Missouri attorney general Andrew Bailey (R.) on Thursday issued an emergency rule that establishes extensive safeguards on providing transgender medical interventions to both adults and children.
The emergency rule, citing dozens of scientific studies and reports, concluded that because gender transition interventions are "experimental" and pose "significant side effects," state law requires "substantial guardrails" around such procedures. Those guardrails, the rule states, include ensuring patients have undergone at least 15 hourly psychiatric assessment sessions over the course of 18 months, informing patients explicitly that the "use of puberty blocker drugs or cross-sex hormones" to treat gender dysphoria "is experimental and is not approved by the Food and Drug Administration," and requiring those who receive such treatments to get medical follow-ups for 15 years.
The act comes as Bailey continues his investigation into St. Louis Children's Hospital's Transgender Clinic. His office launched the investigation in early February in response to a whistleblower's report of "egregious abuses and potential malpractice regarding minors."
While 11 other states prohibit pediatric transgender treatments, citing similar concerns over significant side effects and a lack of solid scientific support, this is the first state rule addressing adult patients.
"The regulation is necessary due to the skyrocketing number of gender transition interventions, despite rising concerns in the medical community that these interventions lack clinical evidence of safety or success," Bailey said in his statement announcing the rule, citing studies by the U.S. Agency for Healthcare Research and Quality and Sweden's National Board of Health and Welfare. The Swedish board recently declared that "the risks" of these interventions "currently outweigh the possible benefits."
"When even progressive countries like Sweden, Norway, Finland, and the United Kingdom have all sharply curtailed these procedures," Bailey said, "it's time for the United States to course-correct."
The American Civil Liberties Union and Lambda Legal, an LGBTQ advocacy group, are among the pro-trans activist groups decrying the rule and threatening legal action. They say that Bailey's rule is "distorted" and "misleading," citing the American Medical Association's and American Academy of Pediatrics's endorsements of "gender-affirming care"—a euphemism for puberty blockers, cross-sex hormones, and sex-change surgeries.
Bailey on March 20 issued a temporary rule that set strict perimeters for minors receiving "gender-affirming care," but the rule was set to expire in September. The new rule is effective April 27, 2023, and expires February 6, 2024.
"Even Europe recognizes that mutilating children for the sake of a woke, leftist agenda has irreversible consequences, and countries like Sweden, Norway, and the United Kingdom have all sharply curtailed these procedures," Bailey said in March. "I am dedicated to using every legal tool at my disposal to stand in the gap and protect children from being subject to inhumane science experiments."