Missouri transgender services lawsuit opens, challenging 2023 law on medical bans

With a judge imported from Douglas County, a two-week bench trial for a lawsuit challenging Missouri's transgender services law opened Monday morning in Cole County.

On hold for over a year, the 2023 law bans gender transition surgeries on minors and imposes a three-year moratorium on hormone therapy and puberty blockers for patients not already on those medications when the law takes effect.

Because the case involves juveniles, Judge Robert Craig Carter of the 44th Circuit limited camera access for the proceeding to a Webex transmission, one he can censor as needed.

"This is not about phobia. This is not about hate,” said Catherine Dreher, a mother of a transgender child. “This is about protecting our children, especially the most vulnerable."

The fight to restrict or eliminate gender reassignment for minors in Missouri is a decade-old debate that ultimately led to Senate Bill 49.

"I feel a lot of this comes from people speaking to 'the children' as a concept, rather than talking to them as people," said therapy access supporter Ian Desmet.

To opponents, parental consent means nothing. "If we wait until some poor Missouri kid comes out and says, ‘my life has been changed forever and that should have never have happened to me,’ we have waited too late," said Republican Cape Fair Rep. Brad Hudson.

An overbooked Cole County Judge Jon Beetem last year sent the case to the Missouri Supreme Court for reassignment.

Carter is the third judge to be involved.

The plaintiffs argue Senate Bill 49 is a government intrusion of the highest order.

"That takes away from transgender adolescents, their parents, and their doctors the ability to make individualized and private decisions about their health care," said Omar Gonzalez-Pagan, attorney for the plaintiffs.

The state counters that Missouri’s law falls in line with some of the most politically progressive countries around the globe, including Britain and Sweden, which have restricted puberty blockers for minors due to "limited evidence to support their safety or clinical effectiveness.”

In court, the attorney general's office took offense at one plaintiff's assertion.

"They say this law only passed the legislature because the legislature is filled with hateful bigots, and the governor is a hateful bigot," said Assistant Attorney General Joshua Divine.

Senate Bill 49 also affects adults by barring the use of Medicaid payments for transgender treatment and it prohibits gender-reassignment surgeries for prison inmates.

The ACLU of Missouri and the national LGBTQ civil rights law firm Lambda Legal have brought the suit. The judge blocked off two full weeks for testimony.