Republican Missouri Atty. General Andrew Bailey and the families of transgender children are battling in court this week over whether a new law prohibiting minors from receiving gender-affirming health care will go into effect on Monday as scheduled.

Lawyers last month filed a lawsuit to overturn the law on behalf of three families of transgender minors, doctors and two LGBTQ+ organizations. They asked a district judge to temporarily block the law as the lawsuit against it unfolds.

Hearings on pausing the law take place this week in Springfield. A judge is expected to rule before Monday.

the law

The law signed by Republican Gov. Mike Parson would in June ban healthcare providers in Missouri from giving puberty blockers, hormones and gender-affirming surgeries to minors. Minors who were prescribed puberty blockers or hormones before Aug. 28 could continue to receive those treatments.

Missouri’s Planned Parenthood clinics had ramped up the number of available appointments and held pop-up clinics to get patients treated before the law goes into effect.

Most adults would still have access to transgender healthcare under the law, but Medicaid would not cover it.

Doctors who break the law face revocation of their licenses and prosecution from patients. The law makes it easier for former patients to sue, giving them 15 years to go to court and promising at least $500,000 in damages if they succeed.

The law expires in August 2027.

Legal arguments

Attorneys for the plaintiffs wrote in a lawsuit that the new requirements unlawfully discriminate against transgender patients by denying them medically necessary care and insurance coverage because of their gender and because of their transgender status.

In the official report, the attorney general’s office argued that the law is not discriminatory because it applies equally to boys and girls.”

The only distinction made is based on the condition being treated, lawyers for the firm wrote. “Puberty blockers, testosterone and estrogen can all still be used to treat a variety of conditions (such as precocious puberty). They simply cannot be used as an experimental response to gender dysphoria.

What health care providers say

The Food and Drug Administration approved puberty blockers 30 years ago to treat children with precocious puberty, a condition that causes sexual development to begin much earlier than normal. Sex hormones synthetic forms of estrogen and testosterone were approved decades ago to treat hormone disorders or as birth control pills.

The FDA has not specifically approved the drugs to treat transgender youth, but they have been used off-label for that purpose for many years, a common and accepted practice for many medical conditions. Doctors who treat trans patients say those decades of use are evidence that the treatments aren’t experimental.

Every major medical organization, including the American Medical Assn., has opposed the ban on gender-affirming care for minors and supported medical care for young people when properly administered. Lawsuits have been filed in several states where bans have been enacted this year.