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Missouri AG Moves to Curtail Gender Transition Procedures for Minors

March 21, 2023

On Monday, Missouri Attorney General Andrew Bailey (R) announced that his office would file an emergency regulation that would restrict access to controversial gender transition procedures for minors, including the use of puberty blockers, cross-sex hormones, and surgeries to remove healthy organs. The move comes amid growing concerns over clinical gender transition practices in the state as well as a rise in lawsuits from former trans-identifying teenagers who cite physical and psychological harms from life-altering medical interventions.

The Missouri AG office’s new rules will require “an 18-month waiting period, 15 hourlong therapy sessions[,] and treatment of any mental illnesses” before minors would be allowed to undergo gender transition procedures. The regulation further stipulates that “any existing mental health comorbidities of the patient” must be resolved before any gender transition procedures can begin. In addition, minors who seek these procedures must be screened for autism and must be evaluated on a yearly basis to make sure they are “not experiencing social contagion with respect to the patient’s gender identity.”

The action comes a month after a whistleblower gave an explosive account alleging shocking misconduct of staff who worked with minors at The Washington University Transgender Center at St. Louis Children’s Hospital. The allegations include staff members dispensing drugs to children against their parents’ wishes, administering cross-sex hormones to mentally ill children, and ignoring the deteriorating physical and mental health conditions of patients — including at least one suicidal teenager.

Attorney General Bailey joined “Washington Watch with Tony Perkins” on Tuesday to discuss details about his office’s new regulation.

“If even 10% of [the St. Louis Children’s Hospital] allegations are true, this is nothing short of child abuse,” he made clear. “And the problem is we’ve asked the clinic to stop and put a moratorium on these procedures while we look into the matter and determine what is and isn’t happening. They’ve refused to do so and claim that they’re the only clinic in the state that provides these services. So we know that’s patently false. We’ve discovered online that other clinics across the state of Missouri are doing this. There’s a clandestine, shadowy industry for gender mutilation of these young children, and we’re going to put a stop to it.”

With the new regulation, Missouri joins a growing list of states taking action to regulate gender transition procedures for minors. In the last two years, eight other states have either passed legislation or taken executive action to restrict the practice, including Alabama, Arkansas, Florida, Kentucky, Mississippi, South Dakota, Tennessee, and Utah.

Bailey went on to underscore the experimental nature of the procedures being used on children who question their gender identity. “The FDA has said that puberty blockers and cross-sex hormones are not approved for these types of procedures and these types of treatments. We know that they cause blindness, brain swelling, [and] a loss of bone density. And we know for a fact that places like Sweden have said that we have to abandon these types of medications and ultimate surgeries because the risks outweigh the benefits.”

Travis Weber, vice president for Policy and Government Affairs at Family Research Council, applauded Bailey’s action.

“It was very encouraging to see the Missouri attorney general announce this policy,” he told The Washington Stand. “Hopefully, this will indicate to other attorneys general that it’s the right thing to do to step up and to protect minors from these harmful unproven procedures that some are claiming are helpful for them but are actually very harmful. I believe this will send a positive signal and encourage others [who] want to protect children that they should do likewise in standing between children and those who want to harm them with these procedures. As he notes in his announcement, these procedures are experimental, and there are all sorts of problematic effects on youth who are given these drugs and procedures.”

A number of medical experts, including FRC’s Dr. Jennifer Bauwens, have pointed to the experimental nature of gender transition procedures and have highlighted numerous studies indicating that these procedures “do not yield the results they claim to produce, such as improved mental health outcomes and reduced suicides.” They also point to “evidence that shows physiological harm from puberty blockers, cross-sex hormones, and surgeries.”

Weber further noted that “existing Missouri law governing unfair, deceptive, and unconscionable business practices” includes “administering health care services,” suggesting that the Missouri AG’s regulation relies on already established legal authority to deal with gender transition procedures for minors.

Notably, an increasing number of individuals are filing lawsuits against health care providers for performing gender transition surgical procedures on them as minors in a deceptive manner and without their informed consent. The latest example came over the weekend, with a report that 18-year-old Layla Jane is suing doctors along with Permanente Medical Group and Kaiser Foundation Hospitals for approving “Layla for cross-sex hormones and a double mastectomy at ages 12-13, without performing an adequate evaluation and treatment of Layla’s extensive mental health co-morbidities.” The suit cites “serious health issues due to the ‘permanent irreversible mutilation,’ including a deepened voice, mutilation, increased body hair, inability to breastfeed, and possible infertility.”

The news follows a similar lawsuit brought last November by Chloe Cole, another 18-year-old, who is also suing doctors as well as Permanente Medical Group and Kaiser for “breaching the standard of care” when she was advised to undergo a double mastectomy and receive cross-sex hormones and puberty blockers between the ages of 13-17.

“It’s good to be reminded that it is very deceptive to push and foist these procedures on youth, and there are currently a number of laws in different states and at the federal level dealing with unfair, deceptive trade and business practices,” Weber told TWS. “It’s quite reasonable to examine how a deceptive push for gender transition procedures fits within that. This is an interesting area and something that should be examined further.”

Dan Hart is senior editor at The Washington Stand.