Two more states join the growing list with moves to restrict gender-affirming care for under-18s

Missouri and Louisiana moved closer to banning transitional care for trans youth, building on a tsunami of state efforts to limit access to puberty blockers, hormone therapies and reassignment surgeries.

Most state-led initiatives restricting gender-affirming care involve minors, with many right-wing voices concerned about what they believe is abuse with far greater risks than benefits to a child’s mental and physical well-being.

But those arguments run counter to reports from major medical organizations like the American Academy of Pediatrics and the American Psychiatric Associationwho support the use of treatments such as puberty blockers as ‘medically necessary’.

Missouri Republican Governor Mike Parson signed into law a bill Wednesday that would ban doctors from performing sex reassignment surgery or prescribing hormone therapy or other drugs for sex reassignment on young people under 18.

Meanwhile, in Louisiana, the senate has revived a once-dead bill banning hormone treatments, menopausal surgeries and puberty blockers for trans minors there.

Most youth who have talked to mental health professionals and caregivers and decide to switch start on puberty blockers (shown) medically

The battle over access to health care for transgender people peaked in early 2022 when Texas Republican Gov. Greg Abbott issued a statewide order allowing parents who felt they approved transitional care for their children to be investigated for child abuse.

The studies ordered by Gov Abbott were the first of their kind and sparked a battle over health care in particular.

Louisiana Republicans have revived the bill after a failed attempt last month to pull it out of committee for a full vote.

The legislation passed largely along party lines in the Senate by a vote of 29 to 10 and will return to the House floor for a final vote, where it is expected to pass before landing on Governor John Bel Edwards’ desk.

While the House is almost guaranteed to send the legislation to the governor’s office, it’s unclear whether Mr. Edwards will sign it into law.

Edwards is a Democrat—a conservative yet a Democrat—who once rejected a measure that would have barred transgender girls and women from participating in sports teams that match their gender identity.

Gov. Edwards labeled it “discrimination” and a “solution in search of a problem that simply doesn’t exist in Louisiana.” More recently, Edwards has chosen not to prevent a similar measure from becoming law.

But even if Governor Edwards rejects the bill if and when it’s sent to his bureau, it might not make a difference.

The measure passed the GOP-controlled legislature by such a wide margin that it could override a veto from Edwards.

Meanwhile, healthcare providers in Missouri will not be allowed to prescribe transitional services to minors as of August 28.

Governor Parson said on Wednesday: ‘We support everyone’s right to his or her own pursuit of happiness; however, we must protect children from making life-altering decisions that they may regret in adulthood once they mature physically and emotionally.”

He further characterized transitional care as ‘harmful, irreversible treatments and procedures’.

Gov. Parson added: “These decisions have lasting consequences for life and should not be made by impressionable children who may be in crisis or influenced by the political beliefs of others.”

Trans rights advocates have criticized Missouri’s new law, calling it “deceptive.”cruel‘, and a ‘shameful abuse of power‘.

The American Civil Liberties Union of Missouri said: ‘While the government pushed this deceptive bill under the guise of protecting children… This law deprives patients and parents of their rights.

It requires the uninformed opinions of politicians to dictate decisions regarding medical treatment based on the consent of medical professionals.”

Transgender health care and access to it has become a major culture war issue, with conservatives more likely to oppose a minor’s authority to make a life-changing decision, such as having breasts removed or testosterone suppression.

There is some evidence that young people with gender dysphoria came to accept their bodies and biological sex without medical intervention.

Dr. Riitakerttu Kaltiala, a Finnish child and adolescent psychiatrist described as an expert in pediatric transition care, said in February that “four in five” trans youth outgrow it.

At the same time, Dutch researchers found that the vast majority of people who start transitioning in childhood continue with care into adulthood.

Researchers reviewed data from 720 trans youth ranging in age at onset from 13 to 17 who attended the Amsterdam UMC Gender Identity Clinic for puberty suppressants. Ninety-eight percent of trans youth continued to use hormone therapies to continue their transition.

The Food and Drug Administration approved puberty blockers 30 years ago to treat children with precocious puberty, which causes sexual development to begin much earlier than normal.

Sex hormones — synthetic forms of estrogen and testosterone — were approved decades ago to treat hormone disorders or as birth control pills.

The FDA has not specifically approved the drugs to treat youth who raise gender questions, but they have been used “off-label” for many years, a common and accepted practice for many medical conditions.