MO AG Bailey withdraws rule banning gender-affirming care for trans adults, children

Missouri Attorney General Andrew Bailey has withdrawn a sweeping emergency rule that would have effectively prohibited gender-affirming care — ending, for now, the danger that transgender adults in the state would no longer have access to hormone therapy.

But Gov. Mike Parson appears likely to sign a bill banning the care for minors, which the General Assembly passed after Bailey proposed the rule in April. Bailey’s rule would have applied to both children and adults.

“We were standing in the gap unless and until the General Assembly decided to take action on this issue. The General Assembly has now filled that gap with a statute,” Bailey said in a statement. “I’m proud to have shed light on the experimental nature of these procedures, and will continue to do everything in my power to make Missouri the safest state in the nation for children.”

Missouri Secretary of State Jay Ashcroft’s website said the rule had been “terminated” as of Tuesday after Bailey’s withdrawal. The proposal from Bailey, a Republican, had drawn enormous backlash and had already been temporarily paused by a St. Louis County judge.

Bailey’s decision to extend the regulations to include adults had divided Republicans, with many saying those over 18 should have the right to access the care even as some have denied the reality of transgender identity.

Some trans Missourians who previously spoke with The Star had predicted that Bailey’s rule was merely a stopgap to give the GOP-controlled General Assembly more time to pass legislation aimed at restricting gender-affirming care. Kale Marie Michael, a 21-year-old trans woman from Kansas City, said Tuesday she was tentatively optimistic.

“I feel like there’s been a lot of bait and switch with things like that,” she said. “I really hope that is a sign that that is not going to be implemented. I also feel like it’s probably an indication that he’s recognizing he had absolutely no legal foundation for the claims he was making about it being an emergency.”

Heidi Schultz, a 44-year-old transgender woman from Kansas City, said Bailey’s withdrawal made her feel excited but uncertain about the future.

“I don’t know if they’re dropping this to regroup later or just dropping it totally because it’s a losing strategy. It’s hard to know in the long term,” she said. “But definitely in the short term, it’s one less thing to worry about.”

Bailey’s restrictions had been temporarily blocked from taking effect until July after a hearing in a lawsuit against the rule was delayed earlier this month. St. Louis County Circuit Court Judge Ellen Ribaudo had previously blocked the restrictions until May 15 after hearing arguments in the lawsuit filed by the American Civil Liberties Union of Missouri and LGBTQ civil rights group Lambda Legal.

The suit alleged that Bailey’s rule violates state law and the Missouri Constitution.

Bailey had justified his emergency rule on the basis that that gender-affirming care was “experimental,” even though the field has standards of care recognized by established medical groups.

He often framed the rule as necessary to protect children and rolled out the proposal after a former employee at Washington University in St. Louis’ transgender clinic at St. Louis Children’s Hospital alleged the center was harming patients. The university’s internal report found the allegations to be unfounded.

But Democrats and even some Republicans had voiced doubts that the rule would stand up in court as it sought to effectively ban an entire area of medical care without legislative action.

“Andrew Bailey grossly overstepped his legal authority, and everyone knows it. So, it isn’t surprising he withdrew his unconstitutional rule knowing another embarrassing court defeat was inevitable,” House Minority Leader Crystal Quade, a Springfield Democrat and potential candidate for governor, said in a statement.

“Missourians deserve an attorney general worthy of the office, not one who persecutes innocent Missourians for political gain.”

Republican lawmakers passed their own ban earlier this month, which would have superseded Bailey’s rule for children. The bill bans all “gender transition procedures” for people under 18 but would allow minors to continue hormone therapy or puberty blockers if they were already prescribed them. The restrictions on hormone therapy and puberty blockers expire in 2027. The ban on gender-affirming surgeries does not expire.

Bailey’s rule had left open the possibility that care for adults could still be targeted, however. Michael said she hopes the withdrawal is a good sign for trans Missourians.

“It makes me a little bit more hopeful for the next few years as I stay in Missouri,” she said. “That sounds like it could potentially be a really good thing for trans adults in this area.”