Debate over transgender health care threatens to upend Missouri legislative session

A litany of bills, as well as the state budget, remain unresolved as lawmakers head into the homestretch of the 2023 legislative session

By: - March 20, 2023 5:55 am

The Missouri Capitol Rotunda (Jason Hancock/Missouri Independent).

Lawmakers return to the Missouri Capitol Monday to kick off the second half of the 2023 legislative session with a laundry list of priorities and a constitutional deadline to get them done. 

Legalizing sports betting, changing the initiative petition process, education policy shifts, tax cuts, banning foreign land ownership, expanding postpartum health care and a litany of other high-profile issues are jockeying for position — all while legislators wrestle with what will be the largest state budget in Missouri’s history. 

But hovering in the background is a specter that has haunted the General Assembly for the last two years and threatens to once again upend the legislative process. 

GOP infighting in the Missouri Senate has largely subsided this year, save for a pair of flare ups just before last week’s spring break

But that uneasy truce is teetering. 

A group of eight Republican senators are vowing to “use whatever tools and procedures necessary under the Missouri Senate rules” to force a vote on legislation banning certain medical procedures — such as puberty blockers and hormone therapy — for transgender Missourians under the age of 18.

Democrats blocked a vote on the bill with a filibuster nearly two weeks ago. And with negotiations over the legislation stalled and no end to the debate in sight, Senate Majority Leader Cindy O’Laughlin adjourned the chamber for spring break a day early

The early adjournment incensed proponents of the bill. A conservative political action committee is organizing a rally at the Capitol Monday afternoon to demand the Senate pass the legislation immediately, promising to gather in the visitor’s gallery in a show of support. 

“We might be there a couple of hours or it could go all night long,” organizers of the rally said in the announcement. 

O’Laughlin has made it clear she has little appetite to immediately turn to procedural maneuvers to cut off the filibuster, noting that Democrats would surely retaliate with procedural moves of their own to derail the rest of the legislative session. 

The use of the nuclear option can effectively end any productivity and we still have big issues to resolve before this year’s session ends,” O’Laughlin wrote on Facebook.

But the legislation’s biggest proponents, led by Sen. Mike Moon of Ash Grove, are unmoved by O’Laughlin’s concerns. 

“This is not about procedural diplomacy,” the group of eight Republicans wrote in a statement released to the media. “This is not about legislative traditions. Protecting Missouri’s children is not up for negotiation.”

Katy Erker-Lynch executive director of the LGTBQ-rights organization PROMO, said those pushing the legislation seek to “create a sense of fear, isolation and loss among transgender Missourians and the friends and family who love trans and gender-expansive siblings.”

Transgender health care

State Sen. Mike Moon, R-Ash Grove, sits with other sponsors of bills that would ban gender-affirming care for transgender youth during a committee hearing on Feb. 14, 2023 (Annelise Hanshaw/Missouri Independent).

Republicans entered the legislative session determined to place restrictions on transgender girls participating in school sports and ban gender-affirming care for minors. 

The push kicked into overdrive after a whistleblower made public allegations of misconduct against the Washington University Transgender Center at St. Louis Children’s Hospital, though families of former patients have disputed the accusations.

A handful of bills tackle the issues separately, but Moon’s bill — which combines them into one package — is where proponents have pinned their hopes. 

Now the legislation has become the latest flash point in an ongoing Civil War within the Senate GOP caucus, which over the last two years has seen the chamber grind to a halt over differences between those aligned with Republican leadership and members of the conservative caucus. 

The infighting got so bad last year that the Senate ended the session and went home early for the first time since a fixed adjournment date was set in 1952.

The conservative caucus officially disbanded before the 2023 session began, with members saying they hoped to put the drama of the last two years behind them. But other senators expressed doubt that the caucus ever really went away. 

And the transgender health care bill has caused those past fissures to reemerge. 

With the Senate possibly on the brink, House Speaker Dean Plocher said his chamber may have to take the lead on the issue, expressing disappointment that the Senate wasn’t able to find a resolution before spring break.

“If the Senate can’t get it done, we will get it done,” Plocher, R-Des Peres, told reporters “We just haven’t turned the burners on yet. And there’s no need yet until the Senate demonstrates its inability to do something, which is coming close.”

Constitutional deadline

House Speaker Dean Plocher, R-Des Peres, talks to the media on March 9, 2023 (Tim Bommel/Missouri House Communications).

Hanging in the balance of the debate over transgender rights could be a host of other bills which need to be completed before the constitutional deadline for the legislature to adjourn for the year at 6 p.m. on May 12.

There is also the state budget, which must be completed and sent to the governor by May 5. 

Lawmakers seem determined to legalize sports betting in Missouri. But just as in previous years, the issue has become tied to unregulated video lottery terminals that have popped up around the state, pitting sports teams and casinos against the owners of the terminals in a showdown that likely dooms both proposals. 

Sen. Denny Hoskins, R-Warrensburg, has said flatly he has no interest in legalizing sports betting without language putting regulations in place for gray-market video lottery machines. And in the first sign Senate dysfunction could be returning, he’s already shown a willingness to upend the chamber’s business in pursuit of that priority

The Republican super majority has also put a lot of energy behind education proposals, from establishing a “parents bill of rights” to allowing students to transfer out of their home district.

Rep. Brad Pollit’s open enrollment legislation squeaked out of the House with just three votes to spare, heading to the Senate where it is expected to get a cold reception from Democrats and some Republicans. 

But the bill does have a powerful ally in that chamber — Sen. Andrew Koenig, a Manchester Republican who chairs the Senate’s education committee. He’s had good luck in recent years negotiating compromises to carry controversial education bills across the finish line. And he is hopeful that luck will continue in the session’s second half. 

Koenig also aims to expand the Missouri Empowerment Scholarship Accounts program that allows low-income students or those with individualized educational plans in cities to use half their family’s state tax burden toward private education.

Among the highest priorities of the GOP majority this year is a push to make it harder to amend the state constitution through the initiative petition process. 

The bill is also the closest to passing of all of the GOP’s priorities. It has already cleared the House and sits on the Senate debate calendar. If it wins approval, it would be placed on the 2024 statewide ballot. 

Republicans argue it is too easy to amend the constitution and want to increase the threshold for an amendment to pass from a majority of voters to 60% of voters. 

Democrats say the GOP is simply upset that voters have an option to go around the legislature when they feel it has fallen short, pointing to recent amendments to expand Medicaid eligibility, legalize marijuana and raise the minimum wage approved by Missourians in recent years. 

During his opening address to the Missouri House this year, Plocher vowed to push for additional tax cuts. Several options — personal property taxes, corporate taxes, sales tax on groceries — have gotten attention this year and could pick up momentum in the session’s final weeks. 

Republicans are also determined to pass legislation allowing for the state to take over control of the St. Louis police department, as well as allow the governor to appoint a special prosecutor to supplant St. Louis Circuit Attorney Kim Gardner. 

Both proposals passed the House but seem likely to inspire Democratic filibusters in the Senate. 

House Minority Leader Crystal Quade, D-Springfield, panned the Republican agenda as divisive and destructive. 

“In the first half of the session alone,” she said, “they prioritized stripping the power of voters to use the initiative petition process, dismantling the political power of Black communities and attacking public schools and their teachers.”

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Jason Hancock
Jason Hancock

Jason Hancock has spent two decades covering politics and policy for news organizations across the Midwest, with most of that time focused on the Missouri statehouse as a reporter for The Kansas City Star. A three-time National Headliner Award winner, he helped launch The Missouri Independent in October 2020.