A New Missouri Bill Would Ban Gender-Affirming Care For All Ages

SB 1190 would allow anyone who has received gender-affirming care to sue their doctors for medical malpractice. It will run providers of transgender healthcare out of the state.

The Missouri State Capitol in Jefferson City | Image: Wikimedia Commons

This week, a number of anti-trans bills have been filed in Missouri ahead of next year’s legislative session. Along with a bill that would ban all forms of ‘social transition’ for trans kids in schools—similar to Texas’ SB 12—and another that would make Missouri’s gender-affirming care ban for minors permanent, one bill goes much, much further. The bill, SB 1190, will effectively entirely ban gender-affirming care in Missouri if passed.

Although the bill’s text is not yet public, the summary posted to the Missouri Senate’s website provides more than enough information. It would allow any person—minor or adult—who received gender-affirming care and regrets it to sue their doctor for up to 15 years after they received care. And even worse, it also carves out an exception to Missouri’s normal cap on medical malpractice damages of $400,000. Instead, it sets the minimum a plaintiff will recover, should they prevail in a suit brought under the law, at $500,000.

Given that many clinics operate on an informed consent model for gender-affirming care, it won’t be difficult for malicious actors seeking a quick payout to obtain an HRT prescription. Then, as long as they can prove that prescription led to any form of ‘personal injury,’ they will receive a large amount of money at the expense of the transgender community. Simply put, this bill would run gender-affirming care providers out of the state. And if any choose to stay, vigilantes will have the ability to sue them until they are forced to close their doors.

It doesn’t end there: unlike attempts in other states to ban gender-affirming care, this bill wasn’t filed by a fringe state representative. Rather, it was filed by State Senator Jill Carter, the Republican Majority Whip. This is especially concerning. For those unfamiliar, a whip is a member of the party leadership whose purpose is to make sure their party’s members vote with the party’s platform. In other words, this bill isn’t just being pushed by a prominent Republican; it’s being pushed by the Republican who is best able to convince other Republicans to vote for or against bills.

So far, bills in other states that ban gender-affirming care for adults haven’t passed, but that’s not for lack of trying. Earlier this year in Texas, Republican State Representative Brent Money introduced HB 3399, which would’ve modified Texas’ existing gender-affirming care ban for minors to apply to all ages. Thankfully though, the bill died in committee. Other attempts, like a 2023 Oklahoma bill that would’ve applied to anyone under the age of 26, also suffered the same fate.

However, these attacks against trans adults are new in Missouri. Currently, Missouri is one of four Republican-controlled states that are yet to pass bills restricting trans people’s bathroom access, and, unlike half of its neighbours, the state’s GOP has not moved to restrict gender markers on its IDs or birth certificates. But if Missouri’s recent gerrymandering at Trump’s behest provides any indication, its time as a ‘moderate’ Republican state is coming to an end. Because even if SB 1190 doesn’t pass, the fact it’s even being floated signals a worrying shift in the state’s willingness to entertain the extreme transphobia it has largely ignored.