ACLU sues to block Missouri rule on transgender health care

The Missouri ACLU filed a lawsuit on Monday to stop new state restrictions that will be implemented on Thursday for both adults and children who seek gender-affirming healthcare.

ACLU, Lambda Legal, and Bryan Cave Leighton LLP lawyers representing transgender Missourians as well as health care providers requested that a St. Louis County Judge stop this first-of its-kind rule.

They claim that Republican Attorney-General Andrew Bailey does not have the authority to use state consumer protection laws to regulate gender affirming care by way of emergency rules.

In a press release, Dr. Samuel Tochtrop, of Southampton Community Healthcare and plaintiff, said that the rule was “a baseless, discriminatory attempt” to limit healthcare options for transgender people, who face many barriers in accessing life-saving and necessary medical care.

The regulation states that before gender-affirming treatments can be given by doctors, patients must have an “intense” pattern of gender dysphoria documented for at least three years. They also need to have had at least 15 hours per week with a therapist during a period of at least 18 month. The patients would also have to undergo a screening for autism and social media addiction, and all psychiatric issues related to mental health would need to be resolved.

Some people will be allowed the option to keep their prescriptions while they receive the necessary assessments.

Bailey stated in a statement on Monday that “our regulation enacts fundamental safeguards for interventions which an international medical consensus determined to be experimental.” These organizations, rather than ensuring that patients are protected with common sense safeguards by a court order to continue their ideologically-based procedures masquerading themselves as medicine, are racing to the courts.

Bailey promoted the restrictions in March as a means to protect minors against what he calls experimental treatments. In the final rule, he also applied limitations to adults.

We have grave concerns about the treatment of children in all parts of the state. “We believe that everyone has a right to adequate mental health and evidence-based medicine,” Bailey spokeswoman Madeline Sieren stated after the rule filing on April 13.

This is a rare move by Missouri’s Attorney General, whose jurisdiction is limited under state law. This office is in charge of defending state law, handling criminal appeals for felonies, and prosecuting consumer fraud and financial crimes.

The lawsuit claims that the rule is “an improper, extra-legislative infringement by an unelected political appointee,” who seeks to use the consumer protection law of the state. Plaintiffs describe the act as “an action intended to ensure that cars are sold on titles and that hardware shops abide by a guarantee on a vacuum.”

The rule will require doctors providing gender-affirming medical care to provide a list of possible negative side effects, as well as information about the treatments.

The new rule requires health care providers to make sure “any psychiatric symptom from existing mental illness comorbidities have been treated and resolved”, before they can provide gender-affirming treatment. Doctors must also screen for signs of social media addiction, Autism and “social contagion” with regards to the gender identity of their patients.

In the early 1990s, the FDA approved puberty blocking agents to treat precocious sexual development in children. Sex hormones, synthetic estrogen and testosterone, were approved for decades to treat hormonal disorders or as birth-control pills.

The FDA hasn’t approved these medications to specifically treat gender-questioning teens. They have been used “off-label” for this purpose for many years, a practice that is common for many medical conditions. The doctors who treat transgender people say that the fact they have been used for decades is proof of their effectiveness.

Critics are concerned about the possibility of children changing their mind. Despite the fact that there are few studies and some weaknesses, evidence shows detransitioning to be less common than opponents of medical treatment for transgender youth claim.