Missouri AG says state law ‘already prohibits’ gender-affirming health care for youth

Missouri Attorney General Andrew Bailey (R) on Monday issued an emergency regulation claiming that state law “already prohibits” gender-affirming health care for transgender youth “in the absence of specific guardrails.”

“As Attorney General, I will protect children and enforce the laws as written, which includes upholding state law on experimental gender transition interventions,” Bailey wrote Monday on Twitter. His office is investigating at least one Missouri children’s hospital that treats transgender minors.

According to Bailey’s emergency regulation, Missouri law already prohibits medical professionals from performing “experimental procedures” without following certain guidelines, including providing patients with informed consent disclosures that communicate the potential harms of experimental interventions.

Because Bailey’s office considers gender-affirming health care to be “experimental,” physicians moving forward must provide their patients with documents including a warning that puberty blockers and hormones are not approved by the Food and Drug Administration (FDA) to treat gender dysphoria.

The emergency regulation will last either 30 legislative days or 180 days, whichever is longer, Bailey’s office said Monday.

Bailey’s order also prohibits health-care providers from providing gender-affirming care to patients who have not received a full psychological or psychiatric assessment consisting of 15 hourly sessions over the course of 18 months or longer. Patients must also be screened for autism.

Any existing comorbidities like anxiety and depression must be “treated and resolved” for a patient to receive gender-affirming health care, according to Bailey’s order, and any adverse effects that arise from treatment must be documented for at least 15 years.

Health care providers must also ensure annually that a patient is not experiencing “social contagion” with respect to their gender identity. Several studies have challenged the “social contagion” hypothesis, which claims that youth identify as transgender because they are influenced by social media or their peers.

Bailey’s order comes just over a month after his office announced that a multiagency investigation into the Washington University Pediatric Transgender Center at St. Louis Children’s Hospital had begun in January. The investigation stems from a sworn affidavit provided to Bailey’s office by Jamie Reed, a former hospital employee who worked with transgender youths and their families.

Reed in February published a first-person account of her time at the hospital in the Free Press that alleged years of malpractice. Sen. Josh Hawley (R-Mo.), responding to Reed’s claims, said last month that his office had launched a separate investigation into the hospital’s transgender center.

Reed’s account has been challenged by reporting from the St. Louis Dispatch. Nearly two dozen parents of children seen at the clinic told the outlet that Reed’s allegations are “just not true.”

Gender-affirming health care for transgender youths and adults is backed by most major medical organizations, which consider treatments like puberty blockers and hormones to be medically necessary for the treatment of gender dysphoria.