Missouri’s Supreme Court upheld the state’s ban on gender-affirming care for minors this week, along with a prohibition on Medicaid coverage of gender-affirming care for anyone in the state.
As the Missouri Independent reports, the court’s unanimous decision upholds a 2024 circuit court ruling in a case challenging Senate Bill 49. The law, signed by Gov. Mike Parson (R) in 2023, bans minors from accessing any form of gender-affirming care, including puberty blockers, hormone replacement therapy, and surgeries. It also bans the state’s Medicaid program from covering gender-affirming care for people of all ages.
Related
The challenge against the law was brought by Lambda Legal and the ACLU of Missouri on behalf of three families of transgender young people, medical providers, and LGBTQ+ advocacy organizations, who argued that the law should be subject to heightened scrutiny, a more rigorous legal standard applied to cases involving the classification of individuals by specific characteristics like gender.
According to the Missouri Independent, the state Supreme Court rejected that argument, as had the lower court. While plaintiffs had argued that the law discriminates on the basis of sex and transgender status, Judge Kelly Broniec wrote in the court’s decision that S.B. 49 “classifies only based on medical use and age.”
Never Miss a Beat
Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights.
The court’s reasoning echoes that in the U.S. Supreme Court’s ruling last year in United States v. Skrmetti, which held that Tennessee’s ban on gender-affirming care for trans youth does not discriminate on the basis of sex or transgender status.
As the Missouri Independent notes, Supreme Court precedent allows lawmakers broad discretion when it comes to issues “fraught with medical and scientific uncertainty.”
While for decades there has been broad scientific consensus — including among all major American medical associations — that gender-affirming care is safe, evidence-based, and often lifesaving for minors experiencing gender dysphoria, conservative organizations and some American media outlets have made massive strides in recent years in sowing doubt about that consensus.
While lawyers for the plaintiffs put forth multiple expert witnesses to defend gender-affirming care for young people during the 2024 trial, the Missouri Attorney General’s Office faced serious questions about the credibility of some of its key witnesses.
In September, Lambda Legal attorney Nora Huppert argued that the lower court’s decision upholding S.B. 49 included “legal and factual errors.” But writing for the Missouri Supreme Court this week, Broniec nonetheless said that the state had “demonstrated the ongoing debate among medical and ethical experts regarding the risks and benefits associated with the treatments at issue.”
The court also rejected arguments that the Medicaid ban violates Missouri’s constitution, with Broniec noting that adults in the state can still pay out-of-pocket to receive gender-affirming care.
Gillian Wilcox, director of litigation at the ACLU of Missouri, responded to the decision saying that it “not only allows the state to target transgender Missourians access to health care but also leaves everyone’s health care options at the whims of politicians, should certain care ever fall into the political arena.”
Subscribe to the LGBTQ Nation newsletter and be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.