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Cole County, Missouri Circuit Court Judge R. Craig Carter has upheld Missouri’s ban on transgender treatments for minors. The American Civil Liberties Union (ACLU) has already vowed to appeal.

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Judge R. Craig Carter ruled that the lawsuit brought by transgender children and their parents did not meet any of the criteria required to block the enforcement of a 2023 law on transgender care. 

During the 13-day trial earlier this year, the state argued that there was no medical consensus on the efficacy of medical transition. 

In his ruling, Judge Carter sided with the state’s argument. He cited a 2007 Supreme Court ruling that said legislative options “must be epically broad” when involving areas “fraught with medical and scientific uncertainties.”

The law prohibits both medical (hormone) transgender treatments and transgender surgeries for minors, which have permanent and often (if not always) effects that include sterilization.

The law, signed by Republican Gov. Mike Parson in June of 2023, prohibits Missouri health care providers from providing puberty blockers, hormones and gender-affirming surgeries to minors. Minors prescribed puberty blockers or hormones before Aug. 28, 2023, would be able to continue to receive those treatments.

In addition to limiting access to treatment, the law also increased potential punishments for physicians who violate the law. Doctors could have their licenses revoked and could be sued by patients. The law makes gives patients 15 years to sure and guaranteed $500,000 in damages if they succeed in court.

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Missouri’s Attorney General, Andrew Bailey, lauded the decision on X.

The law would, on the surface, appear to be non-controversial. There are laws on the books in various jurisdictions prohibiting minors from less impactful procedures, like tattoos or piercings; these are either banned for minors or, at least, require parental approval. Children, it should be noted, cannot give fully informed consent. That is why minors are generally prohibited from signing contracts, getting married, joining the military, buying booze or firearms, or voting.

It would seem inarguable that minors should not be deciding to undergo life-altering treatments of this nature when there is no medical indication for them.

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There is also the question of medical ethics, a primary aspect of which is primum non nocere, or “first, do no harm.” Hormone treatments, not to mention surgeries, have long-term and, in many cases (for surgeries, every case) irreversible effects.

The ACLU of Missouri released a statement that says in part:

“We are extremely disappointed in this decision, but this is not the end of the fight and we will appeal. However, the court’s findings signal a troubling acceptance of discrimination, ignore an extensive trial record and the voices of transgender Missourians and those who care for them, and deny transgender adolescents and Medicaid beneficiaries from their right to access to evidence-based, effective, and often life-saving medical care,” Lambda Legal and the ACLU of Missouri said in a joint statement.

This case will no doubt now move to a higher court. We will, as always, bring you updates as events warrant.