A Missouri court has upheld Missouri’s ban on hormonal treatments and puberty blocking drugs for minors with gender dysphoria.

Wright County Circuit Judge Craig Carter wrote in his 74-page decision Monday that transgender treatments for minors are an “ethical landmine” for a treatment that is not backed by science.

He wrote: “Regarding ethics, it seems that the medical profession is in the middle of a minefield with little evidence to guide it.”

Wright cited Supreme Court precedents that allowed lawmakers broad discretion in areas that were “fraught” with “medical and scientific uncertainty.” Wright concluded that “there is an almost total lack consensus regarding the medical ethics of treatment for adolescent dysphoria.”

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The plaintiffs, which included gender affirming health care providers and transgender minors as well as their families, had to prove that the statute “clearly violated a constitutional provision,” wrote the judge. Because plaintiffs challenged all of the law, they needed to show that “there is no set of circumstances in which the provisions are valid.”

During the nine day trial that took place in September, both sides had experts give their opinions on the scientific research available on gender affirming care. Carter points out that the plaintiffs all agreed that care standards were based on evidence of low scientific quality. Expert witnesses for the plaintiffs testified that they felt enough evidence was available to justify the treatment area.

Carter noted that minors are not allowed to buy even a six-pack of beer or a packet of cigarettes.

Carter wrote: “If we won’t allow a 16-year old to buy six packs of beer or a pack a cigarettes, we’ll let an adult do it for them. Should we let the same child/parent team decide to permanently change a teenagers sexual orientation?”

The ACLU of Missouri, Lambda Legal and other transgender organizations have expressed concern that the “troubling ruling” could lead to discrimination against transgender children.

The legal groups said that the court’s findings “signal a troubling acceptance” of discrimination. They also ignored an extensive trial history and the voices and opinions of Missourians who identify as transgender and their caregivers. And they denied transgender teenagers and Medicaid recipients the right to receive evidence-based and effective medical care, which is often life-saving.

Missouri Attorney General Andrew Bailey stated on X that “the national sentiment on this issue has changed significantly since our investigation began.”

He said that “the state has an important role to play in determining what systems are needed to protect children and to ensure that adults and patients know the lack of science or medicine behind certain procedures recommended.”