Missouri AG issues rules restricting gender-affirming care

The rules require that patients be screened for autism and ensure “that the patient is not experiencing social contagion with respect to the patient’s gender identity.”

Missouri Attorney General Andrew Bailey has issued emergency regulations restricting gender-affirming care for minors in the state.

In a statement, Bailey claimed that gender-affirming care was “experimental” and covered by existing Missouri law governing unfair, deceptive, and unconscionable business practices, including in administering healthcare services.

Gender-affirming care has been well-established since 2007 and has been studied since the 1990s. The American Medical Association, American Academy of Pediatrics, the American Psychiatric Association and the American Association of Clinical Endocrinology have all said that gender-affirming care is safe and the standard of care.

“As Attorney General, I will protect children and enforce the laws as written, which includes upholding state law on experimental gender transition interventions,” Bailey said. “Even Europe recognizes that mutilating children for the sake of a woke, leftist agenda has irreversible consequences, and countries like Sweden, Norway, and the United Kingdom have all sharply curtailed these procedures. I am dedicated to using every legal tool at my disposal to stand in the gap and protect children from being subject to inhumane science experiments.”

LGBTQ activists blasted the announcement.

“The Missouri Attorney General does not have the right to politicize healthcare nor use transgender bodies as political pawns,” said the state LGBTQ rights group PROMO in a statement. “It is clear his office does not respect the professional guidelines of every major medical association in our country, who agrees gender-affirming healthcare is the standard of care for transgender Missourians, and instead is abusing his political power by asserting his beliefs by stating access to lifesaving healthcare is part of a ‘woke, leftist agenda.’”

The AG cited misinformation in announcing the rules. The statement claimed that “The Endocrine Society found that ‘the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/gender incongruent in adolescence.’” The Endocrine Society, a global medical association, also recommends the use of puberty blockers as part of the treatment of gender dysphoria.

It also claimed an FDA study warned that puberty blockers can lead to brain swelling and blindness. The document was a report about a total of six patients and that puberty blocker “use in pediatric patients could not be reliably established due to the small number of cases and data limitations.”

The statement also claimed that an unnamed study said “an individual whose friend identifies as transgender is ‘more than 70 times’ as likely to similarly identify as transgender” and that claimed it was social factors. There was no identifying information on who conducted the study.

The AG’s office said that gender-affirming care was prohibited if a provider failed to do several actions. Many of the actions, including a full psychological or psychiatric assessment, tracking all adverse effects, and obtain and keep on file informed written consent, are already standards of care for gender-affirming care.

However, the rules also require that the patient has been screened for autism and ensure “that the patient is not experiencing social contagion with respect to the patient’s gender identity.” There was no explanation of social contagion or why autism was singled out.

“We consider this regulation a gross and reprehensible action that puts the health, wellness, and very lives of transgender and gender-expansive youth at risk,” PROMO said.

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