Missouri lawmakers debate permanent ban on transgender care for minors

With state law already banning transgender youth from accessing puberty blockers and hormones, a Missouri House committee met late into the evening Wednesday to debate adding more restrictions.

Two statehouse hearing rooms overflowed with witnesses in favor and against bills in the House Emerging Issues Committee that would determine whether it should be compulsory for medical professionals to provide gender-affirming care or if transgender people can use the restroom that aligns with their gender identity.

The committee had a similar hearing a year ago, when it heard bills seeking to limit transgender Missourians’ rights and place restrictions on drag performances.

Wednesday’s nearly nine-hour meeting began with bills sponsored by Republican state Rep. Brad Hudson of Cape Fair that would eliminate a four-year sunset on a law enacted last year banning gender-affirming care for minors. It would also strike a section of the law allowing those already receiving treatment to continue.

These provisions were added as a compromise after Democrats in the Senate filibustered the legislation last spring.

But most testimony lingered on Hudson’s other bill, which would allow medical professionals to object to providing gender-affirming care to transgender patients — both children and adults.

“Every American should have the freedom to operate according to their ethical and religious beliefs, and that includes doctors, nurses and other medical providers,” he told the committee. “The Constitution protects their freedom as much as everyone else’s.”

He said he based his bill on current laws allowing doctors to opt out of providing abortions.

David Stansfield, a family medicine doctor in Hillsboro and member of the Catholic Medical Association, said he previously treated a transgender woman — misgendering her while telling his story — but does not want to provide gender-affirming care again.

“The ability to say no to certain medical procedures, whether they be about transgender medicine or just in general, needs to be in the purview of the physician,” he told committee members.

Leandra Morgenthaler, a medical student at the University of Missouri-Columbia, said she has felt berated in her studies because of her Catholic faith. She would like the option to choose not to perform certain procedures, like gender-affirming care.

“My classmates who share my beliefs and I have been told we should not intersect faith and medicine because of our religion,” she said, “that anyone who has faith beliefs like ours are obviously having the wrong opinion.”

Others were worried the bill may further reduce care options and have additional unintended consequences.

Cassie Brown, executive director of the Missouri chapter of the National Association of Social Workers, said the bill seeks to protect providers, whereas medical practice typically protects patients.

“The reason why all of these ethical codes exist is because patients are in a more vulnerable situation,” she said. “And gender-affirming care has been shown to reduce depression, anxiety and suicidality.”

Rep. Doug Mann, a Democrat from Columbia, asked Hudson who would be held responsible if care is withheld from a transgender person and they are harmed or die as a result. Hudson said it was a “hypothetical,” though many opposing the bill linked gender-affirming care with alleviating suicidality.

Winston Apple testified that he watched his grandson struggle, getting poor grades and suffering with depression until transitioning.

“Now, representative Hudson wants to keep him safe by taking away his right to continue the treatments that have kept him safe from unhappiness, depression and possibly suicide,” Apple told the committee. “I am here today hoping to keep my grandchild safe from politicians who want to violate his God-given rights to life, liberty and the pursuit of happiness.”

Katy Erker-Lynch, executive director for Missouri LGBTQ advocacy group PROMO, said last year’s legislation has had a life-changing impact on transgender Missourians — pushing some to move out of state. During her testimony, she honored a transgender woman who she said died by suicide in December.

“The total harm this legislative body has committed against trans and queer Missourians is incalculable,” she said.

Shannon Cooper, a former Republican lawmaker and a lobbyist representing Kansas City and the Kansas City Chamber of Commerce, said both entities fear the legislation is keeping people from moving to the area.

“We are looking for folks who want to come to Kansas City and continue to make it a very vibrant community, and legislation like this has consistently held people back from making a decision to come move to the state of Missouri, to move into the Kansas City region,” he said. “Currently, we are almost 100,000 employees short of the job opportunities that are there.”

Rep. Ashley Aune, a Kansas City Democrat, asked if Hudson’s bills could affect investment in the region.

“There are many companies that and also events that want to know what kind of community they’re looking at and investing millions of dollars in,” Cooper said.

Restrooms and locker roomsFour bills seek to legislate bathroom and locker-room usage by biological sex.

Rep. Adam Schnelting, a Republican from St. Charles, is sponsoring a bill that would allow parents to sue school districts for allowing a person of the opposite sex into restrooms with their child. He said his bill was intended to prevent sexual assaults.

Aune asked him to name an example of an assault his bill would prevent. He couldn’t, later alleging incidents happened in his local school district.

Schnelting said he based part of his bill from sample legislation by the Heritage Foundation, a conservative think tank based in Washington, D.C..

Republican Reps. Ben Baker of Neosho, and Chris Lonsdale of Liberty filed identical bills to legislate school restrooms.

“As a father of four daughters, I can tell you that it is imperative that we act and protect our children by implementing a universal statewide policy,” Baker told the committee.

Lonsdale described the legislation as “not the most controversial bill we’ve heard in committee,” and said he was inspired by incidents in the national news. He used the pre-transition name, or “deadname,” of swimmer Lia Thomas.

Lonsdale’s and Baker’s bills define biological sex by the sex “indicated on their birth certificate.” It allows for accommodations, like a single-stall restroom, with the approval of parents.

Some questioned the parental approval, saying it could reveal children’s gender identity to unsupportive parents.

Focusing primarily on adults, a bill by Republican Rep. Mark Matthiesen of O’Fallon would place these restrictions on restrooms and locker rooms in the workplace. It would bar transgender people from their chosen restroom unless they have completed “a full medical procedure to change (their) sex.”

Matthiesen said the legislation was intended to protect women.

“As we work together to ensure that all people have access to public spaces, it has been at the expense of biological women,” he said.

He said he was urged to write the bill after constituents worried for female lifeguards at a local pool.

“It needs to start at the state level and bring people together to provide the facilities that accommodate everyone’s needs but certainly not at the expense of women,” he said.

Cooper testified in opposition to Matthiesen’s bill, saying employers don’t want to talk to employees about bathrooms and gender.

“We don’t need you-all telling us all how to use the bathroom,” he said.

Representatives for the City of St. Louis and the Missouri Chamber of Commerce and Industry also told committee members that the bill would hurt businesses.

Others opposed to the legislation said transgender people are more vulnerable to assault.

“Sexual assault and sexual harassment on the basis of being (transgender) happens as well in schools,” Mann said. “It happens at a much higher rate. By forcing them to go into a bathroom that is against their gender identity, the way they present themselves, you’re putting them at risk.”

There is currently a case in Platte County Circuit Court where a 16-year-old transgender girl alleges she faced a threat of sexual assault after being forced to use the boys’ restroom at school.

May Hall, a transgender college student, told the committee she uses the men’s restroom because she doesn’t want to make other women feel uncomfortable. But her conscientiousness has consequences.

“I’ve walked in, and people have groped me; people have called me names; people have called me slurs,” she said. “It is an extremely uncomfortable environment, but I continue to in some spaces use the men’s restroom purely to not discomfort cisgender women.”

Charlie Adams, a transgender medical school student, said he has worked in states with similar laws in place. He doesn’t feel comfortable using the women’s restroom, as would align with the sex at birth, because it doesn’t match his gender.

Adams has broad shoulders, a beard and thick eyebrows. Aune wondered what it would be like if he tried to enter a women’s restroom.

“Talk to me about the concern of just using the restroom that you are using, a men’s restroom, versus what the response would be if you walked in looking as you do, sir, into a women’s restroom,” she said.

Adams said this bill would force him to use the women’s restroom, or otherwise break the law.

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