The Missouri attorney general announced new limitations on gender-affirming care for minors and adults on Thursday in a move that has sparked outrage from advocacy groups and LGBTQ groups.

Attorney General Andrew Bailey’s limitations would require adults to undergo 18 months of psychological or psychiatric assessments through a therapist before receiving gender-affirming care ‘to explore developmental influences on gender identity status of the patient and determine, among other things, whether the person has any mental health comorbidities.

Providers would also have to prove that “the patient has exhibited a medically documented, durable, persistent, and intense pattern of gender dysphoria” for at least three years, according to the announcement.

A spokeswoman for the attorney general’s office, Madeline Sieren, told The Associated Press that the restrictions would apply to minors and adults.

LGBTQ advocates have criticized Bailey’s decision to restrict health care available to adults and minors, arguing that Bailey’s announcement is based on discrimination, not science.

“The Attorney General’s claims are handpicked and come from unverified sources that allow him to promulgate disgusting, obstructive and misleading information in an emergency rule,” said PROMO, the public policy and advocacy organization of Missouri LGBTQ+ Rights, in a statement to ABC News.

Bailey’s announcement focuses on the risks associated with gender-affirming care, but doctors told ABC News that all drugs, surgeries or vaccines for any type of treatment have risks and that gender-affirming care gender are not different.

They say knowing the risks and benefits of treating — and not treating a condition — can help families and individuals make an informed decision.

Major national medical associations, including the American Academy of Pediatrics, American Medical Association, American Academy of Child and Adolescent Psychiatry, and more than 20 others agree that gender-affirming care is safe, effective, beneficial and medically necessary.

Missouri Attorney General Andrew Bailey speaks to members of the media following oral arguments at the U.S. Supreme Court in Washington, DC on February 28, 2023.

Valerie Plesch/Bloomberg via Getty Images, FILE

Due to gender discrimination and gender dysphoria, trans youth are more likely to experience anxiety, depressed mood, and thinking about or attempting suicide. According to a recent study in the New England Journal of Medicine, gender-affirming hormone therapy improves the mental health of transgender teens and teens, on average.

Gender dysphoria refers to the stress of being in a body that does not resemble one’s own.

Although Bailey calls puberty blockers “experimental” in her ad, drugs in the class have been FDA-approved since the 1990s to treat precocious puberty. They are not specifically approved to treat gender dysphoria, but have been studied and commonly prescribed for this purpose for decades. .

Modern gender-affirming care is based on “decades of clinical experience and research and, therefore, is not considered experimental, cosmetic, or practical,” according to the World Professional Association for Transgender Health’s standards of care. .

Studies have also shown that it’s rare for people to reverse a transition after undergoing gender-affirming care, according to a study in the journal LGBT Health which also found that those who reverse their transition often do so because family pressures and social stigma.

Regret rates for gender-affirming surgery are extremely low — research shows they hover around 1%, according to the medical journal Plastic and Reconstructive Surgery. Regret rates for knee and hip surgeries are significantly higher, studies show.

Bailey also cited the high death rate for transgender people in her announcement. Studies at Duke University Press, National Cancer Institute and Lancet Diabetes & Endocrinology have shown that transgender people face economic and social marginalization, violence and discrimination at a higher rate than non-transgender people – this research argues that these issues likely play a role in the persistence poor health and higher mortality in the community.

Research says these issues likely play a role in the persistence of poor health and higher mortality in the community.

Bailey’s announcement comes amid an investigation into a St. Louis transgender health center accused by a whistleblower of ‘using experimental drugs on children’, dispensing drugs ‘without individualized assessment and “without parental consent,” according to the attorney. general’s office.

The center said it was “alarmed by the allegations”.

The emergency regulations are in effect from April 27 to February 6, 2024.

“We take this matter very seriously and have already begun the process of reviewing the situation to establish the facts,” the University of Washington Transgender Center said in a statement. “As always, our top priority is the health and well-being of our patients. We are committed to providing compassionate, family-centered care to all of our patients and we hold our physicians to the highest professional and ethical standards. high.”

Civil rights organizations, including Lambda Legal and the American Civil Liberties Union of Missouri, have pledged to file lawsuits against the attorney general’s office move.

“Gender-affirming care is essential to helping transgender adolescents succeed in school, build healthy relationships with friends and family, live authentically as themselves, and dream about their future,” the organizations said in a joint statement. “We will defend the rights of transgender people through any necessary legal action, just as we have done in other states engaged in this anti-science and discriminatory fear campaign.

Gender-affirming care for young people has been restricted in at least 12 states.

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