Las Vegas Review-Journal (Sunday)
Gender-affirming care rulings unpredictable
Missouri ban upheld; law in Texas rejected
COLUMBIA, Mo. — A judge on Friday ruled against Texas’ ban on gender-affirming health care for minors while a separate judge in Missouri let a similar ban take effect, jumbling again where in the U.S. transgender youth can receive treatment.
The conflicting decisions, handed down hours apart in two Republican-led states, added to the legal unpredictability that is unfolding nationwide over a historic wave of new laws this year that target LGBTQ+ rights.
Underscoring the fast-changing landscape, Texas swiftly appealed to keep its new restrictions on track to take effect Sept. 1, when it would become the largest state in the U.S. to enforce a ban on gender-affirming care for minors.
“Across the country, countless transgender youth are having their well-being threatened and their lives uprooted by dangerous and unconstitutional bans,” said Elizabeth Gill, an attorney for the ACLU, which represented families and doctors challenging the Texas ban.
More than 20 states have adopted laws to ban some gender-affirming care for minors, but some are not yet in effect or have been put on hold by courts. Many of them prevent transgender minors from accessing hormone therapies, puberty blockers and transition surgeries, though medical experts say such surgical procedures are rarely performed on children.
In Texas, state District Judge Maria Cantu Hexsel sided with a group of families who argued it would violate parents’ rights and have devastating consequences for transgender children and teenagers who would be denied treatment recommended by their physicians.
Cantu Hexsel, an elected judge who ran as a Democrat, also ruled the state’s ban would discriminate against transgender children and violate doctors’ ability to follow “well-established, evidence-based” medical guidelines under threat of losing their license.
Almost immediately, the state filed an appeal to the Texas Supreme Court, putting the lower ruling on hold. In a statement, the Texas attorney general’s office said it would “continue to enforce the laws duly enacted by the Texas Legislature and uphold the values of the people of Texas.”
In Missouri, the ruling by St. Louis Circuit Judge Steven Ohmer means that beginning on Monday, health care providers are prohibited from providing gender-affirming surgeries to children. Minors who began puberty blockers or hormones before Monday will be allowed to continue on those medications, but other minors won’t have access to those drugs.
Some adults also will lose access to gender-affirming care. Medicaid no longer will cover treatments for adults, and the state will not provide those surgeries to prisoners.
Physicians who violate the law face having their licenses revoked and being sued by patients. The law makes it easier for former patients to sue, giving them 15 years to go to court and promising at least $500,000 in damages if they succeed.
The ACLU of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner last month sued to overturn the Missouri law on behalf of doctors, LGBTQ+ organizations, and three families of transgender minors, arguing that it is discriminatory. They asked that the law be temporarily blocked as the court challenge against it plays out. The next hearing in the case is scheduled for Sept. 22.
But Ohmer wrote that the plaintiffs’ arguments were “unpersuasive and not likely to succeed.”
“The science and medical evidence is conflicting and unclear. Accordingly, the evidence raises more questions than answers,” Ohmer wrote in his ruling.