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Missouri attorney general drops controversial emergency rule that would have banned gender-affirming care for children and many adults


Galen Bacharier/Springfield News/USA Today Network

Missouri Attorney General Andrew Bailey speaks to reporters after being sworn into office in January at the Missouri Supreme Court in Jefferson City.


A controversial emergency rule to ban gender-affirming care for minors and most adults in the state of Missouri was withdrawn Tuesday by the attorney general who first proposed it days after state lawmakers passed their own ban.

“The Legislature has now passed a ban that exceeds the authority of the rule that we passed, so we will now be prepared to defend the statute in court,” Attorney General Andrew Bailey told CNN affiliate KMOV.

The attorney general’s rule — which was among the nation’s far-reaching limits on gender-affirming care — has already been paused through at least July 20 as a lawsuit unfolds.

Bailey’s rule sought to make it “unlawful” for individuals or health care providers to provide gender-affirming treatment without confirming that a patient has “for at least the past 3 consecutive years … exhibited a medically documented, long-term, persistent, and intense pattern of gender dysphoria.”

Gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person move from their assigned gender – the one the person was assigned at birth – to the affirmed gender, the gender that one wants to be known by . .

The rule, announced late last month, was quickly met with backlash, and advocacy groups sued to stop it, asking the Circuit Court of Saint Louis County to declare the emergency rule invalid “due to the Attorney General’s lack of statutory authority to promulgate it.”

Petitioners said at the time that the attorney general’s rule targets gender-affirming care with “unprecedented and unique restrictions that are so burdensome as to effectively prohibit the delivery of this necessary, safe and effective care to many, if not most, transgender people in Missouri.”

The ACLU of Missouri on Tuesday applauded the decision to withdraw the emergency rule.

“After weeks of embarrassing Missouri on the national stage, the attorney general has finally joined everyone else in recognizing that his hasty attempts to usurp other branches of government cannot withstand scrutiny,” the organization said in a news release Tuesday.

While the emergency rule has been withdrawn, Missouri’s legislature last week passed its own bill that bans most gender-affirming care for most minors, but not transgender adults. That bill awaits the signature of Republican Gov. Mike Parson.

If passed, the bill would prevent health care providers from performing gender reassignment surgeries, even though such surgeries are not typically performed on children and many health care providers do not offer them to minors.

Republicans, including the governor, have argued that the bill is about protecting minors from permanent health care treatments.

The move to limit gender-affirming care in Missouri comes on the heels of similar bans in other states.

North Dakota Gov. Doug Burgum signed a bill last month banning gender-affirming care for most minors, with the possibility of a felony for health care professionals who provide it. Indiana and Idaho both also enacted their own bans on youth gender-affirming care this month, and several other states have signed into law restrictions on gender-affirming care for minors in the past few years.

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