On Monday, the Missouri chapter of the American Civil Liberties Union (ACLU) filed a lawsuit to block the state’s new restrictions on gender-affirming health care, set to go into effect on Thursday. Attorneys from the ACLU, Lambda Legal, and Bryan Cave Leighton LLP are representing transgender Missourians and healthcare providers. The lawsuit argues that Republican Attorney General Andrew Bailey has no legal authority to use a state consumer-protection law to regulate gender-affirming care through emergency rule-making.
The new rule requires individuals seeking gender-affirming medical treatments to have documented gender dysphoria for three years and to have received at least 15 hourly therapy sessions over at least 18 months. Patients will also be screened for autism and “social media addiction,” and any psychiatric symptoms from mental health issues would have to be treated and resolved before receiving gender-affirming care. The restrictions apply to both minors and adults.
Critics of the new rule argue that it is a baseless and discriminatory attempt to limit healthcare options for transgender individuals who already face significant barriers to accessing necessary and life-saving medical care. The ACLU’s lawsuit alleges that the rule is an improper, extra-legislative overreach by an un-elected political appointee, seeking to use the state’s consumer-protection law, which plaintiffs describe as “an act purposed on making sure that cars are sold with titles and that hardware stores abide by a warranty on a vacuum.”
Bailey marketed the restrictions as a way to protect minors from what he describes as experimental treatments when he announced plans to create the rule in March. However, doctors who treat transgender patients say the use of puberty blockers and sex hormones to treat gender dysphoria is not experimental, as they have been used for many years “off label,” a common and accepted practice for many medical conditions.
If the rule takes effect, doctors who provide gender-affirming health care must first provide a lengthy list of potential negative side effects and information warning against those treatments. Health care providers will need to ensure that any psychiatric symptoms from existing mental health comorbidities of the patient have been treated and resolved before providing gender-affirming treatments under the new rule.
The ACLU’s lawsuit seeks to stop the rule from taking effect and ensure that all Missourians are entitled to evidence-based medicine and adequate mental health care, regardless of their gender identity.