On May 10, 2023, the Missouri legislature passed a bill restricting access to gender affirming care for individuals under the age of 18. The bill is now headed to Governor Parson’s desk for signature. Given the Governor’s previous comments encouraging the legislature to pass similar types of legislation, he is expected to sign the bill. The bill (if signed) will become effective on August 28, 2023.

Like bills being passed in other states, the bill will primarily affect the ability of an individual who is under the age of 18 to access gender transition surgery and prescriptions for “cross sex” hormones or puberty blocking drugs. Additionally, the bill prohibits Missouri Medicaid from paying for gender transition surgery or prescriptions for the purpose of gender transition for any individual.

Prohibition of Treatment

The bill prohibits health care providers from knowingly performing gender transition surgery on any individual under 18 years old. Additionally, health care providers cannot knowingly prescribe or administer any hormones or puberty blocking drugs for the purpose of gender transition to an individual under the age of 18. If an individual has been prescribed or administered hormones/drugs before August 28, 2023, then the individual may continue to receive these drugs/hormones despite the prescription prohibition. Additionally, the prescription provision is only in effect from August 28, 2023 to August 28, 2027. Afterward, the provisions prohibiting prescriptions expire.

Any violation of these prohibitions by a health care provider will be considered unprofessional conduct, and the health care provider’s license to practice shall be revoked by the applicable licensing board. Additionally, the bill will allow individuals to sue their health care practitioner if the practitioner prescribed or administered hormones/puberty blocking drugs to them when they were under the age of 18 for the purpose of a gender transition.

Missouri Medicaid

The bill also prohibits Missouri Medicaid from making any payment for gender transition surgeries or hormones/puberty-blocking drugs for the purpose of gender transition. This prohibition applies to adults and minors.

Prohibition of Surgery for Offenders in Correctional Centers and County Jail

Finally, the bill prohibits offenders in correctional centers and county jails from receiving gender transition surgery regardless of their age.

Once signed, this bill will join a slew of recent legislation in various states across the country restricting types of permissible healthcare services, especially to those under the age of 18. These restrictions on available care will take effect shortly after signing, therefore, it important for providers to stay apprised of these pending laws and start thinking about transition plans now to ensure future compliance, especially when they offer care on a multi-state or national level.