Missouri Transgender Center Shuts Down over SAFE Act Liability Provision

The Washington University Transgender Center at St. Louis Children’s Hospital has stopped providing gender transition procedures for minors, it announced earlier this month, due to a provision in the Missouri SAFE Act which “creates unsustainable liability” for its operations. The law was passed earlier this year and became effective on August 28, 2023.

In June, an analysis by The College Fix found that 14 youth gender centers were likely to close this year as a result of state legislation protecting minors from gender transition procedures. This month, two transgender centers at children’s hospitals in Missouri confirmed that they have ceased operations specifically because of the state’s new SAFE Act.

The Missouri Save Adolescents from Experimentation (SAFE) Act of 2023 (SB 49) forbids a health care provider from “knowingly perform[ing] a gender transition surgery” or “knowingly prescribe[ing] or administer[ing] cross-sex hormones or puberty-blocking drugs for the purpose of a gender transition” to anyone under the age of 18. The provision protecting minors from gender transition hormones exempts anyone who began treatment before the law’s effective date and expires after four years. Any health care provider who violates these provisions would have their license revoked.

Missouri’s SAFE Act also makes prescribing or administering puberty blockers or cross-sex hormones for the purpose of gender transition “a cause of action against the health care provider.” The law offers infertility as an example of the types of harm that could be caused. A Daily Wire investigation this summer discovered that a transgender center at the University of Virginia Children’s Hospital listed “irreversible infertility” as a possible side effect of cross-sex hormones. Missouri minors harmed by these drugs can bring a malpractice suit until they reach the age of 36 or until 15 years after treatment for their injury has ceased.

In such a suit, the law places a heavy burden of proof on the health care provider, while the person harmed “shall be entitled to a rebuttable presumption that the individual was harmed … and that the harm was a direct result of the hormones or drugs prescribed or administered.” If a health care provider lost such an unfavorable suit, it would be required to pay a minimum of $500,000.

The Washington University Transgender Center shut down because of this provision, which it said “creates unsustainable liability.”

“If it was real medicine, that wouldn’t be an issue,” Family Research Council Senior Fellow for Biblical Worldview and Strategic Engagement Joseph Backholm told The Washington Stand. “Doctors have always faced liability for their work, and if they knew it was the right thing to do, they would continue doing it.”

In February of this year, a whistleblower described the practices at Washington University’s Transgender Center as “morally and medically appalling.” According to the whistleblower, who self-identifies as far-left and pro-trans, the center lacked formal protocols for treatment, placed children on drugs without proper review, and lied to government officials about referring minors for gender transition surgery. In 2021, the center encouraged a school to “affirm” a group of 5th grade girls who identified as transgender en masse.

The whistleblower’s explosive account led Missouri Attorney General Andrew Bailey (R) to launch an investigation of the center in February, which was still ongoing in late July. “If even one-tenth of the allegations are true, they’re abusing children,” said Bailey.

“And, in fact, parents were coerced into making these decisions,” Bailey added. One mother who took her 13-year-old son to the center said she “felt bullied” by clinic staff who bombarded her with suicide statistics. “I really felt like this is not a meeting for me to get answers to my questions and for everybody to have equal say.”

In March, Bailey filed an emergency regulation to restrict the transgender center’s access to minors, but he withdrew the rule in May after it was blocked by a judge.

Although Washington University’s transgender center has been among the most controversial, it is not the only one to close due to recent state laws. A transgender center at the University of Missouri Children’s Hospital also stopped providing gender transition procedures to minors on August 28, a spokesperson said. “Both blamed a section of the law that increased the liability for providers,” recorded the Associated Press.

Also according to the AP, “at least some providers” in North Dakota and “across the South” have stopped providing gender transition procedures to minors simply due to uncertainty about what the laws prohibit.

“The number of clinics stopping this ghoulish work once liability is firmly established illustrates their own lack of confidence in the long-term benefits for the kids and themselves,” continued Backholm. “Clinics do this because they get rich and because they win progressive brownie points for doing so, but this suggests they may be unable to defend the work they do today years from now.”