JEFFERSON CITY, Mo. — Missouri Attorney General Andrew Bailey on Monday said his office plans to file a set of emergency rules aimed at restricting how doctors provide gender-affirming care to minors.
The rules include strict psychological therapy requirements for doctors providing care as well as banning care until all of a patient’s other mental health issues have been treated and resolved.
“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,” Bailey, a Republican, said in a statement.
Madeline Sieren, Bailey’s spokesperson, said in an email that the rules will be filed in “the coming days.” It’s unclear when the rules would take effect once filed.
Bailey announced the proposed rules the same day that a group of anti-transgender activists descended on the Missouri Capitol to urge lawmakers to support GOP-led legislation that would ban gender-affirming care for minors.
Doctors, transgender individuals and family members in Missouri have collectively pushed back against legislation targeting transgender care. They view the bills as attacks on transgender individuals’ existence and their ability to access medical care.
Tom Bastian, a spokesperson for the ACLU of Missouri, said in a statement that Bailey was acting outside of his authority to file a “ban on life-saving health care.”
“The real threats to trans individuals are abuse and violence, which dramatically increase the risk of depression, substance abuse, and suicide,” the statement said. “Sadly, rather than addressing the real harm trans students face, Missouri’s General Assembly and Attorney General are using their governmental powers to erase trans existence.”
Brandon Barthel, a Kansas City-based endocrinologist who has provided care for transgender adults for six years, said some of the rules are already fairly standard procedure. However, he said, they may create a chilling effect for doctors who fear retaliation for providing care.
“With this announcement, I think you’ll see that very few clinicians are willing to risk direct, retaliatory, legal action and or risk to their professional license,” Barthel said in an email to The Star. “Wouldn’t surprise me if this effectively halts any gender affirming care on minors in the state of Missouri.”
Barthel said the rules would be difficult to enforce, specifically pointing to the provision that requires doctors to ensure that a patient’s “existing mental health comorbidities” have been treated and resolved before being able to provide gender-affirming care.
“It also doesn’t make sense to wait for all mental health comorbidities to completely resolve,” Barthel said. “That doesn’t seem very realistic, considering how many of them are chronic in nature.”
The Republican-controlled Missouri Senate was expected to debate a bill banning gender-affirming care for minors later on Monday.
The rules come one month after Bailey launched an investigation into the Washington University Transgender Center at St. Louis Children’s Hospital after allegations that the center harmed children. However, patients and parents of patients who spoke with The Star have cast doubt on the allegations.
Julie Flory, a spokesperson for the university, said in an email that the university would review Bailey’s rules when they are filed.
“We take the care and safety of our patients very seriously,” the email said. “Our focus remains on our commitment to providing compassionate, family-centered care to all of the patients and families we serve.”
Leaders from Children’s Mercy, which provides gender-affirming care to minors in the Kansas City region, in a statement said the hospital was reviewing Bailey’s proposed rules.
“We are monitoring the proposed legislation, and now the emergency regulation, closely and continue to be dedicated to providing the best evidenced-informed care focused on the long-term physical and mental health outcomes for every child we see,” the statement said. “Children’s Mercy will always follow the law.”
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