Missouri Senate approves four-year ban on medical procedures for transgender minors

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(Missouri Independent) – After 13 hours of overnight debate, the Missouri Senate gave initial approval Tuesday morning to a pair of bills that would limit medical procedures for transgender children and place restrictions on transgender girls playing school sports.

Both bills still need to be approved one more time by the Senate before being sent to the House.

Sen. Mike Moon, R-Ash Grove, sponsored the legislation that would ban puberty blockers, hormone therapy, and surgeries for individuals younger than 18. A last-minute change to the bill allows patients to continue taking puberty blockers or hormone therapy if they started those treatments before Aug. 28, 2023, when the law would take effect.

And as a concession to Democrats, the bill’s restrictions on puberty blockers and hormone therapy expire on Aug. 28, 2027, unless the legislature re-approves them.

The ban on surgeries does not expire.

“We’ve gotten some good things done to protect the children of Missouri,” Moon said Tuesday morning. “I didn’t get everything I wanted right away. But in good faith, we’ve gotten to a point where we have four-year protection. That’s a start.”

Shortly after approving Moon’s bill, the Senate also gave initial approval to legislation sponsored by Sen. Holly Thompson Rehder, R-Scott City, that would restrict transgender athletes to playing on school sports teams matching the sex on their birth certificate. That restriction would also expire Aug. 28, 2027.

The votes came after a long night of debate, with Democrats using a filibuster to block the bills while negotiations took place behind the scenes.

Monday saw supporters of a ban on transgender care rally at the Missouri Capitol to urge Senators to take action. Attorney General Andrew Bailey also announced Monday an emergency regulation he argued would require medical facilities providing gender-affirming care to file expansive informed-consent paperwork.

For the Senate, Tuesday morning’s vote avoids a potential procedural showdown that threatened to derail the legislative session.

Some Republicans wanted Senate Majority Leader Cindy O’Laughlin, R-Shelbina, to cut off debate to end the Democratic filibuster and force a vote on the measure. She resisted, noting that Democrats would retaliate by using their own procedural maneuvers to gum up the chamber — putting every other bill, and the state budget, at risk.

And when the Senate returned from spring break Monday afternoon, the chamber initially took up Rehder’s bill pertaining to student-athletes and added the health care provisions.

Moon cried foul, arguing that combining the two issues into one bill put it at risk of a legal challenge. Missouri’s Constitution limits a bill to one subject and bars amendments that change a bill’s original purpose.

The all-night negotiations led to the Tuesday morning compromise, though the debate was at times heated.

Children can be easily manipulated, said Republican Sen. Rick Brattin of Harrisonville, noting that when he was young he was convinced by his grandfather that watermelon seeds would grow in his stomach if he swallowed them. He accused Democrats and critics of the bill of pushing a “counterfeit culture that wants to spit in the eye of anything that is wholesome.”

Sen. Denny Hoskins, R-Warrensburg, bristled at accusations that the bill was an attempt to target or hurt vulnerable transgender kids.

“I’m not against trans people. I’m not against the LGBTQ+ community,” Hoskins said. “But to force that on kids, that’s what this whole bill is about. Protecting kids.”

Republican senators repeatedly pointed to accusations of misconduct by a former caseworker at the Washington University Transgender Center at St. Louis Children’s Hospital, who said the clinic overlooked the mental health needs of patients and did not inform adolescents and their parents of potential side effects of treatment.

Critics of the bills say they will do more harm than good, denying treatments that national medical associations — including the American Academy of Pediatrics, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry — have concluded are safe, effective, beneficial, and medically necessary.

Transgender youth are more likely to experience anxiety, depressed mood, and suicidal ideation and attempts, often due to gender-related discrimination and gender dysphoria, and a recent study in the New England Journal of Medicine found gender-affirming hormone therapy has been proven to improve the mental health of transgender adolescents and teenagers.

The GOP-backed bills take away parents’ rights to make medical decisions for their children, said Sen. Karla May, D-St. Louis.

“You think you love their children more than they love their children,” May said. “You’re saying you have more compassion for their children than parents have.”

The Senate’s only openly gay member — Sen. Greg Razer, D-Kansas City — decried the GOP rhetoric around transgender rights that dominated the debate over the legislation.

“This is the crap they said about people like me for decades,” Razer said. “They can’t say it about me anymore, so now they’re going after another group. But this time they’re kids. They’re using kids as political pawns and that burns me up.”

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Jason Hancock


Jason Hancock has been writing about Missouri since 2011, most recently as lead political reporter for The Kansas City Star. He has spent nearly two decades covering politics and policy for news organizations across the Midwest and has a track record of exposing government wrongdoing and holding elected officials accountable.