A Missouri court upheld a state law on Monday that bans gender-transition surgeries and treatments, including hormones and puberty blockers, for minors — about a week before the Supreme Court considers a similar case.
Judge R. Craig Carter sided with the state’s argument that there is no medical consensus on the efficacy of transitioning children. To back his ruling, he cited a 2007 Supreme Court ruling that authorized state and federal legislatures “to pass legislation in areas where there is medical and scientific uncertainty.”
While large medical organizations like the American Academy of Pediatrics support gender transitions, others such as the American College of Pediatricians oppose such treatments for minors suffering from gender dysphoria. The judge noted there are many uncertainties surrounding the controversial practices.
“The evidence from trial showed that the medical ethics of gender dysphoria treatment for children and adolescents are entirely unsettled,” Carter, who sits on the 44th Judicial Circuit Court of Missouri, wrote. “Any person — including a minor — would be able to obtain anything from meth, to ecstasy to abortion so long as a single medical professional were willing to recommend it.”
Lambda Legal and the American Civil Liberties Union of Missouri, which are representing the plaintiffs who sued the state over the ban, said they will appeal the ruling.
The circuit court judge’s decision makes Missouri “the first state in the nation to successfully defend such a law at the trial court level,” Republican attorney general Andrew Bailey, who defended the legislation in court, said in a celebratory statement.
“I’m extremely proud of the thousands of hours my office put in to shine a light on the lack of evidence supporting these irreversible procedures. We will never stop fighting to ensure Missouri is the safest state in the nation for children.”
Governor Mike Parson signed Missouri Senate Bill 49 in June 2023 after it passed the legislature. The law limited access to so-called gender-affirming surgeries and medications for children and teenagers under 18, unless the minor was receiving such medications before August 2023.
It also imposed significant penalties on physicians who violate the law. If they engage in any minor-related gender-transition practice, Missouri health-care providers could have their professional licenses revoked or be subject to lawsuits. The measure expires in August 2027.
Missouri is one of at least 26 states that ban or otherwise legally restrict transgender surgeries and treatments for minors.
On December 4, the Supreme Court will hear oral arguments in U.S. v. Skrmetti. The case involves Tennessee’s ban on all treatments for “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex.” The question that the Court will soon face is whether Tennessee Senate Bill 1 violates the equal-protection clause of the 14th Amendment.
The high-profile Supreme Court case comes as president-elect Donald Trump has vowed to pursue legislation to stop child mutilation after he enters the White House for a second term in January.