Sen. Josh Hawley (R-MO) Photo: Natureofthought/via Wikipedia
At an event in September, Sen. Josh Hawley (R-MI) claimed that an upcoming Missouri state ballot measure to enshrine abortion rights into the state constitution will also enshrine gender-affirming care by placing it into the state constitution. He argues that this is because gender-affirming care falls under the umbrella of ‘reproductive care.’
“This is about an effort to come into our schools behind your backs without your knowledge, to tell our kids that there’s something wrong with them and to give them drugs that will sterilize them for life, to push them toward procedures that will fundamentally change their bodies irrevocably for life,” Hawley said at the Ozark anti-abortion event, repeating a right-wing lie that schools provide transitional medication to children without parental consent. “And there will be nothing we can do about it.”
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LGBTQ Nation investigated this claim to see whether it stands up to scrutiny.
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Background and what Missouri’ ballot measure says
In June 2022, the landmark decision guaranteeing abortion rights across the country, Roe v. Wade, was overturned by the U.S. Supreme Court in its Dobbs v. Jackson Women’s Health Organization decision. While protests erupted across the country, Missouri swiftly allowed a 2019 law banning abortion statewide to go into effect.
The Missouri abortion ban is a total ban that only allows exceptions in cases where the pregnancy would harm the parent. Even for those who are granted an abortion, there is still a mandated 72-hour waiting period as well as additional counseling to discourage the parent from terminating the pregnancy.
In response to this, the group Missourians for Constitutional Freedom collected hundreds of thousands of signatures from people across the state to get a voting measure on the state’s ballot in November. The group succeeded back in August with an amendment that would supersede most of the existing abortion ban by protecting abortion rights and reproductive healthcare in totality.
The text of the proposed abortion amendment is visible on the Missouri government website, with information on the exact wording as it’ll appear to voters. The amendment’s text does not mention gender-affirming care — it focuses exclusively on matters regulating abortion and pregnancy rights.
The amendment’s text says, “The Government shall not deny or infringe upon a person’s fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.”
The text of the ballot measure also makes no mention of gender-affirming care. Additionally, the state’s definition of reproductive care doesn’t mention gender-affirming care.
LGBTQ Nation is not aware of any legal precedent from proponents of either reproductive healthcare or gender-affirming care that regulates the latter practice as a form of reproductive medical care. In the legal rights website Nolo, attorney Stacey Barret outlined the legal precedent for gender-affirming care, but her explanation contained scarce mention of reproductive healthcare except as an entirely distinct type of care that trans people can receive as part of their transition.
The World Professional Association for Transgender Health’s (WPATH) Standards of Care 8 — the leading document regulating gender affirming care — also does not discuss gender-affirming care as a subset of reproductive care. Rather, WPATH’s standards outline how, while certain medical interventions for trans people may limit fertility, trans people should be referred to receive reproductive care to preserve their sperm and egg cells.
All in all, there is no evidence that gender-affirming care and reproductive care are regulated or conducted similarly in practice. Rather, they’re distinct forms of care that may be given to the same patient based on their specific needs.
Expert Reactions
LGBTQ Nation reached out to Sen. Hawley’s campaign for comment but did not receive a response before publication.
However, The Kansas City Star quoted quotes Mary Ziegler, law professor at the University of California at Davis, as saying, “I’ve never seen anyone argue that gender-affirming care is reproductive health care… I guess you could argue that it makes people unable to reproduce. But it’s not usually something that an obstetrician-gynecologist would deliver.”
Tori Schafer, an attorney with the ACLU of Missouri — who works with Missourians for Constitutional Freedom — also told The Kansas City Star, “Anti-abortion politicians will say anything no matter how outlandish to distract from the public health crisis they have created in Missouri when they banned abortion. This is a false narrative being pushed by politicians using scare tactics to divide Missourians and distract us from what this amendment is about: protecting the right to abortion and letting Missourians make their own healthcare decisions.”
Conclusion
Based on the above evidence and expert testimony, there is no evidence that this amendment would regulate gender-affirming care. There is no mention of such care in any rhetoric from proponents of this amendment, and there is no legal or medical precedent for gender-affirming care to be considered reproductive. LGBTQ Nation rates Hawley’s claim as false.
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