Judge temporarily halts Missouri transgender care restrictions from taking effect

A judge on Wednesday temporarily halted the implementation of Missouri Attorney General Andrew Bailey’s restrictions on transgender care a day before they were set to take effect, allowing Missourians to continue accessing gender-affirming care until May 1.

St. Louis Circuit Court Judge Ellen H. Ribaudo, appointed by former Democratic Gov. Jay Nixon in 2015, in a written order Wednesday said she would rule on a proposed temporary restraining order against the restrictions on that date. She wrote that Bailey’s office “graciously invited” her to enter a stay on the restrictions so she had more time to review the case.

The regulations, which include requiring 15 separate hourly therapy sessions over 18 months before a person can start transgender care, would make Missouri the first state to severely restrict gender-affirming care for adults, in addition to children. The rule has divided Republicans, with Missouri Secretary of State Jay Ashcroft and others questioning whether it will hold up in court.

Ribaudo made the ruling after hearing arguments in a lawsuit against the restrictions. Bailey’s office earlier on Wednesday had tried unsuccessfully to move the case out of St. Louis County Circuit Court and into U.S. District Court for the Eastern District of Missouri.

The lawsuit, filed by the American Civil Liberties Union of Missouri and LGBTQ civil rights group Lambda Legal, alleges the regulations violate state law and the Missouri Constitution. While attorneys for the plaintiffs were in the courtroom, Missouri Solicitor General Josh Divine, who represented Bailey’s office, streamed into the hearing from Jefferson City.

Madeline Sieren, a spokesperson for Bailey’s office, downplayed the judge’s ruling in a statement to The Star on Wednesday.

“This order merely stays the implementation of our rule so the Court can review the briefing,” the statement said. “We will continue fighting for all patients to have access to adequate health care.”

The ACLU of Missouri and Lambda Legal in a joint statement Wednesday said they were grateful for the decision.

“No less than the health and wellbeing of thousands of transgender Missourians is at stake,” the statement said in part. “Gender-affirming care is supported by overwhelming scientific data, decades of clinical experience, and the medical consensus of major medical organizations in the United States...While we welcome this temporary relief, we look forward to the judge ultimately preventing this rule from going into effect.”

St. Louis Circuit Court Judge Kristine Kerr, also appointed by Nixon, was initially scheduled to hear the case, but Bailey’s office asked for a last-second change before the hearing.

During Wednesday’s hearing, Tony Rothert, an ACLU attorney, compared Bailey’s medical restrictions to Frankenstein, taking scraps of out-of-context quotes and non-peer reviewed articles to make his rule. Rothert spent much of the hearing detailing how the restrictions would severely restrict Missourians from receiving necessary health care

“This rule is a monster,” Rothert said. “It’s terrifying thousands of Missourians today and will cause serious harm, potentially even death.”

Divine, in his arguments, countered that Bailey’s rules were necessary, painting gender-affirming care as experimental. In one of his points, Divine touted talk therapy as a replacement to gender-affirming care.

The solicitor general also argued that Wednesday’s hearing over the emergency rule that his office filed was rushed, contributing to why attorneys from Bailey’s office did not attend.

He pointed to a grandfather clause in Bailey’s rule, claiming that the transgender plaintiffs in the case – which include the families of two minor transgender girls — would be grandfathered in and not affected by the restrictions.

“Nothing prevents them from continuing the intervention that they’re already doing,” he said.

Advocates for transgender health care responded to the order with cautious optimism on Wednesday.

Yamelsie Rodríguez, the president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, which is also suing Bailey’s office for investigating gender-affirming care that it provides, said the stay would provide relief to patients as they wait on a full ruling.

“We are optimistic the court will permanently strike down these harmful restrictions and send a message to the attorney general that he has no business regulating people’s health care,” Rodriguez said in a statement.