Missouri Attorney General Singlehandedly Bans Care For Trans Adults Too, No Law Required

Because it's an 'emergency.'

On Thursday, the Missouri House voted in favor of passing the grotesquely titled Save Adolescents From Experimentation Act (SAFE Act) , which would make it illegal not only for doctors to perform gender-affirming surgeries on children under the age 18, but to even prescribe them hormone treatments or puberty blockers, which are reversible.

But this was not enough for Missouri Attorney General Andrew Bailey. The bill, of course, would have had to go back to the Senate and then get signed by the governor, and that kind of thing takes time. Time in which transgender children could be getting the care they need and that the vast majority of medical and psychological organizations in the United States consider to be best practices for children in their situation. Time in which they and their parents and their doctors would be able to determine the best course of action for them, without even considering how it might affect Missouri Attorney General Andrew Bailey. It also didn't go far enough in protecting Andrew Bailey from potentially having to be in the same room as an adult who has transitioned.

So Andrew Bailey decided to go and issue an "emergency rule" barring gender affirming care not only for children, but for many adults as well.

"As Attorney General, I will always fight to protect children because gender transition interventions are experimental,” said Attorney General Bailey in a press release. “My office has uncovered a clandestine network of clinics across the state who are harming children by ignoring the science."

To be clear, "the science" actually supports gender-affirming care, and his office has uncovered no such thing. His statement is likely in response to the already debunked and refuted account from Jamie Reed, a former employee of the Washington University Pediatric Transgender Center at St. Louis Children’s Hospital, who claimed in an article published earlier this year in Bari Weiss's Free Press substack that the hospital's staff was just going around transitioning every kid who walked through the doors without telling them or their parents about potential side effects and not really caring if the kids were actually transgender or not.

“This emergency rule is necessary to protect the public health, safety, and welfare, and also to protect a compelling governmental interest as the attorney general is charged with protecting consumers, including minors, from harm and investigating fraud and abuse in the state’s health care payment system,” the emergency regulation states.

According to the press release, the rule will prohibit gender transition interventions when the provider "fails" to,

- ensure that the patient has received a full psychological or psychiatric assessment, consisting of not fewer than 15 separate, hourly sessions (at least 10 of which must be with the same therapist) over the course of not fewer than 18 months to explore the developmental influences on the patient’s current gender identity and to determine, among other things, whether the person has any mental health comorbidities

- ensure that any existing mental health comorbidities of the patient have been treated and resolved

- ensure that, for at least the 3 most recent consecutive years, the patient has exhibited a medically documented, long-lasting, persistent and intense pattern of gender dysphoria

- with respect to a patient who is a minor, ensure that the patient has received a comprehensive screening (at least annually) for social media addiction or compulsion and has not, for at least the six months prior to beginning any intervention, suffered from social media addiction or compulsion

- maintain data about adverse effects in a form that can be accessed readily for systematic study

- adopt and follow a procedure to track all adverse effects that arise from any course of covered gender transition intervention for all patients beginning the first day of intervention and continuing for a period of not fewer than 15 years

- obtain and keep on file informed written consent

- ensure that the patient has received a comprehensive screening to determine whether the patient has autism

- ensure (at least annually) that the patient is not experiencing social contagion with respect to the patient’s gender identity

The vast majority of this "emergency" rule is based on the bizarre right-wing theory that thousands of children who are not actually trans are claiming to be trans due to "social contagion," which is not a thing. Multiple studies have shown that this is not a thing ( Restar et al., 2019 ; Kuper et al., 2019 ; Kennedy, 2020 ; Bauer et al., 2021 ; Sansfaçon et al., 2021 ; Sorbara et al., 2021 ; Puckett et al., 2022 ; Turban et al., 2022 ; Brakefield et al., 2014 ) and that the reason two children who are friends might both come out as transgender is better explained by the mere fact that people tend to hang out with people like themselves ( Aral et al., 2009 ; Shalizi & Thomas, 2011 ).

The regulation also bars adults who have autism from transitioning. Some studies have shown that gender dysphoria is more common among people with autism, but it is entirely unclear why autistic adults would be specifically barred from transitioning. Is it that Bailey assumes that autistic people are being nefariously preyed upon by doctors desperate to do gender-affirming surgeries? If so, to what end?

This is not a case of "Oh, these people just don't understand and they are sincerely worried about children having the right judgment to make life-altering decisions like that." If it were, they would not also be going after care for adults. If it were, they would not also be arguing in favor of child marriage, as the sponsor of the bill targeting transgender youth care, state Sen. Mike Moon, did on the floor this week.

“Last night, Missouri voted to ban care for trans youth and ban from sports to "protect kids." Later, the sponsor, Sen. Moon, was asked about a vote on child marriage. He DEFENDED 12 year olds getting married, saying he knows some who are still married! https: //t.co/LFFICu4ecC”

— Erin Reed (@Erin Reed) 1681309021 

Rep. Peter Meredith (D-St. Louis) brought up the fact that Moon had previously supported a bill that would have allowed adults to marry children as young as 12 as long as the child's parents were cool with it. You know, like how many parents of 12-year-old girls were okay with their children marrying Warren Jeffs or David Koresh.

Moon owned this, retorting, “Do you know any kids who have been married at age 12? I do. And guess what? They’re still married." This is not entirely surprising as someone who raises their own spouse is likely to exercise a certain amount of control over them that might make it difficult for them to leave. It also seems rather unlikely that a girl who gets married to an adult at 12 would have been allowed to go to college or get any sort of training that might make her able to be financially independent.

This just shows that all of this is has nothing to do with whether or not people are able to make good decisions at any age or whether they should be allowed to make life-altering ones as a child. This is about these people and the world they want to live in. They do not want to live in a world in which they have to deal with the existence of transgender people. They think it's icky. They don't like people who are different from themselves. And they really don't like living in a world where they no longer have the social power to dissuade people from coming out for fear of rejection.

Both the bill and the emergency rule are absurdly cruel and will result in thousands of children and adults at best being chased out of the state of Missouri entirely and at worst being traumatized for life. These are decisions that should be made between patients, their doctors and, if they are underage, their parents. Not by some random Republican politicians who want to be able to live in a world that makes sense to them.

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