Missouri Democrats once again filibuster ban on medical procedures for transgender minors

The Missouri Senate returned from its spring break Monday with Democrats resuming their filibuster of a bill that would ban gender-affirming care for transgender children.

The Senate reconvened to debate legislation sponsored by Sen. Holly Thompson-Rehder, R-Scott City, that began as a ban on transgender girls participating in school sports but was expanded to include prohibitions on medical procedures for transgender minors. 

The move to debate Rehder’s bill irked the handful of Senate Republicans who had pressed for GOP leadership to cut off debate before the annual legislative spring break and force a vote on a bill sponsored by Sen. Mike Moon, R-Ash Grove. 

They expressed disappointment in the decision to go to Thompson-Rehder’s bill, arguing that adding the transgender health care provision could it runs afoul of constitutional provisions that limit a bill to one subject and bar amendments from changing a bill’s purpose.

“If we pass a bill like this, with those two together, and it passed the House and was sent to the governor, that there could be a lawsuit?” Sen. Rick Brattin, R-Harrisonville, asked Moon.

Moon replied: “There’s probably likely to be a lawsuit even if the bills are separate. Because this is a volatile topic.”

Republicans talked for roughly an hour after the bill was brought up for debate before Democrats once again began to filibuster the bill. 

In addition to bans on certain health care options, the latest version of the bill would allow people who received gender-affirming care as a minor to sue their medical practitioner and open physicians to discipline from licensing entities. Former patients who received gender-transition procedures and medication as a minor could seek action against their doctors for up to 30 years from the time they turn 18 or four years after they identify harm, whichever is later.

The timing of Monday’s filibuster corresponded with a rally earlier in the day pushing for the passage of Moon’s legislation. Around 250 people were in attendance at the gathering, held by right-wing groups like Gays Against Groomers and Turning Point USA.

At the rally, the bill’s most vocal legislative supporters gave hearty promises to push the bill across the finish line over Democratic objections.

“I’m ready to stay here every night this week,” said Sen. Denny Hoskins, R-Warrensburg.

Sen. Bill Eigel argued the legislation protects  “the most vulnerable” Missourians.

“I am not afraid of a small group of misguided Democratic senators that are going to want to leave Missouri behind in the policy of barbaric practices of yesterday,” he said. “I’m not afraid to stay up all night to protect these kids.”

“Those that don’t belong to protect children are going to find out how bold and courageous we are this week,” Eigel continued.

Rally attendees filed into the Senate gallery Monday evening, slowly trickling out after a few hours of debate. A pile of signs prepared by the rally organizers was discarded by the gallery doors, prohibited from being carried inside by Senate rules.

During the Senate’s spring break, eight Republican senators signed a letter threatening to “use whatever tools and procedures necessary…to bring Senate Bill 49 to a final vote during the legislative week of March 20, 2023.”

Under Senate rules, eight senators isn’t enough to utilize a procedural maneuver to cut off a filibuster and force a vote — though whispers of turning to the “nuclear option” have made the rounds.

Shortly before Monday’s rally, Missouri Attorney General Andrew Bailey announced an emergency regulation he argued would require medical facilities providing gender-affirming care file expansive informed-consent paperwork.

It also specifies that physicians must verify that “any existing mental health comorbidities of the patient have been treated and resolved” and that “social contagion” is not contributing to a patient’s gender dysphoria, among other rules.

He also wants medical facilities to ensure patients do not have autism before providing gender-affirming care.

These “guardrails” are similar to concerns voiced by whistleblower Jamie Reed in her affidavit given to Bailey. The attorney general’s office is investigating the Washington University Transgender Center at St. Louis Children’s Hospital as a result of her testimony.

Bailey is applying a Missouri law on deceptive business practices — legislation that is rarely, if ever, applied to medical care.

“I do not recall it ever being used in the medical arena,” said Jim Layton, who spent most of his 22 years in the Missouri attorney general’s office as the state’s solicitor general.

The declaration does not specify that it only applies to minors, though Bailey mentions “protecting children” in his news release.