Respect Equality

Anxiety builds as Missouri lawmakers weigh restrictions on gender-affirming care

Members of Missouri’s House of Representatives this month signaled they may consider banning gender-affirming care for transgender and nonbinary people younger than 25 years old.
The Missouri House of Representatives Chamber in the Missouri State Capitol Building located in Jefferson City, Missouri (Stephen Emlund/Getty Images)

Story at a glance

  • A Missouri House bill would bar doctors in the state from providing gender-affirming care to patients younger than 18 years old. Some say gender-affirming care should be off-limits to people under 25 years of age, citing brain maturity.

  • The bill currently would only apply to Missouri minors if it is signed into law, but young adults in the state that have not yet turned 25 worry their care may still be taken away from them.

  • The bill’s sponsor, Rep. Suzie Pollock, is sponsoring another piece of legislation this year that would require physicians to provide those seeking gender-affirming care with “the most recent available studies on detransitioners.”

Elliot Laurence is 23 years old. He’s an editor at Saint Louis University School of Law and just ended a six-year enlistment in the United States Air Force, where he served as a staff sergeant. 

Laurence is also transgender, and, under a proposed Missouri law, may soon be considered ineligible to receive the gender-affirming hormone replacement therapy (HRT) he has been taking for four years – that is, until his 25th birthday in July of 2024.

Missouri House Bill 2649, introduced in February, would bar physicians and other health care providers in the state from providing “gender transition procedures” like puberty blockers or hormones to individuals younger than 18 years old. 

The bill, officially titled the Save Adolescents from Experimentation (SAFE) Act, has been championed by conservative legislators who say their intent is to protect children from making “drastic” changes to their bodies before they are able to fully comprehend the gravity of those choices.

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“Giving children puberty blockers, cross-sex hormones and even irreversible surgery violates the first duty of medicine, which is ‘Do no harm,’” Missouri state Rep. Suzie Pollock (R), who is sponsoring the bill, said during a recent hearing. “Minors cannot consent to these harmful physical interventions.”

But state lawmakers this month debated whether the state’s proposed ban on gender-affirming care should be extended to adults, pointing to research suggesting the human brain is not fully developed before the age of 25.

Before then, individuals are not able to fully comprehend the “dramatic and drastic and irreparable changes to their bodies,” Laurie Haynes, a psychologist, said last week during a public hearing, where she also equated gender-affirming care to child abuse. 

In some cases, Haynes said, conversion therapy may be an option for those who “voluntarily want to explore whether they have the capacity to moderate” their identities.

While the bill as it currently reads only applies to minors, young transgender and nonbinary adults in Missouri are beginning to worry that the measure, which passed its final House committee on Wednesday, will be amended to restrict gender-affirming care to individuals younger than 25.

For people like Laurence, that could mean being forced off their hormones for years.

At 23 years old, Laurence is a veteran sergeant of the U.S. military and holds a bachelor’s degree in English Language and Literature from Webster University in Missouri, for which he was permitted as a teenager to borrow thousands of dollars from the government.

“But I’m still not developed enough to decide what name and pronouns I want to use? It just doesn’t add up,” he told Changing America.

In an interview, Laurence said he feels as though his own journey differs from the “typical transgender narrative” and, growing up, he didn’t mind wearing dresses and had similar interests to those of his sisters. But something always felt “off,” he said.

“It took me a little while to realize what it was,” he said, “because I am more of a feminine person, even now.”

After enlisting in the military at 17, just before his high school graduation, Laurence began experimenting with male clothing and challenging the idea of conventional masculinity. He cut his hair short and started using male pronouns.

At 19, Laurence placed an order at a fast food restaurant under the name “Elliot,” which has been his legal name since 2019. When a restaurant employee called him “sir,” Laurence said everything fell into place.

“It was like, this is it – this is what I’ve been waiting for,” he said. That same year, he began taking testosterone.

If a statewide ban on gender-affirming care was extended to adults under 25 years old, health care providers in Missouri would risk losing their medical licenses by supplying Laurence with the hormones his body has become accustomed to. His voice would remain low, but his facial hair would stop growing. Some of his breast tissue would grow back.

“That would put me into the place that I was before I started transitioning, which is very upset with my body, feeling strange in my own skin – things that I have been able to overcome in the last four years,” he said.

Pollock, the bill’s sponsor, did not respond to multiple inquiries from Changing America about whether she plans to alter the bill’s language to extend the state’s proposed ban to transgender and nonbinary individuals younger than 25. She also did not respond to questions asking whether people like Laurence would be forced off their care if her bill were to become law.

Pollock last year voted in favor of a bill with an amendment barring transgender women and girls in Missouri from competing on sports teams consistent with their gender identity. The bill itself bore no similarities to the amendment, and was initially introduced as a measure to protect the grade averages of students adversely affected by the COVID-19 pandemic.

Pollock earlier this month spoke on a panel about “transgenderism” at an event held by the conservative organization Concerned Women for America, which in March filed a Title IX complaint against the University of Pennsylvania for allowing Lia Thomas, a transgender swimmer and the first transgender NCAA Division I champion, to compete on the university’s women’s team.

A second bill sponsored by Pollock this year would require physicians to provide those seeking gender-affirming care with “the most recent available studies on detransitioners,” or individuals who sought gender-affirming care and “later regretted doing so.”

According to the 2015 National Transgender Survey, detransitioning is exceedingly rare and more than 60 percent of those who do detransition do so only temporarily.

“I have no regrets,” Laurence said, adding that if he is forced off HRT before his 25th birthday, he doesn’t have “any doubts” that he’ll start taking testosterone again once he turns 25.

But he’s hoping it won’t come to that – for his sake and for the sake of other young gender-expansive adults in Missouri.

“That’s a lot of people. That’s a lot of people who have full time jobs and a lot of people who have college degrees,” Laurence said. “That’s a lot of people who have been told by the government that they’re not developed enough to make decisions for themselves.”