Shortly after approving Moon’s bill, the Senate also gave initial approval to legislation sponsored by Sen. Holly Thompson Rehder, R-Scott City, that would restrict transgender athletes to playing on school sports teams matching the sex on their birth certificate. That restriction would also expire Aug. 28, 2027.
The votes came after a long night of debate, with Democrats using a filibuster to block the bills while negotiations took place behind the scenes.
Monday saw supporters of a ban on transgender care rally at the Missouri Capitol to urge Senators to take action. Attorney General Andrew Bailey also announced Monday an emergency regulation he argued would require medical facilities providing gender-affirming care file expansive informed-consent paperwork.

For the Senate, Tuesday morning’s vote avoids a potential procedural showdown that threatened to derail the legislative session.
Some Republicans wanted Senate Majority Leader Cindy O’Laughlin, R-Shelbina, to cut off debate to end the Democratic filibuster and force a vote on the measure. She resisted, noting that Democrats would retaliate by using their own procedural maneuvers to gum up the chamber — putting every other bill, and the state budget, at risk.
And when the Senate returned from spring break Monday afternoon, the chamber initially took up Rehder’s bill pertaining to student athletes and added the health care provisions.
Moon cried foul, arguing that combining the two issues into one bill put it at risk of a legal challenge. Missouri’s Constitution limits a bill to one subject and bars amendments that change a bill’s original purpose.
The all-night negotiations led to the Tuesday morning compromise, though the debate was at times heated.
Children can be easily manipulated, said Republican Sen. Rick Brattin of Harrisonville, noting that when he was young he was convinced by his grandfather that watermelon seeds would grow in his stomach if he swallowed them. He accused Democrats and critics of the bill of pushing a “counterfeit culture that wants to spit in the eye of anything that is wholesome.”
Sen. Denny Hoskins, R-Warrensburg, bristled at accusations that the bill was an attempt to target or hurt vulnerable transgender kids.
“I’m not against trans people. I’m not against the LGBTQ+ community,” Hoskins said. “But to force that on kids, that’s what this whole bill is about. Protecting kids.”
Missouri Democrats once again filibuster ban on medical procedures for transgender minors
Republican senators repeatedly pointed to accusations of misconduct by a former casework at the Washington University Transgender Center at St. Louis Children’s Hospital, who said the clinic overlooked mental health needs of patients and did not inform adolescents and their parents of potential side effects of treatment.
Critics of the bills say they will do more harm than good, denying treatments that national medical associations — including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry — have concluded are safe, effective, beneficial and medically necessary.
Transgender youth are more likely to experience anxiety, depressed mood and suicidal ideation and attempts, often due to gender-related discrimination and gender dysphoria, and a recent study in the New England Journal of Medicine found gender-affirming hormone therapy has been proven to improve the mental health of transgender adolescents and teenagers.