Transgender Adults Brace For Treatment Cutoffs In Missouri

TRANSGENDER: Ellie Bridgman spent her Thursday night shift at a local gas station in Union, Missouri, planning for the day she’ll lose access to gender-affirming therapies the transgender and nonbinary 23-year-old credits with making “life worth living.”

Missouri’s Republican Attorney General Andrew Bailey issued a first-of-its-kind emergency regulation this week that will place severe requirements on adults and children before they may obtain puberty-blocking medications, hormones, or operations “to transition gender.”

Transgender rights campaigners have threatened to sue before the regulation is enacted on April 27. However, pledges of fast legal action have done little to assuage the fears of trans-Missourians like Bridgman, who believe it is time to leave the state.

Before physicians can administer gender-affirming medical therapies, patients must have had an “intense pattern” of documented gender dysphoria for three years and at least 15 hourly sessions with a therapist for at least 18 months. Patients would also need to be evaluated for autism and “social media addiction,” and any psychiatric symptoms associated with mental health concerns would need to be treated and cured.

Some people will be permitted to keep their medications while they wait for the necessary exams.

Bridgman, who uses the pronouns she/they, is autistic and depressed. She sees only two options: travel across the country, away from all her friends and family, to a state that protects access to gender-affirming care, or accept the major health risks associated with illegally purchasing hormones online.

She went to the pharmacy on Friday afternoon to pay for her remaining refills out of pocket.

“Placing restrictions on transitioning for people with depression is just a way for them to completely bar us from transitioning at all,” Bridgman explained. Transgender “Dysphoria is the root cause of depression for many trans people.” You can’t treat sadness unless you tackle the underlying dysphoria.”

Bridgman admitted that before beginning hormone replacement therapy last summer, “life felt meaningless,” and suicidal thoughts flooded her mind. Her “last chance at life,” she added, was to receive gender-affirming care.

He’ll lose access to gender-affirming therapies the transgender and nonbinary 23-year-old credits with making “life worth living.”

The legislation comes as Republican lawmakers around the country, including Missouri,Transgender have introduced hundreds of bills addressing practically every aspect of transgender life, with a focus on health care.

At least 13 states have passed legislation restricting or prohibiting gender-affirming Transgender care for minors. Governors in Montana, North Dakota, and neighboring Kansas have bills awaiting action, while almost two dozen more states are exploring laws to limit or prohibit care.

National LGBTQ+ rights advocates argue that the Missouri regulation, based on a state law against misleading and unfair commercial practices, goes further than most other regulations.

Three states have restricted gender-affirming care through regulation or administrative order, but Missouri is the only one that restricts adult treatments.

The National LGBTQ Task Force’s Cathy Renna said the rule indicates how Republicans are now successfully widening the reach of gender-affirming treatment limitations beyond children, which groups have been warning about for months.

“When they see something that works in one state, they’ll try to replicate it in another,” Renna said.

Bailey’s ban comes after a former employee at a transgender child clinic in St. Louis claimed that physicians at the Washington University Transgender Centre rushed to offer therapy without doing a proper patient assessment.

Bailey stated that he is looking into the facility but has yet to produce a report. Others, including another former employee and patients, have denied the allegations of mistreatment. Bailey and the university did not reply to phone and email queries seeking comment.

Dr. Meredithe McNamara, an assistant professor of pediatrics at Yale School of Medicine specializing in adolescent medicine, said data strongly supports preserving access to hormone therapy and other gender-affirming care.

Bailey’s rule requires that patients be shown paperwork containing nearly two dozen explicit statements raising concerns about gender-affirming treatments as part of the consent process — a practice doctors like McNamara have condemned as conversion therapy.

“There is no evidence that psychotherapy as a sole treatment is effective,” she stated.

Depression will prevent her from receiving hormones.

In preparation for limits, Stacy Cay, an autistic trans woman in Kansas City, has been storing vials of injectable estrogen. The 30-year-old comedian and model realized she only needed a modest quantity of estrogen and had conserved enough for a year. She must cross state boundaries to fill prescriptions or consider moving when that runs out.

Cay claims that her continuous depression will prevent her from receiving hormones under the regulation and that her autism diagnosis may hinder her future care. While the regulation does not state whether autism disqualifies a person from receiving gender-affirming care, it does require an evaluation.

According to a 2020 study published in the natural sciences journal Nature Communications, transgender and gender-diverse people, or those whose gender expressions do not correspond to gender standards, are 3-6 times more likely to be autistic than cisgender people. They were also more prone to suffer from other developmental and psychological disorders like depression.

“They know a lot of us are autistic, and it’s part of their strategy to paint us as unstable — that we can’t be trusted to make our own medical decisions,” Cay explained.

Attorneys from Lambda Legal and the American Civil Liberties Union have stated that they intend to sue to challenge the new rule.

Missouri is subject to the jurisdiction of the 8th United States Circuit Court of Appeals, which upheld a preliminary injunction last year blocking Arkansas from implementing a first-in-the-nation ban on trans minors obtaining gender-affirming therapy. Federal judges have also stopped a similar measure in Alabama.

Republican lawmakers in charge of Missouri’s push to prohibit gender-affirming therapies for minors said Friday that they have no plans to expand their proposal to cover adults.

Separate proposals enacted by the Missouri House and Senate prohibit treatments for children under 18 but not for people covered by private insurance or willing to pay for their health care.

“I believe it is detrimental to a person’s body, Transgender and probably even their psyche, to go through treatments like that,” said state Sen. Mike Moon, the Senate legislation’s lead sponsor. “Adults can make decisions like these.”

SOURCE – (AP)