Trial on Missouri transgender health care law to begin Monday in Jefferson City
JEFFERSON CITY — The legal fight to overturn a law that stopped Missouri physicians from prescribing puberty blockers and hormone treatment to transgender youth heads to trial Monday in the capital city.
Circuit Judge Robert Craig Carter of Douglas County, assigned to oversee the case by the Missouri Supreme Court, has blocked off 10 days for testimony and arguments in the case.
Three parents from St. Louis County, and their minor children who are transgender, are the lead plaintiffs in the effort to overturn the law.
Other plaintiffs include Southampton Community Healthcare in St. Louis, a provider of gender-affirming health care for minors and Medicaid recipients before the law took effect. Two medical professionals at the clinic also joined the case.
Two LGBTQ+ rights groups, PFLAG and GLMA , also are listed as plaintiffs.
The law, which took effect in August 2023, also bans gender-affirming surgeries for minors, which plaintiffs said can be indicated for some older transgender adolescents and adults. For adolescents under 18 with gender dysphoria, the plaintiffs say "the most common gender-affirming surgery would be masculinizing chest surgery."
The law also affected certain adults by barring Medicaid payments for hormone therapy, puberty blockers and gender-affirming surgeries. It also prohibits gender-affirming surgeries for prisoners.
The restrictions have been in place since August 2023, when St. Louis Circuit Judge Stephen Ohmer allowed it to take effect, rejecting the plaintiffs' request for a preliminary injunction while the case played out.
In July 2023, the original lawsuit said one of the plaintiffs, a transgender boy who was 10 at the time, had been diagnosed with gender dysphoria and sought to receive medically necessary care affected by the law.
After Ohmer's ruling, the plaintiffs subsequently asked for a new judge, leading to Carter's appointment by the Missouri Supreme Court and the upcoming trial.
In a pre-trial brief filed Sept. 9, attorneys say the law has caused immense harm to people like the plaintiffs.
"The Minor Plaintiffs have been prevented from obtaining medically necessary and evidence-based care in coordination with their families and doctors in Missouri," the brief said. "The Parent Plaintiffs have had their parental judgment and decision-making authority usurped by the government."
Last year, Ohmer, in denying the plaintiffs' request for a preliminary injunction, called the plaintiffs' constitutional arguments "unpersuasive and not likely to succeed."
"The science and medical evidence is conflicting and unclear," Ohmer wrote in his order. "Accordingly, the evidence raises more questions than answers."
Republican Attorney General Andrew Bailey's office referred to Ohmer's findings in its pretrial brief, saying that no developments within the last year had undermined Ohmer's decision.
"To the contrary, the few developments that have occurred further undermine Plaintiffs' position by reaffirming that there is no solid evidence that gender transition interventions are safe and effective," the state said.
Attorneys argue Missouri is in alignment with "progressive" countries such as the United Kingdom, which announced plans in June 2023 to restrict puberty blockers for minors except in research due to limited "evidence to support their safety or clinical effectiveness."
"It is not every day that Missouri finds itself following the lead of the world's most progressive countries," the state argues.
The plaintiffs say in their pretrial brief that six expert witnesses will testify on medical protocols and present "proof that the treatment is safe, effective, and evidence-based."
The plaintiffs' brief says gender-affirming medical care dates back nearly a century, with the first gender-confirming surgeries performed at the Institute for Sexual Science in Berlin in the 1920s.
The brief describes a shift in the medical profession from encouraging conformity with societal expectations to helping transgender people express themselves in a way that aligns with their gender identity.
"For more than four decades," the brief says, "medical organizations have studied the treatment of gender dysphoria and created evidence-based standards for the medical treatment of transgender patients."
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