Judge turns down bid to block Missouri ban on transgender treatments for minors

Judge Steven Ohmer’s ruling means transgender youth will be barred from starting puberty blockers or cross-sex hormones beginning Monday

By: - August 25, 2023 5:06 pm

Members of LGBTQ advocacy organization PROMO and others following legislation imposing restrictions on health care and sports participation by transgender minors watch a January legislative hearing from an overflow room. A judge on Friday denied a request to block enforcement of a ban on medical treatments for transgender minors that takes effect Monday.(Annelise Hanshaw/Missouri Independent)

A St. Louis judge ruled Friday afternoon that a new state law blocking Missouri’s transgender youth from beginning new gender-affirming-care treatments can take effect Monday. 

Circuit Court Judge Steven Ohmer denied a preliminary injunction in a lawsuit brought by the ACLU of Missouri and Lambda Legal. The lawsuit claims a ban on medical treatments to treat a condition called gender dysphoria would have “extremely serious negative health consequences.”

Ohmer, in his two-page order, wrote that the petitioners didn’t prove that there was a substantial threat of injury if the court didn’t intervene.

“The balance between the harm to petitioners and injury to others does not clearly weigh in favor of granting a preliminary injunction,” his order says.

Ohmer was assigned to the case when the original judge from Cole County could not schedule the necessary hearing before the law took effect. The next step in the case will be a status hearing in September.

The state brought outspoken “detransitioners,” or formerly transgender people, Zoe Hawes and Chloe Cole as some of its witnesses. Cole, a teenager from California, travels throughout the country to advocate against gender-affirming care.

Backers of legislation to ban gender-affirming treatments for minors waved signs that say “Kids 1st” during a March rally in the Missouri Capitol. (Annelise Hanshaw/Missouri Independent)

Cole visited the state capitol in the spring, invited by Sen. Mike Moon, R-Ash Grove, to advocate for the legislation. She often shares an emotional story of regret after a surgical operation to affirm a gender identity she no longer holds.

The new law imposes a four-year moratorium on starting hormonal therapies, puberty blocking medications and surgical procedures for minors. It does not ban counseling for minors experiencing gender dysphoria and those who have already begun medical treatments can continue. If no future legislative action is taken, the ban on puberty blockers and cross-sex hormones will expire on Aug. 28, 2027.

Medical providers in Missouri rarely perform gender-affirming surgeries on those under 18.

Another witness for the state, Jamie Reed, stirred an investigation into her former employer, the Washington University Transgender Center at St. Louis Children’s Hospital.

The investigation, led by Attorney General Andrew Bailey, went public in February after Reed published her story in a national media outlet.

But patients of the Transgender Center and Reed’s former coworker question her allegations. Documents from the center contradict part of Reed’s affidavit, which alleged the Transgender Center allowed children to transition with minimal oversight.

After the multi-day hearing, the ACLU of Missouri appeared confident in its argument, calling the state’s experts “not up to snuff” on Twitter.

“The law is rooted in discrimination as it would deny evidence-based, necessary and often life-saving medical care to transgender people while a non-transgender person [can] obtain the same treatment,” the ACLU of Missouri posted prior to the order.

‘There’s no point in staying’: Transgender Missourians describe toll of legislative session

Friday afternoon, the organization’s spokesperson Tom Bastian sent a statement: “While we are disappointed in and disagree with the court’s ruling, we will not stop fighting to protect the rights of transgender people in Missouri. The case is not over and will go to a full trial on the merits.”

Ohmer didn’t think stopping the law would be in the public’s interest, according to the order.

A majority of Missourians interviewed in a St. Louis University/YouGov poll responded that they were opposed to gender-affirming care banned in the new law, like surgeries and hormone replacement therapy. Respondents were split evenly on if they agreed with gender-affirming therapy, which is still allowed under the law.

The judge also questioned the science behind gender-affirming care — treatment approved by the American Medical Association, the American College of Physicians, the Endocrine Society, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the American Psychiatric Association.

“The science and medical evidence is conflicting and unclear,” Ohmer wrote. “Accordingly, the evidence raises more questions than answers.”

There are scientific studies of various qualities showing evidence for and against gender-affirming care. Some have been pulled from scientific journals after ethical debates and quality concerns.

Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, accused Missouri politicians of using “ideology and junk science” to justify the new law.

“On Monday, trans and gender-expansive young Missourians will have their rights stripped away — unless a higher court intervenes,” she said. “They are terrified and furious that Missouri politicians are using ideology and junk science to deny them life-saving health care and erase their existence — and we are right alongside them.”

Aro Royston, board secretary for Missouri’s LGBTQ+ advocacy organization PROMO, said in a statement that gender-affirming care is life-saving and supported by major medical organizations.

“Not one single person who is in favor of this legislation understands how this law truly impacts the transgender community,” he said. “None of them understand the breath of relief we get to feel when we finally understand who we are and how beautiful it is to be transgender. They cannot fathom the best part of gender-affirming healthcare, which is being able to look into the mirror and see in the reflection the person you always knew yourself to be.

“Today, you have robbed us of this immense joy and our ability to thrive within this state as our authentic selves.”

Missouri isn’t the only state undergoing litigation on a gender-affirming care ban.

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

While arguments were underway, Bailey’s office asked the court to take note of a decision upholding Alabama’s ban on transgender treatments handed down Monday by the 11th Circuit Court of Appeals. The appeals court overturned a preliminary injunction issued by a district court blocking enforcement of the Alabama law banning puberty blocking medications and hormone treatments for children.

And 16 states, including Alabama, wrote an amicus brief asking the judge to allow the law to become effective.

“The Missouri Save Adolescents from Experimentation (SAFE) Act is a valid exercise of Missouri’s police power,” the states wrote. “Missouri, like many other States, became concerned that healthcare providers were risking the long-term health and well-being of gender dysphoric children with unproven hormonal and surgical treatments.”

Bailey took note Friday that Missouri, unlike Alabama, defeated a request to pause the law at the circuit-court level.

“Missouri is the first state in the nation to successfully defend at the trial-court level a law barring child mutilation,” he said in a statement. “I’ve said from day one as Attorney General that I will fight to ensure that Missouri is the safest state in the nation for children. This is a huge step in that direction.”

Moon said he was pleased with the ruling.

“I’m grateful for all who defended (the law), and I’m hopeful that those who are seeking help due to dissatisfaction with their identity will find the counseling they need,” he wrote to The Independent in a text message.

The parties will return to court in St. Louis September 22.

Rudi Keller of the Independent staff contributed to this report.


Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site. Please see our republishing guidelines for use of photos and graphics.

Annelise Hanshaw
Annelise Hanshaw

Annelise Hanshaw writes about education — a beat she has covered on both the West and East Coast while working for daily newspapers in Santa Barbara, California, and Greenwich, Connecticut. A born-and-raised Missourian, she is proud to be back in her home state.