Transgender adults face ‘egregious’ barriers to care under new Missouri rules, advocates warn

JEFFERSON CITY, Mo. — Missouri’s foremost LGBTQ advocacy group raised alarm on Friday that adults currently receiving transgender medical care will face “egregious” barriers to continued treatment under new emergency rules in Missouri.

Missouri Attorney General Andrew Bailey, a Republican, on Thursday published rules that will apply to all Missourians starting April 27.

“Gender-affirming health care will be very challenging to access for transgender adults and transgender youth going forward,” said Shira Berkowitz, spokesperson for the Missouri advocacy group PROMO.

Bailey had previously only mentioned regulations for minors, and his office only acknowledged the expanded rules when questioned by the news media.

National LGBTQ rights groups have condemned Bailey’s action affecting transgender people of all ages.

“It will chill the effect of providers being able to provide care to their current patients and their future patients,” Berkowitz said. “And it’s going to continue to instil a huge amount of fear and sadness in a community that is … being used as political pawns.”

While Bailey’s public statements have so far focused on minors, his spokeswoman acknowledged Thursday night the emergency regulations would affect everyone. Puberty blockers, hormone therapies and surgeries would be restricted under the regulation.

“We believe everyone is entitled to evidence-based medicine and adequate mental health care,” said Madeline Sieren, spokeswoman for Bailey.

She did not respond to a request to interview Bailey about the rules.

While the requirements say that current patients may continue with a “prescription or provision of a specific intervention that has already begun,” the patient or their provider would need to “promptly” seek “to initiate the treatments and assessments called for” by the state.

Bailey’s new rules require a “full psychological or psychiatric assessment,” of at least 15 separate, hour-long sessions over at least 18 months.

The rule also bars treatment unless a provider ensures that “any psychiatric symptoms from existing mental health comorbidities of the patient have been treated and resolved.”

The rules require annual assessments to ensure someone is “not experiencing social contagion” and for minors, annual assessments for social media addiction.

The requirements also include annual assessments on whether the patient continues to have gender dysphoria, and a requirement that physicians provide a health disclosure to patients written by the attorney general’s office.

Patients would also need to be screened for autism.

National LGBTQ advocacy groups Lambda Legal, the American Civil Liberties Union, the National Center for Lesbian Rights, Human Rights Campaign, and GLBTQ Advocates and Defenders issued on Thursday a joint statement blasting the rules.

“This action by Missouri’s Attorney General crosses a red line that should strike fear in the heart of every person who values individual liberty and believes that individuals, not government officials, should make health care decisions for their children and themselves,” the letter said.

“Cutting off treatment for those who need it will create predictable, unnecessary, and serious harm,” the groups said. “It is also a blatant attempt to strip transgender people of equal protection under the law and to subject them to intrusive government surveillance and control.”

The ACLU of Missouri and Lambda Legal issued a joint statement Thursday:

“We will defend the rights of transgender people through any necessary legal action, just as we have done in other states engaging in this anti-science and discriminatory fear-mongering.”

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