Missouri to Enact Transgender Health Restrictions for Adults and Minors

Missouri’s attorney general announced new restrictions Thursday on gender-affirming care for minors and adults in a move that drew outrage from advocacy and LGBTQ groups.

Attorney General Andrew Bailey’s restrictions would require adults to attend 18 months of psychological or psychiatric evaluations by a therapist before receiving gender-affirming care “to examine the developmental impact of the patient’s current gender identity and to determine, among other things , whether the person has any co-occurring mental illnesses.’

Providers will also have to prove that “the patient has exhibited a medically documented, long-lasting, persistent, and intense pattern of gender dysphoria” for at least three years, according to the release.

A spokeswoman for the attorney general’s office, Madeline Searen, told The Associated Press that the restrictions would apply to both minors and adults.

LGBTQ advocates criticized Bailey’s decision to limit health care available to both adults and minors, arguing that Bailey’s announcement was based on discrimination, not science.

“The Attorney General’s claims are maliciously selected and come from unverified sources that allow him to promulgate disgusting, obstructive and misleading information in an emergency rule,” PROMO, a Missouri LGBTQ+ public policy and advocacy organization, said in a statement to ABC News.

Bailey’s announcement focused on the risks associated with gender-affirming care, but doctors told ABC News that any medication, surgery or vaccine for any type of treatment comes with risk, and gender-affirming care is no different. .

They say knowing the risks and benefits of treating — and not treating — a disease can help families and individuals make an informed decision.

Major national medical associations, including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and more than 20 others agree that gender-affirming care is safe, effective, beneficial, and medically necessary.

Because of gender discrimination and gender dysphoria, trans youth are more likely to experience anxiety, depressed mood, and suicidal thoughts or attempts. Gender-affirming hormone therapy has been found to improve the mental health of transgender adolescents and teenagers on average, according to a recent study in the New England Journal of Medicine.

Gender dysphoria refers to the stress of being in a body that doesn’t feel like your own.

Although Bailey called puberty blockers “experimental” in his announcement, drugs in this class have been FDA-approved since the 1990s to treat early puberty. They are not specifically approved for the treatment of gender dysphoria, but have been studied and often prescribed for this purpose for decades.

Modern gender-affirming care is based on “decades of clinical experience and research and is therefore not considered experimental, cosmetic, or convenience,” according to the World Transgender Health Professional Association’s Standards of Care.

Studies also show that it’s rare for people to reverse transition after going through gender confirmation care, according to research in the journal LGBT Health, which also found that those who do reverse often do so because of pressure from family and social stigma.

The regret rate for gender reassignment surgery is extremely low—research shows it hovers around 1 percent, according to the Medical Journal of Plastic and Reconstructive Surgery. Regret rates for knee and hip surgeries are significantly higher, studies show.

In his announcement, Bailey also cited the high mortality rate of transgender people. Studies in Duke University Press, the National Cancer Institute and the Lancet Diabetes & Endocrinology show that transgender people face economic and social marginalization, violence and discrimination at a higher rate than non-transgender people – this research argues that these issues likely play a role in the persistence of poor health and higher mortality in the community.

The research argues that these problems likely play a role in the persistence of poor health and higher mortality in the community.

Bailey’s announcement comes amid an investigation into a transgender health center in St. Louis, which has been accused by a whistleblower of “using experimental drugs on children,” distributing drugs “without individual evaluation” and “without parental consent.” , according to the attorney general’s office.

The center said it was “disturbed by the allegations”.

The emergency regulation is in effect from April 27 to February 6, 2024.

“We take this matter very seriously and have already begun the process of reviewing the situation to establish the facts,” the University of Washington’s Transgender Center said in a statement. “As always, our highest priority is the health and well-being of our patients. We are committed to providing compassionate, family-centered care to all of our patients and hold our physicians to the highest professional and ethical standards.”

Civil rights organizations, including Lambda Legal and the American Civil Liberties Union of Missouri, have vowed to pursue lawsuits against the move by the attorney general’s office.

“Gender-affirming care is critical to helping transgender youth succeed in school, establish healthy relationships with friends and family, live authentically as themselves, and dream about their futures,” the organizations said in a joint statement. “We will defend the rights of transgender people through all necessary legal action, just as we have done in other countries engaged in this unscientific and discriminatory fear-mongering.”

Gender care for youth is restricted in at least 12 states.

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