The law, Senate Bill 49, prohibits health care providers from administering medications including puberty blockers and hormone replacement therapy to treat gender dysphoria in minors, with an exception carved out for transgender young people who began treatment before Aug. 28. 

The measure also bars transgender youths under 18 from receiving gender-affirming surgeries and prohibits MO HealthNet, the state’s Medicaid program, from covering transition-related procedures. Missouri prisons, jails and correctional centers under the new law are also unable to provide gender-affirming medical care to transgender inmates irrespective of age.

The law, which hit several stumbling blocks before it was able to advance through both chambers of the legislature, will lapse after four years thanks to a “sunset” provision added after hours of closed-door negotiations between party leadership in the state Senate.

Missouri Sen. Mike Moon (R), the bill’s sponsor, told The Hill previously that he plans to lobby for the removal of the sunset clause before it expires.

LGBTQ rights groups on Friday slammed Ohmer’s refusal to block the law from taking effect.

“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,” Aro Royston, board secretary for PROMO Missouri, an LGBTQ rights group, said Friday in a statement.

“Not one single person who is in favor of this legislation understands how this law truly impacts the transgender community,” said Royston, who is transgender. “None of them understand the breath of relief we get to feel when we finally understand who we are and how beautiful it is to be transgender.”

“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.