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Groups Sue to Block Missouri AG’s “Draconian” Rules on Gender-Affirming Care

Barring an injunction, Missouri AG Andrew Bailey's regulations on gender-affirming care will go into effect on Thursday.

The Supreme Court of Missouri is pictured in early morning in Jefferson City, Missouri.

Several advocacy groups representing transgender people, their family members and medical providers filed a lawsuit on Monday seeking to overturn Missouri Attorney General Andrew Bailey’s (R) new restrictions on gender-affirming care in the state.

The lawsuit, filed in a St. Louis court, seeks to find Bailey’s rules illegal, alleging that they are an overreach of his regulatory powers that go beyond his role and into the realm of health care. Bailey is using the state’s Merchandising Practices Act to regulate people’s health care choices.

“He is sort of taking a law that is about refrigerators and using it to go after trans people and tell doctors and other medical providers how they can practice,” Nora Huppert, a staff attorney for Lambda Legal, one of the organizations behind the lawsuit, told St. Louis Public Radio.

The ACLU of Missouri and Bryan Cave Leighton Paisner law firm are also part of the lawsuit, representing a medical practice, a therapist, transgender youth in the state and their parents, and a transgender adult, judicial journalist Chris Geidner reported. A hearing in the case is scheduled for Wednesday.

Gender-affirming care includes a wide range of treatment options, including counseling, puberty blockers, hormones and surgery. Medical organizations and experts widely agree that such care is safe and beneficial for trans people — and in many cases, gender-affirming care can even be lifesaving.

“Our organizations strongly oppose any legislation or regulation that would discriminate against gender-diverse individuals, including children and adolescents, or limit access to comprehensive evidence-based care which includes the provision of gender-affirming care,” the American Academy of Pediatrics has said in the past regarding attacks on trans health care.

The lawsuit seeks to block the implementation of the new restrictions before they’re set to begin being enforced on Thursday.

“Never before has an Attorney General sought to regulate the practice of medicine, let alone in this way, in Missouri. Yet, usurping authority and powers outside those of his office, [Bailey] claims expansive authority under the [Missouri Merchandising Practices Act] to regulate the practice of medicine,” the lawsuit alleges.

It continues:

The Attorney General’s action violates Missouri’s constitutionally established separation of powers and is an attempt to legislate behind closed doors through Missouri’s limited emergency rulemaking procedures…without any input from the Missourians the Rule will affect most.

The rules place “draconian restrictions on the ability of, and, in many circumstances categorically prohibits Missourians from receiving necessary, effective and safe gender-affirming medical care” that are “entirely divorced from and in contravention of the expert opinions of learned medical providers and the treatment protocols for gender dysphoria recognized by the leading medical associations in the United States,” the litigants add.

The rules Bailey seeks to impose would place undue burdens on transgender children and adults in the state who are seeking therapeutic and medical treatments. The rules require people to undergo 18 months of therapy and document years of gender dysphoria before they can receive gender-affirming care, despite the fact that a diagnosis of gender dysphoria is not a universal experience of all trans people.

The new regulations would force providers to give false warnings about gender-affirming care being harmful. They would also require screenings for autism and social media addiction, playing into the false and dangerous notion that trans people are seeking gender-affirming treatment due to “social contagion” rather than out of genuine medical need.

PROMO, an LGBTQ advocacy group in the state, condemned Bailey for creating unnecessary restrictions on gender-affirming care, saying in a statement earlier this month that he has “fanned the flames of hate by including transgender adults’ ability to access care in his culture war.”

“It should be clear to anyone paying attention that the real threat to Missourians is the attorney general himself,” the group said.

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