The Missouri attorney general, citing a consumer protection law normally used to prosecute fraudulent business practices, issued a new state directive Thursday that would severely restrict gender-transitioning treatment for both adults and minors in the state.
In the emergency regulation, Attorney General Andrew Bailey, a Republican, said it was necessary to put up “substantial guardrails” around such medical treatments because they were considered “experimental.” Those guardrails include at least 18 months of therapy with a psychologist or psychiatrist before receiving puberty-blocking drugs or surgeries.
He invoked the state’s Merchandising Practices Act in issuing the directive, saying that the attorney general “is charged with protecting consumers, including minors, from harm.”
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“The regulation is necessary due to the skyrocketing number of gender-transition interventions, despite rising concerns in the medical community that these interventions lack clinical evidence of safety or success,” said Bailey, who was appointed in November. He is running for a full four-year term in 2024.
The rule will go into effect April 27 and expire in February. Transgender rights advocates said it would make Missouri the first state in the country to restrict gender-transitioning care for all ages.
Lambda Legal and the American Civil Liberties Union of Missouri promised swift legal action, saying that the rule was “based on distorted, misleading and debunked claims” and an attempt “to play politics with lifesaving medical care.”
And PROMO, an LGBTQ advocacy group in Missouri, said Bailey had “fanned the flames of hate by including transgender adults’ ability to access care in his culture war.”
The group added, “It should be clear to anyone paying attention that the real threat to Missourians is the attorney general himself.”
While there is some debate among medical professionals about how to put in place gender-transitioning treatment for children, leading medical groups in the United States, including the American Academy of Pediatrics, say this care should be available to minors, and they oppose legislative bans.
Bailey’s order comes amid a broader push by Republican state lawmakers across the country to regulate the lives of transgender youth in areas like sports and health care.
On Tuesday, North Dakota barred transgender girls and women from joining female sports teams. Since the beginning of the year, 10 states have passed laws restricting what doctors call gender-affirming care for minors.
In Missouri, the attorney general’s order came on the same day that the Republican-controlled House of Representatives passed a bill restricting care for transgender youth.
The House bill is more restrictive than a version passed earlier this year by the Senate, which is also led by Republicans. Among other compromises negotiated by Democrats, the Senate bill would allow care for minors who are already undergoing treatment. And with the legislative session approaching its final weeks, Republican Senate leaders have shown no appetite for the House bill.
Bailey zeroed in on transgender health care after opening an investigation earlier this year into a former employee’s allegations of mistreatment at a transgender youth clinic operated by Washington University in St. Louis.
“We take this evidence seriously and are thoroughly investigating to make sure children are not harmed by individuals who may be more concerned with a radical social agenda than the health of children,” he said in a statement in February.
When asked Friday about Bailey’s latest action, state Sen. Greg Razer, a Democrat from Kansas City, said, “Missouri’s unelected attorney general, in an extreme act of government overreach, is attempting to ban health care for adults.”
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