Background
In June, Gov. Mike Parson, Republican of Missouri, signed into law the ban on gender-affirming care for new patients under 18, part of a wave of more than 20 laws across the country severely restricting such care.
Under the new law, existing patients of Washington University’s youth gender clinic were still allowed to receive the treatments. But the law includes a provision allowing patients to make legal claims against doctors who prescribe hormonal medications to minors. The university said this part of the law made it “untenable” to continue providing this care.
Since it opened in 2017, the St. Louis clinic had seen a sharp increase in patient demand, overwhelming its small staff, The New York Times reported last month. Many patients and their families told The Times that the clinic’s doctors provided excellent care, and that the hormonal treatments profoundly improved patients’ mental health.
But the clinic’s staff members struggled to give thorough psychological evaluations to patients with serious mental health problems, highlighting tensions among experts over how much screening should be required before giving adolescents access to hormones.
This nuanced medical debate has run in parallel to a sweeping political movement to ban gender treatments for minors. Major medical groups have opposed bans on gender-affirming care for minors, as have many of the clinicians who have raised concerns that some children are being rushed into treatment.
What’s Next
Washington University said that its gender clinic would still provide hormonal treatments to adult patients, and that it would offer education and mental health support to patients of all ages.
“Our medical practitioners have cared for these patients with skill and dedication,” the school’s statement said. “They have continually provided treatment in accordance with the standard of care and with informed consent of patients and their parents or guardians.”
After the clinic’s former employee, Jamie Reed, went public, Missouri’s attorney general, a Republican, opened an investigation into the clinic’s operations, which is continuing. Senator Josh Hawley, Republican of Missouri, is conducting a similar inquiry.
Civil rights groups are challenging Missouri’s ban, which has a “sunset” provision and will be in effect for four years. Last month, a judge declined the groups’ request for an injunction that would have temporarily blocked enforcement of the law.
