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Missouri Attorney General Andrew Bailey has announced that temporary rules limiting gender-affirming care for transgender people will go into effect on April 27. Bailey said the rules, which expire February 6 of next year, are an effort to protect minors from what he calls harmful medical procedures.

The emergency regulations prohibit health care workers from offering medical gender-transitioning interventions unless they ensure someone has exhibited medically documented gender dysphoria for the past three years, received at least 15 separate hours of therapy, and “resolved” any existing mental health issues. Some provisions, such as the ones requiring three years of established gender incongruity and the therapy rules, do not apply to people who are already receiving gender-affirming medical care. The attorney general has said the regulations are aimed at protecting minors from receiving procedures too quickly. However, the regulations do not mention only applying to those under 18.

Transgender patients and advocates say gender-affirming procedures, including puberty blockers and hormones, have been used for decades and are not experimental. They have accused Bailey of selectively choosing which studies to highlight and ignoring the positions of professional medical organizations, which support access to age-appropriate gender-affirming treatments and say such care is best decided on by patients, their families, and their doctors.