Missouri Judge Blocks State's Ban on Child Sexual Mutilation

AP Photo/David A. Lieb

A Missouri judge issued a temporary block on Monday against an emergency ruling mandating both adults and children complete over a year of therapy and meet various other prerequisites before being eligible for gender-affirming treatments such as surgery, hormones, and puberty blockers.


St. Louis County Circuit Judge Ellen Ribaudo granted a temporary restraining order against the emergency rule created by Republican Attorney General Andrew Bailey, which will remain in effect until May 15, unless extended. She also scheduled a hearing on May 11 to consider an American Civil Liberties Union (ACLU) lawsuit challenging the ruling.

The regulation introduced by Bailey stipulates that patients seeking gender-affirming treatment must attend 15 individual hour-long therapy sessions for at least 18 months and provide documentation of experiencing a persistent pattern of gender dysphoria for three years or more before receiving care. Additionally, healthcare providers must confirm that the patient’s mental health conditions have been thoroughly treated and resolved.

In her ruling, Ribaudo wrote that transgender individuals “be subjected to immediate and irreparable loss, damage or injury if the Attorney General is permitted to enforce the Emergency Rule, and its broad, sweeping provisions were implemented without further fact-finding or evidence.”

Bailey had previously argued the restrictions were implemented as a result of an inquiry conducted by his office, which was initiated after a former case manager at the Washington University clinic for transgender youths at St. Louis Children’s Hospital filed allegations of patient mistreatment. The accusations included hasty administration of treatments. However, some parents of children who received treatment at the clinic have refuted the allegations.


She added that transgender patients “are at high risk of having their medical care interrupted for an unknown length of time; once the Rule goes into effect, they may lose access to medical care through their current providers until such time as the provider can come into compliance with the Rule’s requirements.”

In a statement Monday, Bailey said his office would continue to defend his ruling through the appropriate means. “We remain confident in our position because the Court even acknowledged that it deferred its consideration of the science until a later date,” the statement. “Our six pages of endnotes speak for themselves: these procedures are experimental. We will continue to fight for all patients to have access to adequate health care.”

The lawsuit was originally filed by ACLU, whose deputy director of litigation for Missouri celebrated the ruling as a “win for transgender Missourians over an unprecedented attempt by the Attorney General to unilaterally legislate and harm their right to self-expression, bodily autonomy, and access to lifesaving health care.”

The plaintiffs in the lawsuit included two transgender teenagers’ families, a 36-year-old transgender man who has been undergoing testosterone treatment for a decade, a therapist specializing in transgender patient care, and the Southampton Community Healthcare clinic, which offers gender-affirming care in southern St. Louis. They also enlisted Lambda Legal and the Bryan Cave Leighton Paisner law firm as their legal representatives.


Similar bills restricting transgender surgery have passed in Arkansas, Iowa, Idaho, Georgia, and West Virginia over the past month, as Republican-controlled states seek to stem the explosion in transgender identification and activism among minors. Other states to have already done so include Arizona, Florida, Georgia, Tennessee, Texas, and Utah.



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