HomeNewsMissouri’s Transgender Rule Faces Legal Battle as Judge Extends Suspension

    Missouri’s Transgender Rule Faces Legal Battle as Judge Extends Suspension

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    A Missouri judge has extended her order blocking the enforcement of a controversial rule that would require transgender people to undergo therapy and other requirements before receiving gender-affirming treatments. The rule, pushed by the state’s Republican attorney general, is facing a legal challenge from a group of transgender plaintiffs who argue that it violates their constitutional rights and medical privacy.

    The rule, which was set to take effect on April 27, would require transgender people to have experienced an “intense pattern” of documented gender dysphoria for three years and to have received at least 15 hourly sessions with a therapist over at least 18 months before they could receive treatments such as puberty blockers, hormones and surgery. The rule would also require screening for autism, social media addiction and other mental health issues.

    Attorney General Andrew Bailey said the rule was intended to protect minors from what he called experimental medical treatments, though the rule would also apply to adults. He said the rule was based on “common sense” and “sound science.”

    However, the plaintiffs in the lawsuit, represented by the American Civil Liberties Union of Missouri and other groups, said the rule was discriminatory and harmful. They said the rule would interfere with their medical decisions, delay or deny their access to care and expose them to stigma and harassment.

    St. Louis County Judge Ellen Ribaudo granted a temporary restraining order on Monday and originally scheduled a hearing on the lawsuit for May 11. However, on Thursday, she pushed back the hearing to July 20, following a joint request from both sides. The order will remain in effect until July 24 or until the judge rules on whether to grant a preliminary injunction.

    Ribaudo’s ruling noted that the plaintiffs were at “high risk” of having their medical care interrupted indefinitely and losing care through their current providers if the rule took effect. She also said the plaintiffs had shown a likelihood of success on the merits of their claims.

    Legal experts and transgender advocates said that Missouri’s rule was unprecedented and extreme. They said it would make Missouri the first state to restrict gender-affirming care for adults and the first to enact such restrictions through emergency rule-making instead of through a new law.

    On Thursday, the Kansas City Council introduced a resolution making Missouri’s largest city a “sanctuary city” for transgender people receiving gender-affirming care. The resolution, which now goes to a committee for further action, said the city would oppose any state or federal efforts to limit access to such care and would support health care providers who offer it.

    The resolution also cited a statement from the American Medical Association, which said that “there is no medically valid reason” to delay or deny gender-affirming care and that such care is “medically necessary” for many transgender people.

    According to the attorney general’s office, there are 12,400 Missourians who identify as transgender. The office estimated that 600 to 700 Missourians would begin intervention in the next year.


    • Missouri AG’s transgender rule faces legal challenge by KSDK News, May 3, 2023
    • Kansas City Council introduces resolution to protect transgender people from Missouri AG’s rule by The Kansas City Star, May 4, 2023
    • Missouri AG defends transgender rule as ‘common sense’ by The Associated Press, May 2, 2023

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