If you’re a transgender resident of Missouri, the next 10 months are going to be awful. Under an emergency regulation from state Attorney General Andrew Bailey, it will soon become incredibly difficult, if not impossible, for many patients to receive gender-affirming care.
This is just the latest attempt by the red state to reduce the treatment of trans people, but what sets these new regulations apart is their scope. Elsewhere, Republicans have framed their crusades against trans youth as attempts to save minors from themselves or the predations of “groomers” who supposedly turn them into sexualized victims. Missouri’s new regulations, on the other hand, affect everyone, including trans adults, according to a spokesperson for Bailey’s office.
Although some observers attempted to claim otherwise, the push to transition to America was never going to remain limited to miners.
Starting April 27, it will be considered “an unfair, deceptive, fraudulent, or otherwise illegal practice” for Missouri health care providers to provide gender-affirming care without forcing their patients through a number of new hurdles. . To receive treatment, patients will need to have a documented medical history of gender dysphoria within the past three years. If you’ve only contacted a doctor about trans identity in the past year, you’re out of luck no matter how long you’ve had these feelings.
Among the more onerous provisions of the regulations is one that prohibits the treatment of trans people unless they undergo at least 15 hourly sessions over a period of one and a half years to “explore developmental influences on the the patient’s current gender identity and determine, among other things, whether the person has mental health comorbidities. Unlike other states, Missouri has not decided to exclude gender-affirming treatments from health insurance coverage. But even with private health insurance, the costs associated with the number of therapy sessions required could be higher than some patients can afford.
Even if these hurdles are lifted, healthcare providers can still break the new rules if they fail to “ensure that all psychiatric symptoms of the patient’s existing mental health comorbidities have been addressed and resolved” and “that the patient has received a comprehensive screening to determine if the patient has autism. Translation: Patients whose depression or anxiety is not ‘resolved’ before seeking gender-affirming care cannot legally obtain the care that might alleviate some of their symptoms of anxiety or depression.And while the emergency regulations don’t say that autistic people are prohibited from receiving care, it does place yet another stigma on the community, such as the noted MSNBC columnist Eric Garcia recently.
Finally, providers are also required to read to patients or post on their website a long list of statements that portray gender-affirming care as unproven and unsafe, mirroring how “pregnancy crisis centers” attempt to dissuade pregnant women from having an abortion. . They must then keep records of “all adverse effects (expected and unexpected) that arise from any covered gender transition intervention course for all patients beginning on the first day of the intervention and continuing for a period of at least 15 years”. These effects must be kept “in a form easily accessible for systematic study”. And it requires providers to “document and maintain in such patient records a detailed description of compliance with the provisions of the section.”
The only benefit to be found is that the prescription includes an exclusion for “continuing to prescribe or provide a specific intervention that has already begun,” as long as the provider “promptly” brings itself into compliance with treatments and assessments. required by regulations. But the sprawling scope of Bailey’s order has sparked uncertainty and fear among trans Missourians. “I don’t know how it’s going to affect me — maybe I could get my meds and I couldn’t,” Zora Williams, a 41-year-old transgender woman from St. Louis, told the Kansas City Star.
“It is abundantly clear that the purpose of this order is to deter providers in Missouri from providing this care,” Shannon Minter, legal director for the National Center for Lesbian Rights, told the 19th. “The purpose of this order is to make it so burdensome and so contrary to medical ethics and the standard of care that providers give up and no longer treat transgender patients.” And it seems to be working, as some patients have already learned that their treatment will be suspended as clinicians try to limit their legal exposure.
Only the most gullible can be surprised at this turn of events. Although some observers attempted to claim otherwise, the push to transition to America was never going to remain limited to miners. Social conservatives have made it clear that they deliberately chose anti-trans rhetoric as their new rallying cry after full legalization of same-sex marriage.
As things stand, Lambda Legal and the ACLU of Missouri said they plan to file a lawsuit to stop Bailey’s orders from taking effect. That may work, given that the ban hinges on a new reading of Missouri’s consumer protection laws. But even if a court enjoins regulation, that won’t be enough to stop Republican efforts to impose similar restrictions right on the books. I fear Missouri is just the first of many places where trans adults will be subjected to the same level of persecution and harassment under the law that trans minors are already experiencing across the country.
