Patients scramble for gender-affirming care in Missouri ahead of April 27 restrictions

ST. LOUIS — Planned Parenthood held a pop-up clinic at its Central West End location on Monday for people seeking gender-affirming care, 10 days before new rules take effect that would make Missouri the first state to dramatically restrict care of transgender adults.

The doors opened at 8 a.m. Two hours later, the more than two dozen slots were filled for the day, and another dozen people made appointments for later that week.

“This is a last ditch effort not to lose access to care that I have received for much of my life,” said Emmett Campbell, 19, a sophomore at the University of Washington. He went to the pop-up clinic to get a testosterone prescription.

Planned Parenthood also filled additional appointments for gender-affirming care at its clinics in Fairview Heights and Springfield, Mo., on Monday; administrators added more than 200 appointment slots at the three clinics to try to manage demand ahead of the launch of the new rules on April 27.

Missouri Attorney General Andrew Bailey, a Republican, on Thursday filed an emergency settlement under consumer protection laws, saying such medical treatments are experimental and provided without adequate mental health care.

The new rules require a long checklist before receiving care, including three years of medically documented gender dysphoria, 15 therapy sessions over at least 18 months, and treatment and resolution of all mental health issues.

Campbell has been taking testosterone since he was 14 and said he was looking for a new doctor to prescribe the drug for him when Bailey announced the new rules. Her home endocrinologist in Tennessee had quit her job due to that state’s recent ban on gender-affirming medical care for minors.

Just three weeks out on her current prescription, Campbell cried when she heard the news.

“Terrifying is an understatement,” he said.

Dr. Collen McNicholas, chief medical officer for Planned Parenthood of the St. Louis area, provided walk-in patient care on Monday.

Some came, she said, because their medical providers stopped offering gender-affirming care; others wanted to start the process, while some were looking to resume treatment.

“Today, many patients have said that this therapy has saved their lives,” McNicholas said. “It’s important to do what we can to make sure they get that care.”

Bailey’s spokeswoman, Madeline Sieren, did not respond to a reporter’s request to interview Bailey about the rules.

When the proposed rules were first announced a few weeks ago, they only applied to minors. This year, Republican-led state legislatures across the country moved to restrict gender-affirming care for minors, arguing that little is known about the long-term impacts.

“We believe everyone has a right to evidence-based medicine and adequate mental health care,” Sieren said Friday, after the rules were filed.

Iz Silva, 20, from Kirkwood, could not be seen at the walk-in clinic on Monday but left with a smile after securing an appointment for Thursday.

Silva uses the pronouns they/them and was planning to start testosterone this summer, when they had a break from community college classes and tried to enroll in a nursing program. Emergency regulations accelerated their plans.

Although they are happy to get a date before April 27, Silva said: “That doesn’t stop me from being scared.”

Jah’kayla Moore, 36, of St. Louis, said she has identified as female for nearly 20 years.

“I only wear men’s clothes for my mother,” she said.

That changed by the time she was 21 and living alone.

But the hair, clothes and makeup weren’t enough for others to accept, she said. Moore came to the clinic because she felt like it was her last chance to finally receive estrogen-based hormone therapy. without health insurance, she could never afford it.

“Am I living my life? No, because I get ridiculed every day when I leave home. I get talked about every day,” Moore said. “I know you’re not supposed to care what other people think of you, but it’s hard.”

“I don’t want to be known as ‘him’,” she said.

Jack Grimes, 21, a senior at the University of Washington, identified as male since he was 9, but was never able to fully be himself growing up in a small town in North Carolina . He started using testosterone a year ago, a decision “necessary for my continued survival,” he said.

Grimes said he was a month away from needing to refill his prescription, and with the new rule, his current doctor could not promise the prescription could be refilled and would not fill it any sooner. With so much uncertainty, he said, he requested a new prescription from the walk-in clinic.

As soon as he graduates, Grimes said he plans to move to Minneapolis to live in a state that has taken steps to protect gender-affirming care.

“I want people to just stay out of our business,” he said.