A Missouri judge on Wednesday blocked the state attorney general from enforcing a novel rule that restricts access to transgender medical treatments for both children and adults, just hours before it was set to take effect.
The rule crafted by Republican Attorney General Andrew Bailey places requirements on both minors and adults before they would be allowed to receive sex-reassignment surgery, cross-sex hormones or puberty blockers. It was set to take effect Thursday, but transgender Missourians and health care providers sued to stop it from being enforced.
St. Louis County Circuit Judge Ellen Ribaudo said Wednesday that she would like more time to review the matter before deciding whether to issue a temporary restraining order. She delayed implementation of the rule until 5 p.m. Monday, saying she anticipates she will issue a ruling before then.
Bailey has called the rules an effort to protect children from experimental treatments that have significant side effects. However, the restrictions would affect transgender adults as well, requiring patients to show three years of documented gender dysphoria, receive at least 15 hours of therapy over 18 months and be screened for autism before receiving "gender transition interventions," among other requirements.
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"These are intended to protect all patients and make sure that all patients have access to mental health services, and that all patients understand the experimental nature of the drugs," Bailey told St. Louis Public Radio.
Opponents of the rule, including medical professionals, say the treatments are not experimental and have been prescribed to treat gender dysphoria for decades. The lawsuit challenging Bailey's rule claims he overstepped his authority by going around the state legislature and attempting to regulate transgender medical treatments under the state's consumer protection laws.
Attorney Tony Rothert, with the American Civil Liberties Union of Missouri, told Ribaudo at a court hearing Wednesday that the regulations "will cause immediate, severe and potentially irreparable harm" for people who could lose access to medications that include puberty blockers and sex hormones.
He and other attorneys challenging the rule said that transgender people who cannot get access to treatment are at risk of suicide.
Assistant Attorney General Joshua Divine told the court that Baiely's rule does not ban transgender medical treatments. He said the rule provides "basic procedural guardrails" to protect patients, especially kids.
The Missouri attorney general's office has pointed to medical groups in both the U.S. and Europe who have criticized transgender medical treatments to defend its emergency regulation.
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The U.S. Agency for Healthcare Research and Quality has said, "[t]here is a lack of current evidence-based guidance for the care of children and adolescents who identify as transgender, particularly regarding the benefits and harms of pubertal suppression, medical affirmation with hormone therapy, and surgical affirmation." Sweden's National Board of Health and Welfare likewise declared there is a "lack of reliable scientific evidence concerning the efficacy and the safety" of cross-sex hormones and puberty blockers and that "the risks" of these treatments "currently outweigh the possible benefits."
However, other major medical groups including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association support transgender medical treatments as best practice for gender dysphoric patients, including children.
The Associated Press contributed to this report.
