The St. Louis Integrated Health Network (IHN) stands with transgender members of our community and advocates for access to gender-affirming care for both transgender children and adults in Missouri.
IHN is committed to advancing health equity and overcoming health disparities across all underserved and under-represented populations, including the LGBTQI+ community, which likewise deserves full access to health care.
IHN condemns all attempts to limit access to health care services and inhibit clinical care decisions that should be left to the people seeking care and their respective medical providers.
On April 13, 2023, Missouri Attorney General Andrew Bailey issued an “emergency regulation” that would severely restrict access to age appropriate, medically necessary gender-affirming care for transgender and non-binary Missourians.
The Attorney General’s emergency regulations institute extreme restrictions that include requirements such as:
- Medically documented gender dysphoria for three years
- Receiving “full psychological or psychiatric assessment” consisting of at least 15 separate hourly sessions over the span of 18 months.
- Screening for social media addiction.
- Screening for autism.
- All mental health conditions are treated and resolved prior to gaining access to gender-affirming care.
Bailey claims that these emergency regulations were issued to protect children and falsely characterizes gender-affirming health care treatments as experimental, adding that the care has significant side effects.
However, every major medical association, including the American Medical Association, the American Psychological Association, the American Academy of Pediatrics, and the Endocrine Society, supports gender-affirming care, and many of those treatments have been standard practice for more than a decade.
Multiple states have enacted similar bans on such care for minors in recent years. However, the Missouri Attorney General’s rules represent the first time a state has attempted to impose such restrictions on trans adults.
Establishing new barriers to access for those seeking gender affirming care and will not only harm the health of individual patients, but also reinforces discrimination, stigma, and negative mental health outcomes for the transgender community. Furthermore, transgender youth of color are especially vulnerable due to the additional negative effects of systemic racism and marginalization.
Bailey’s regulations were scheduled to go into effect on April 27, 2023 and expire on February 6, 2024, however, St. Louis County Circuit Judge Ellen Ribaudo temporarily halted the rule just hours before, then on Monday, May 1, 2023, issued an order that will temporarily halt Bailey’s regulations for two weeks as she considers whether to block them for longer.
Any person affected by this rule on gender-affirming care is encouraged to contact:
- Legal Help Desk at Lambda Legal or the ACLU of Missouri for more information on their legal rights.
- Metro Trans Umbrella Group (MTUG) for local services and resources available to transgender folks. MTUG maintains a list of inclusive therapists and medical providers.
- Trans Lifeline at 877-565-8860 or the St. Louis Queer+ Support Helpline at 314-380-7774 for emotional, identity-affirming support.
The St. Louis County Dept. of Public Health notes that gender affirming care is available in Illinois and may be accessed through a variety of providers.
The St. Louis County Dept. of Public Health also advises that healthcare providers who have transgender patients should take the following actions before the Missouri Attorney General’s emergency regulations take effect:
- Contact transgender patients to provide referrals to out-of-state gender affirming care physicians.
- Provide immediate assistance to transgender patients requesting their medical records.
- Ensure transgender patients have the care they need, while they are still able to access it.
- Contact their medical licensing board for any needed clarification on the regulations.
As IHN continues to follow the progress of the Missouri Attorney General’s emergency regulations, we remain committed to our mission of advancing health equity, working to overcome disparities, and eliminating barriers to healthcare access across all demographics in the St. Louis regions, including the transgender community.