BY DMITRY MARTIROSOV
Missouri News Network
A slew of transgender bills are still awaiting action in the Missouri General Assembly, but many of the proposals have already begun to impact the LGBTQ community, lawmakers and providers said.
At least 31 bills that have been filed are aimed at the LGBTQ community. The bills seek to curb anything from transgender participation in sports different from birth gender to preventing transgender youth from receiving gender-affirming health care to banning discussion of sexual orientation and gender identity by public and charter school teachers and other officials.
Of the bills, eight — four in each chamber — aim to ban access to gender-affirming medical care to anyone under 18 and prohibit health care providers from offering referrals for other physicians. Doctors who violate these provisions, the bills state, would be subject to disciplinary measures such as losing their license.
Although none of the bills have passed either chamber, Rep. Ashley Aune, D-Kansas City, believes harm has already been done.
“I don’t think that these bills need to pass to affect trans youth in Missouri,” Aune said. “Just by proposing the legislation and talking about it so openly ... that has such a devastating effect in and of itself.”
Aune was one of six Democrats present at the much-discussed, nine-hour public hearing in the House General Laws Committee on Jan. 24, when eight bills seeking to restrict certain LGBTQ rights were heard. She alluded to the fact that Missouri is one of the leading states with the most pre-filed LGBTQ-restrictive bills, trailing only Oklahoma, with 34.
“When the Missouri legislature makes headlines for targeting marginalized communities, those communities feel it whether the law passes or not,” Aune said. “Because what we’re doing is getting a permission structure to our constituents to discriminate against an entire group.”
Figures, preliminary impacts
Currently, in Missouri, an estimated 12,400 people 13 and older identify as transgender, according to a 2022 study by the Williams Institute, a think tank at the University of California-Los Angeles School of Law. Of those, an estimated 2,900 are transgender youth ages 13 to 17.
Although Missouri’s transgender youth population has increased only by an estimated 400 people in the past five years, the nation’s population, in comparison, has more than doubled, growing from roughly 150,000 transgender youths in 2017 to more than 300,000 in 2022, according to the Williams Institute.
Regardless of whether any bills pass, this budding population is already feeling the impacts, said Anthony Banks, a licensed social worker and a clinical therapist with the Counseling Hub, a Columbia-based counseling service.
“There is a multitude of research that shows the relationship between an adolescent teen’s access to gender-affirming health care, activities and overall perceived support, and their mental health,” Banks said.
“There’s always an increased risk of anxiety, depression, gender dysphoria, self-harming behaviors, suicidality and general feelings of hopelessness when there’s lower support, whether that support is familial or in the community,” he said.
Banks, whose caseload consists of 50% LGBTQ clients, added that after the U.S. Supreme Court overturned Roe v. Wade, giving states the authority to determine whether women would have the power to choose whether to have an abortion, he saw a shift in his clients’ demeanor.
“I noticed clients being more concerned with a possibility of gender-affirming services becoming more limited as well as LGBTQ+ rights overall,” he said. “I believe this concern has only continued.”
Banks noted that when lawmakers create legislation that acts as a barrier to health care, the message often is that “people will stand in their way, and that they cannot be themselves.”
These adverse effects are amplified by a recent poll by the Trevor Project, a nonprofit organization that sampled more than 700 LGBTQ youth.
The poll found that 86% of trans and nonbinary youth say that debates around these bills have a negative impact on their mental health. The poll also found that 45% of trans and nonbinary youth report being cyberbullied or experiencing online harassment, 42% stopped speaking to a family member or relative, and 29% feel unsafe going to a doctor when feeling sick or injured — all a result of these debates.
Law and differing opinions
Under Missouri law, as outlined in the state’s physician manual, gender reassignment surgeries are not covered by MO HealthNet. That means that even if transgender people were to seek gender-affirming health care, they would likely have no other option than to pay out of pocket.
Sen. Greg Razer, D-Kansas City, said physicians in Missouri don’t perform these types of procedures.
“No one does surgery on minors,” Razer said. “It’s just not something that’s done.”
He added that since insurance doesn’t cover these medical procedures, it remains too costly for people to pay for privately.
But Rep. Brad Hudson, R-Cape Fair, sponsor of HB 419, one of the eight bills heard in the Jan. 24 hearing, pushed back.
“How (does he) know that?” Hudson said. “That’s been a question I’ve been asking.”
As one of the most outspoken opponents in the General Assembly regarding LGBTQ-restrictive legislation, Razer, the only openly gay senator in Missouri, believes that some of these bills stem from “sheer ignorance.”
“I mean that in the literal term,” he said. “Lack of knowledge.”
And this lack of knowledge remains baffling to him.
“We’re legislating on something that the vast majority of my colleagues have no idea what we’re talking about,” Razer said. “And now they want to make medical decisions based on an issue that they don’t understand.”
Again, Hudson pushed back.
Citing drugs and surgeries related to gender transition procedures as “harmful,” Hudson said that as a member of the General Assembly he can’t stay idle.
“As a legislature, we need to act, and we need to act quickly,” he said. “Because we’re talking about children here — we’re talking about protecting children.”
He added that an increase in awareness in the general public has made this type of legislation particularly urgent.
“Why would we want to wait until some poor Missouri kid comes out and says ‘my life has been ruined because of this,’” Hudson said. “Why don’t we put this in statute now? Why don’t we act to protect children now?”
On Feb. 16, Hudson’s HB 419 — along with HB 183, sponsored by Rep. Jamie Burger, R-Benton, also presented in the Jan. 24 hearing — was voted out of the General Laws Committee and will now head to the House floor for debate. It has not yet been placed on the House calendar.
Democrats in the Senate last week stalled efforts to debate a transgender bill, although it is expected to come up next week when the Senate returns from its break.
Foresight and recent developments
This ongoing battle between sponsors and opponents of the bills recently gained new ground when Missouri Attorney General Andrew Bailey, on Feb. 9, confirmed that his office launched an investigation into St. Louis Transgender Center for allegedly harming children after a whistleblower who worked at the center came forward.
The announcement was followed a day later by a request from Bailey for the center to immediately pause all prescriptions for puberty blockers or cross-sex hormones to new patients while the investigation is ongoing.
On Feb. 15, the center rejected the request.
Hudson said that talking about these issues remains vital.
“We need to be able to have these conversations as a legislature, as a society,” he said, “as citizens who care about children.”
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