Missouri attorney general Andrew Bailey (R.) has announced that he is issuing an emergency regulation to set guardrails on gender-transition treatments for minors in his state.
The new rules will require that minors seeking gender transition sign specific informed-consent disclosures, that they be assessed for any mental illness during an 18-month waiting period, and that any adverse effects of the gender transition be tracked for a period not shorter than 15 years.
“As Attorney General, I will protect children and enforce the laws as written, which includes upholding state law on experimental gender transition interventions,” said Bailey in a statement, adding that “countries like Sweden, Norway, and the United Kingdom have all sharply curtailed these procedures.”
“I am dedicated to using every legal tool at my disposal to stand in the gap and protect children from being subject to inhumane science experiments,” Bailey added.
Bailey’s move appeared to sidestep the Missouri legislature, which has debated, but not passed, legislation to restrict gender-transition treatments for minors, the St. Louis Post-Dispatch reported.
Patients will have to sign paperwork that informs them that the use of puberty blockers and cross-sex hormones to treat gender dysphoria is experimental. The paperwork will also cite research from Sweden’s National Board of Health and Welfare that the benefits of puberty blockers are outweighed by the risks.
Additionally, patients will be informed of a study that “an individual whose friend identifies as transgender is ‘more than 70 times’ as likely to similarly identify as transgender, suggesting that many individuals ‘incorrectly believe themselves to be transgender and in need of transition’ because of social factors.” Finally, the Endocrine Society will be cited in the disclosures as holding that “the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/gender incongruent in adolescence.”
Under the new rules, gender-transition treatments will only be allowed once the patient has received a full psychological assessment, consisting of no fewer than 15 separate, hourly sessions over the course of at least 18 months. All mental health comorbidities must be treated before proceeding.
Possible adverse effects must be tracked for at least 15 years following the gender transition. The patient must also submit to some form of annual examination to ensure that, as the attorney general puts it, “the patient is not experiencing social contagion with respect to the patient’s gender identity.”
LGBT organizations have criticized the rules and they are likely to be challenged in court. In a statement to the Post-Dispatch, PROMO, a Missouri LGBT organization, disagreed with the attorney general’s assessment that gender-transition treatments are experimental and noted that the treatments are “backed by every major medical association in the United States.”
The Missouri legislature will continue to debate gender-transition treatments for minors and may act of its own accord. Legislation concerning transgender athletes is also under debate.