Missouri lawmakers ban gender-affirming care, trans athletes; Kansas City moves to defy state

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JEFFERSON CITY, Mo. (AP) — Missouri lawmakers approved bills Wednesday to ban gender-affirming health care for minors, and prevent transgender girls and women from participating on female sports teams, sending their bills to the Republican governor as the state's largest city moved to defy the state.

Transgender minors in Missouri no longer would have access to puberty blockers, hormones or gender-affirming surgery under one bill passed by the GOP-led House Wednesday. The ban also affects some adults — Medicaid health care won’t cover any gender-affirming care in the state, and surgery will no longer be available to prisoners and inmates.

Another bill, to ban transgender girls and women from participating in female sports teams, would apply from kindergarten through college, both at public and private schools. Schools that allow transgender girls and women to play on such teams would lose state funding.

Both measures would expire in 2027, thanks to concessions made through Republican negotiations with Senate Democrats.

Gov. Mike Parson is expected to sign both bills. He threatened to keep lawmakers working beyond the normal end of their session if they didn't approve the gender-affirming care ban, which would take effect Aug. 28. The ban includes exceptions for minors already getting such treatments.

“Every person in the state should be alarmed by this weaponization of the government to intimidate people through the denial of basic health care and exclusion from extracurricular activities,” the ACLU of Missouri said in a statement.

As the bills were clearing the Republican-controlled Legislature, a City Council committee in Kansas City opened a hearing on a resolution to designate the city as a sanctuary for people seeking or providing gender-affirming care. The committee approved the resolution, forwarding it to the full council, which plans to consider it Thursday.

“It would minimize the legal violence toward trans people in accessing gender-affirming care," Merrique Jenson, a transgender woman and founder of a nonprofit that advocates for trans women of color, told the council committee.

Missouri's bans come amid a national push by conservatives to put restrictions on transgender and nonbinary people that has become, alongside abortion, a major theme running through legislative sessions across the country in 2023.

“When you have kids being surgically and or chemically altered for life for no good reason, yes, it’s time for the government to get involved,” Republican Rep. Brad Hudson told colleagues on the House floor Wednesday.

At least 16 states have now enacted laws restricting or banning gender-affirming care for minors, and several states are still considering bills this year to restrict or ban care, creating uncertainty for many families. Florida and Texas have banned or restricted the care via regulations or administrative orders, and a bill to restrict care is on Republican Florida Gov. Ron DeSantis’ desk.

At least 21 other states have passed restrictions on transgender athletes’ participation in sports.

Missouri's legislative leaders vowed to stop minors from accessing puberty blockers, hormones and surgeries this year. And Missouri's Republican attorney general, Andrew Bailey, took up the charge after Parson appointed him to fill the vacant position in January.

Democrats wept during the Missouri House debate.

“To deny these children care is to deny them their very existence,” Democratic Rep. Joe Adams said.

Kansas City’s resolution is coming from a Democratic-leaning city in a Republican-led state that already controls the city's police department. In Texas, the state capital of Austin declared last year that it should be considered a sanctuary for transgender youth and their families, and Harris County, home to Houston, declared it wouldn’t pursue cases against parents over gender-affirming care.

California,Minnesota and Washington have declared themselves sanctuary states for gender-affirming care, as have the cities of Chicago; Minneapolis, Minnesota; and West Hollywood, California.

The Kansas City resolution says the city will not prosecute or fine any person or organization that seeks, provides, receives or helps someone receive gender-affirming care such as puberty blockers, hormones and surgery. It also says city personnel will make enforcing requirements against gender-affirming care “their lowest priority.”

Supporters acknowledged that the city could face retaliation from the state.

But council member Melissa Robinson said, "I do believe in good trouble, and this might just be one of those lines of good trouble.”

Bailey, now campaigning to keep the state attorney general's job in 2024, launched an investigation in February into St. Louis' Washington University Transgender Center following a former staffer's complaints that doctors were prescribing hormones too quickly and without enough mental health wraparound services. An internal Washington University review found no malpractice.

Bailey has since expanded his investigation to any clinic offering pediatric gender-affirming care in Missouri, and demanded records from a St. Louis Planned Parenthood where doctors provide such health care.

In April, Bailey took the novel step of imposing restrictions on adults as well as children under Missouri's consumer-protection law. A judge temporarily blocked the limits from taking effect as she considers a legal challenge.

Under Bailey’s rules, before gender-affirming medical treatments can be provided by physicians, people would have to document that they experienced an “intense pattern” of gender dysphoria for at least three years and undergo at least 15 hourly sessions with a therapist for at least 18 months.

Screening for autism and “social media addiction” would be required, and a treatment provider would have to declare that any mental health issues are resolved. Some patients could maintain their prescriptions as long as they promptly receive the required assessments.

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Hanna reported from Topeka, Kansas. Also contributing was Margaret Stafford in Kansas City, Missouri.

Summer Ballentine And John Hanna, The Associated Press