Judge Upholds Missouri’s Ban on Transgender Procedures for Children

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The judge said he found a lack of consensus as to the medical ethics of those treatments.

A Missouri judge has upheld the state’s law that bans transgender procedures for children.

In a ruling handed down on Monday, Judge R. Craig Carter of the Circuit Court of Cole County, Missouri, said the challenge failed to substantiate multiple arguments, including that there exists a medical consensus on whether using drugs and surgeries to treat adolescent gender dysphoria is ethical.

“Regarding the ethics of adolescent gender-affirming treatment, it would seem that the medical profession stands in the middle of an ethical minefield, with scant evidence to lead it out,” Carter wrote.

“States do have abiding interest in protecting the integrity and ethics of the medical profession.”

The law in question, officially known as the Save Adolescents from Experimentation (SAFE) Act, forbids health care providers from prescribing puberty blockers and cross-sex hormones or performing transgender surgeries for individuals younger than 18. Those who were already prescribed the so-called “gender-affirming” medications prior to Aug. 28, 2023, may continue to receive them.

The law also gives patients 15 years after their treatment ends or 15 years after their 21st birthday, whichever is later, to file a civil lawsuit against the medical provider. Patients who are harmed—defined as infertility caused by transgender procedures—may be awarded a minimum of $500,000 with no maximum, and the burden of proof is on the medical provider.

Missouri Gov. Mike Parson signed the law in June 2023, saying that children lack the capacity to provide informed consent for irreversible treatments they might regret later in their lives.

“These decisions have permanent consequences for life and should not be made by impressionable children who may be in crisis or influenced by the political persuasions of others,” Parson said at the time.

The Challenge

The law faced a legal challenge in July 2023, just before it took effect in August. A coalition of LGBT activists, health care providers, and three Missouri families of gender-dysphoric children sued the state, arguing that the SAFE Act violates parental autonomy—the fundamental right of parents to seek and follow medical advice to safeguard their children’s health and well-being.

By Bill Pan

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