Missouri judge upholds ban on trans treatment for minors

Missouri Judge Robert Craig Carter ruled this week in favor of the Saving Adolescents from Experimentation (SAFE) Act, which prohibits health care professionals from providing hormone therapy or transition surgeries to anyone under 18.

"It would seem that the medical profession stands in the middle of an ethical minefield, with scant evidence to lead it out," Carter wrote. On the evidence point, he noted that both sides of the lawsuit agree with him that information on the short- and long-term effects of trans treatments is lacking:

"There are no long-term studies anywhere, so how can we discuss what treatment success or failure might look in 1 year or 20 years?"

Faced with the argument that parents should be able to decide about their minor children, or they themselves about their own bodies, the judge recalled the profound change these treatments mean: while "puberty blockers and cross-sex hormones greatly diminish natural human growth and maturation of the body and organs," the surgeries directly "remove natural body parts." The impact is enough for the state to legislate this behavior, he asserts, just as it does in other cases:

"If we don’t let a 16-years-ol buy a six-pack of beer and a pack of smokes, or let an adult buy those items for them, should we allow some kid/parent team to decide to change a teenager’s sex forever?"

Patients for life

Carter countered another of the points most advocated by those calling for curbing such medical interventions, "all of this treatment will never result in a full change of sex for the patient."

He also emphasized the argument of the "lifelong patients," as they are known in the debate on the subject. Those who, after undergoing these therapies, must continue for a long time with hormone treatment and psychiatric counseling. Rather than a "cure," he says, it is "a journey that never actually ends."

"Not only does gender dysphoria care never really end, but some patients eventually regret having ever starting the drugs and surgeries," he adds, referring to those known as detransitioners.

Adding to this, she notes that "credible evidence from this case shows that adolescent gender dysphoria usually resolves itself over time." This is the case, he asserts, in 80-90% of cases.

ACLU vows to appeal

Andrew Bailey, state attorney general, hailed the court decision as "a resounding victory." "Mutilation is not healthcare," he said.

"We are extremely disappointed in this decision," argued the plaintiffs, ACLU Missouri and Lambda Legal. "The state has prioritized politics over the well-being of its people," they criticized before vowing to appeal.

Meanwhile, the Supreme Court is preparing to hear oral arguments on a similar Tennessee law early next month.

Access the full lawsuit