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Advocacy organizations have filed a lawsuit to prevent a Missouri emergency rule banning gender-affirming services from taking effect this week

Advocacy organizations filed a lawsuit against Missouri Attorney General Josh Hawley on Monday after he issued an “emergency rule” limiting transgender treatment for minors and adults – a regulation that is set to take effect this week, according to his office.

Gender-affirming treatment is medically necessary, evidence-based care that employs a multidisciplinary approach to assist a person in transitioning from their assigned gender – the gender assigned to them at birth – to their affirmed gender, the gender by which they wish to be identified.

The new rule asserts that people frequently undergo “life-altering interventions,” such as pubertal suppression or gender transition surgery, “without any talk therapy at all,” and that the emergency action is “needed because of a compelling governmental interest and a need to protect the public health, safety, and welfare” of Missourians.

The rule states, among other things, that it is “illegal” for people or health care professionals to offer gender-affirming services to patients without first confirming that they have, “for at least the three most recent consecutive years… exhibited a medically documented, long-lasting, persistent and intense pattern of gender dysphoria.”

The order is set to go into effect on Thursday and will expire on February 6, 2024, according to a press statement from Attorney General Andrew Bailey’s office.

Petitioners asked the Circuit Court of Saint Louis County to declare the rule invalid “due to the Attorney General’s lack of statutory authority to promulgate it,” among other legal arguments, according to the petition filed by advocacy groups representing Southampton Community Healthcare in St. Louis and several providers and patients.

“The Rule targets gender-affirming care with unprecedented and unique restrictions that are so onerous that it effectively prohibits the provision of this necessary, safe, and effective care for many if not most, transgender people in Missouri,” according to the petition.

The suit also demands a stay of the rule’s planned Thursday start date, as well as reasonable costs and expenses, as well as any other remedy the court deems just and proper, according to the petition.

In a statement to the associated press, Bailey stated, “Our regulation enacts fundamental safeguards for interventions that a global medical consensus has determined to be experimental.” These groups “are racing to court to continue their ideologically-based procedures masquerading as medicine, rather than ensuring that patients are protected by common sense safeguards.”

The regulation, according to the attorney general’s office, “is based on dozens of scientific studies and reports, which are cited in endnotes.”

Lambda Legal, a civil rights organization, responded to Bailey’s assertion.

“This emergency rule is an unprecedented attempt to prevent broad categories of transgender people – including adults – from receiving gender-affirming care that is evidence-based, supported by the overwhelming medical consensus of major medical organizations, and in no way ‘experimental,'” Lambda Legal attorney Nora Huppert said in a statement. “And any ‘race’ to obtain relief from this rule is entirely the result of the Attorney General’s decision to implement sweeping, draconian regulations on two weeks’ notice that threaten trans people’s access to medically necessary care, even decades into their transition.”

The World Professional Association for Transgender Health, an organization that focuses on transgender health concerns, and one of its affiliates, the United States Professional Association for Transgender Health, have claimed that the rule is partially based on “flawed reports.”

The associations responded to an earlier announcement from Attorney General Andrew Bailey’s office about the impending regulation last month, stating that “the emergency regulation issued by Missouri Attorney General Andrew Bailey is based upon manipulated statistics, flawed reports, and incomplete data, and prevents the provision of medically necessary care.”

One of the plaintiffs at Southampton Community Healthcare, according to the petition filed on Monday, has transgender patients who “have expressed to its providers that they fear they will be denied continuation of their hormone therapy if they share symptoms of other mental health issues.”

Dr. Samuel Tochtrop of Southampton Community Healthcare said in a statement that Missouri Attorney General Andrew Bailey’s emergency order “is a baseless and discriminatory attempt to limit the healthcare options for transgender individuals, who already face several barriers accessing necessary and life-saving medical care.” Southampton Community Healthcare has the honor of opposing this regulation on behalf of Missourians who identify as transgender.

The bill, according to the president and CEO of the LGBTQ advocacy group GLAAD, is “an unprecedented attempt to restrict an entire group of people.”

In a news release, Sarah Kate Ellis stated that “the rule issued by Missouri’s attorney general includes outright lies and falsehoods about best practice care supported by every major medical association.” This is an extraordinary attempt to prevent a whole group of individuals from having access to the medical information they need to live healthy lives.

“Health care decisions need to remain between patients, their doctors, and their loved ones – not subject to the whim of craven politicians looking to score political points,” added Ellis. “GLAAD is extending our full support to the activists and members of our organizational partners in Missouri who are working assiduously to overturn this unlawful decree as quickly as possible. Because transgender persons are welcome, this rule will be overturned.

The move in Missouri comes after Gov. Doug Burgum of North Dakota enacted a law this week prohibiting gender-affirming care for the majority of adolescents, with those who administer it facing the prospect of being charged with a felony. This month, Indiana and Idaho passed their laws prohibiting the provision of gender-affirming treatment to children, and several other states have passed laws restricting the provision of gender-affirming care to children in recent years.

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