Missouri Healthcare Provider Restricts Transgender Care for Minors Following Implementation of New Legislation

Washington University in St. Louis said Monday physicians at the Transgender Center at St. Louis Children’s Hospital, which it oversees, will no longer prescribe puberty blockers and cross-sex hormones to minors.

It is the second medical provider of transgender services to stop the practice since a state law took effect Aug. 28 that bans minors from beginning puberty blockers and cross-sex hormones and outlaws gender-transition surgeries for youths. Shortly after the law took effect, University of Missouri Health said it would stop providing the treatments.

Even though Republican Attorney General Andrew Bailey said in a letter to health care providers the law allows for treatments that started before Aug. 28 to continue, Washington University and University Missouri Health cited potential legal concerns for stopping the treatments.

“We are disheartened to have to take this step,” Washington University said Monday in a statement. “However, Missouri’s newly enacted law regarding transgender care has created a new legal claim for patients who received these medications as minors. This legal claim creates unsustainable liability for health-care professionals and makes it untenable for us to continue to provide comprehensive transgender care for minor patients without subjecting the university and our providers to an unacceptable level of liability.”

The providers’ concerns stem from a provision in the statute that allows those who received puberty blockers and cross-sex hormones as minors to sue their doctor for malpractice 15 years after treatment or their 21st birthday, whichever is later.

The law does not prohibit Washington University and University of Missouri Health from offering education and mental health services to transgender youths, and both have said they will continue to do so. Also, transgender adults will still be able to receive treatments from such providers.

The law withstood a legal challenge from the ACLU of Missouri and other transgender activist groups when Cole County Circuit Court Judge Steven Ohmer on Aug. 25 declined to issue a preliminary injunction, ruling those challenging the law had “not shown probable success on its Constitutional challenges of the law” and that “the science and medical evidence [on transgender interventions] is conflicting and unclear.”

Washington University’s transgender center faced intense scrutiny from state and federal officials earlier this year when a whistleblower alleged the center overlooked the mental health needs of patients and did not inform adolescents and their parents of potential side effects of treatments. The whistleblower also alleged the center gave children puberty blockers and cross-sex hormones after just two one-hour visits.

An investigation by Washington University said the whistleblower’s claims were unsubstantiated. But the allegations led to investigations of the center by Bailey’s office and by U.S. Sen. Josh Hawley, R-Mo., and prompted the Missouri Legislature to write the bill that recently took effect.

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