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Missouri Attorney General Sets Severe Restrictions on Gender-Affirming Care

Missouri Attorney General Sets Severe Restrictions on Gender-Affirming Care

AG Andrew Bailey

The regulation affects both transgender adults and youth.


Missouri’s Republican Attorney General Andrew Bailey put out an emergency regulation on Thursday severely restricting gender-affirming care, claiming that gender-affirming care is already banned in the state due to a state law blocking some medical treatments deemed to be dangerous.

A vast majority of the major medical association in the United States supports providing gender-affirming care to trans people — youth and adults. Many health experts say bills targeting gender-affirming care are based on unscientific reports.

In the regulation, any medical intervention for trans people would require psychological or psychiatric assessment and would institute a three-year waiting period. Those assessments would need to be 15 sessions across 18 months. Individuals who transition would have to get a medical follow-up in the 15 years following the intervention.

The regulation goes into effect on April 27.

Bailey, who is up for re-election in 2024, wrote on Twitter that he was putting the regulation in place, “because gender transition interventions are experimental and have significant side effects, state law already prohibits performing those procedures in the absence of substantial guardrails that ensure informed consent and adequate access to mental health care."

Gender-affirming care isn’t experimental.

In March, Bailey released a regulation demanding trans youth wait more than a year to receive care.

“Let’s be clear – gender-affirming care is based on decades of clinical experience and research and is not considered experimental. The Attorney General’s claims are maliciously cherry-picked and come from unverified sources that allow him to promulgate disgusting, obstructive, and misleading information into an emergency rule. It should be clear to anyone paying attention that the real threat to Missourians is the Attorney General himself,” said a statement from the Missouri LGBTQ+ advocacy group PROMO.

The group added, “We are living through an all-out attack on transgender Missourians’ lives and very ability to exist.”

Lambda Legal and the American Civil Liberties Union of Missouri have said they will file legal action against the rule.

“The Attorney General’s so-called emergency rule is based on distorted, misleading, and debunked claims and ignores the overwhelming body of scientific and medical evidence supporting this care as well as the medical experts and doctors who work with transgender people every day. This rule is a shocking attempt to exploit Missouri’s consumer protection laws in order to play politics with life-saving medical care,” the groups said in a joint statement. “Transgender people in Missouri deserve the support and care necessary to give them the same chance to thrive as their peers. Gender-affirming care is critical in helping transgender adolescents succeed in school, establish healthy relationships with their friends and family, live authentically as themselves, and dream about their futures. This emergency regulation will have a drastically negative impact on transgender youth, compounding the prejudice, discrimination, violence, and other forms of stigma they continue to face in their daily lives.”

The groups note that The Equality Federation has tracked 117 healthcare bans targeting transgender people in the United States.

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