JEFFERSON CITY — A 2023 state law restricting medical care for transgender youth is discriminatory and based on unreliable evidence, an attorney representing three minor children and their parents told the Missouri Supreme Court Wednesday.
Attorney Nora Huppert said a trial court judge who upheld the Republican-led initiative last year relied too heavily on anecdotal and flawed evidence in deciding the case.
“This is a law that targets gender transition. It is motivated by a discriminatory purpose,” Huppert said, asking the high court to strike down the prohibition.
In defending the ban on behalf of Gov. Mike Kehoe, Missouri Solicitor General Lou Capozzi said states have wide discretion to approve laws addressing medical uncertainty.
“There is an ongoing medical controversy,” Capozzi said.
At issue is a law approved by the General Assembly that aims to shut down all medical treatment of transgender youth and ban the use of Medicaid health insurance to pay for any procedures.
Passage of the law came after Jamie Reed, a former case manager at the Washington University Transgender Center, raised concerns about care being provided at the clinic.
Reed testified at the trial last year in defense of Missouri’s restrictions.
After the law took effect, Washington University said it would stop providing gender-affirming medications to minors who were technically eligible for the treatments under an exception in the law for minors already taking medications. The school cited “unacceptable” legal liability contained in the law.
Three parents from St. Louis County and their children challenged the limits, arguing the minors had been prevented from obtaining medically necessary and evidence-based care and that the government had usurped parental judgment and decision-making authority.
In November, Circuit Judge Robert Craig Carter issued a 74-page judgment affirming the restrictions, saying there is “an almost total lack of consensus as to the medical ethics of adolescent gender dysphoria treatment.”
The case has drawn attention in other Republican-led states where culture war issues, including transgender care and bathroom assignments by sex, have dominated legislative debate.
A brief filed in support of the law by Alabama’s attorney general and 24 other states said Missouri’s law is similar to other prohibitions on minors.
“That is why states routinely set age limits on risky endeavors, be it driving a car, buying a beer, or consenting to a hysterectomy. Undergoing sex-change procedures is no different,” the brief says.
Written briefs filed by attorneys for the parents and children call on the court to treat the ban with a higher level of skepticism.
“It is also subject to heightened scrutiny because it purposely discriminates against a vulnerable minority and politically unpopular group — namely, transgender people,” the plaintiffs’ brief states. “The act represents purposeful discrimination against transgender people by the legislature.”
The plaintiffs’ attorneys also argued the trial court erred in denying the parents relief from the law because parents “have a fundamental right to direct the medical care of their children and the act violates that right.”
“The state may not, without justifications surviving strict scrutiny, invade the fundamental right of parents to direct the medical care of their children,” the brief states.
In their written briefs, attorneys for the state argued the law is constitutional and should not be overturned.
“The state has broad authority ‘to act in areas fraught with medical and scientific uncertainties,’” the attorney general’s office said.
The attorney general’s office also defended the General Assembly’s decision to bar the use of Medicaid funding on transgender treatments, saying 30% of those who undergo treatment later “de-transition.”
“Medicaid dollars would have been expended on treatments the recipient regretted,” the state said.
The court did not set a date for a decision.
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Kurt Erickson | Post-Dispatch
Jefferson City reporter
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