Conflicting Judicial Decisions Add Uncertainty to Treatment Access for Transgender Youth in Texas and Missouri

On a recent Friday, a Texas judge struck down the state’s prohibition on gender-affirming healthcare for minors. Simultaneously, in Missouri, another judge permitted a comparable ban to come into effect. These discordant rulings, issued mere hours apart in two Republican-controlled states, contribute to the growing legal ambiguity surrounding the treatment rights of transgender minors in the United States.

These incongruent legal outcomes have further complicated an already tumultuous environment in the U.S. where a surge of new legislation targeting LGBTQ+ rights has emerged this year. Texas was quick to appeal the decision in an effort to have its new restrictions come into effect on September 1, potentially making it the largest U.S. state to enforce such a ban on gender-affirming healthcare for underage individuals.

Elizabeth Gill, an ACLU attorney who represented the families and healthcare providers challenging the Texas prohibition, stated, “Numerous transgender youths nationwide are facing threats to their well-being due to these perilous and unconstitutional restrictions.”

Over 20 states have enacted legislation that restricts some form of gender-affirming healthcare for minors, with some of these laws either not yet in force or temporarily restrained by the judiciary. Many of these laws inhibit access to hormone treatments, puberty blockers, and surgical transition procedures for transgender minors, despite medical experts asserting that such surgeries are seldom conducted on minors.

In Texas, District Judge Maria Cantu Hexsel sided with families who contended that the ban would infringe upon parental rights and severely affect transgender youths by denying them medically-recommended treatments. Judge Cantu Hexsel, who was elected as a Democrat, ruled that the ban also violated the rights of healthcare providers to adhere to “well-established, evidence-based” medical guidelines under the risk of license revocation. The Texas attorney general’s office swiftly appealed, putting the lower court’s decision on temporary hold.

Contrastingly, in Missouri, Circuit Judge Steven Ohmer’s ruling will prohibit healthcare providers from administering gender-affirming surgeries to minors starting Monday. While minors already receiving hormone treatments or puberty blockers can continue, new patients will be denied these medications. The law also affects adults as Medicaid will no longer cover these treatments, and the state will not offer these surgeries to incarcerated individuals.

Physicians contravening the Missouri law could lose their medical licenses and face lawsuits, with former patients given a 15-year window to initiate legal action and guaranteed at least $500,000 in damages if successful. Various organizations and families of transgender minors have already filed lawsuits against the Missouri law, claiming it is discriminatory. However, Judge Ohmer found the plaintiffs’ arguments to be “unpersuasive,” stating that the scientific and medical evidence was “ambiguous.”

A 10-year-old transgender boy, one of the plaintiffs in Missouri, faces a precarious future as he has not yet entered puberty and will thus not qualify for puberty blockers once the law takes effect. The law is set to expire in August 2027.

Proponents of these restrictive laws argue that gender-affirming treatments are both untested and unsafe. Missouri Attorney General Andrew Bailey cited similar restrictions in countries like England and Norway to bolster his case, though it should be noted that these nations have not instituted outright bans.

Every major medical organization in the United States, such as the American Medical Association, opposes such bans. Furthermore, medications like puberty blockers and synthetic hormones, though not FDA-approved for treating transgender youth, have been used “off-label” for years, a practice common in the medical community.

Reported by Vertuno from Austin, Texas.

Frequently Asked Questions (FAQs) about gender-affirming healthcare for transgender minors

More about gender-affirming healthcare for transgender minors

• Texas Judge Strikes Down Ban on Gender-Affirming Care
• Missouri Court Allows Gender-Affirming Care Ban
• ACLU’s Statement on Recent Rulings
• American Medical Association’s Position on Gender-Affirming Healthcare
• FDA Approval Status for Puberty Blockers and Hormones
• State-by-State Guide to Gender-Affirming Care Legislation
• Legal Timeline for Gender-Affirming Care Laws
• Missouri Law and its Implications
• Impacts of Gender-Affirming Care Bans on Transgender Youth
• Global Perspective: Gender-Affirming Policies in England and Norway