Missouri may offer a prime example of a red state primed for plug-and-play laws restricting transgender rights.
A robust network of conservative advocacy groups stretching across the country has eagerly seized the chance to show the Show Me State just how to do that.
Last year, lawmakers passed a ban on access to gender-affirming care for minors and another law effectively shutting transgender athletes out of girls鈥 and women鈥檚 sports. Since then, more bills reining in a range of LGBTQ rights have been introduced by a Republican-dominated General Assembly eager to accommodate voters.
Polling shows that Missouri鈥檚 conservative electorate broadly agrees with the new Missouri law regarding transgender people, but that comes with a partisan split.
The Democratic Party has lost ground in what used to be a national bellwether state. That means Republican lawmakers increasingly find themselves without serious competition in general elections, instead in danger of challenges from the right in primary elections.
Now, with elections looming and a veto-proof supermajority, ambitious Republican politicians are homing in on the issue with what critics as a 鈥渇irehose of anti-trans legislation.鈥
In some cases, the impact of the legislation looks concrete, like the proposed Missouri law shutting off transgender people from the bathrooms that match their gender identity. Others, like a ban on government diversity efforts, could throttle cultural changes in recent years and make transgender people feel increasingly threatened.
National groups lobby Missouri lawmakers
Last year, Reuters news agency 142 bills filed in 37 states that would outlaw or restrict gender-affirming care. At least 17 states have enacted laws restricting or banning gender-affirming care for minors. The trend has continued this spring.
A well-documented network of groups helps ghostwrite legislation, lobby for its passage and elect conservatives willing to back similar approaches. Groups across the country, from all political , .
But an AP found that 130 bills in 40 statehouses last year mimicked model legislation peddled to lawmakers by the conservative groups and the .
In March 2023, the World Professional Association for Transgender Health (WPATH) said in a the 鈥渂road and sweeping鈥 legislation being introduced in states and said bills that would restrict access to care violate best-practice medical standards.
In , lawmakers filed at least 19 bills regarding LGBTQ issues in the Missouri General Assembly, according to data from the ACLU. In , the number jumped to 48. In , at least 34 bills have been introduced.
Many LGBTQ people in Missouri say the bills exploit ideas popular among some people that create life-threatening damage to others.
鈥淲e鈥檙e seeing in Missouri an attempt to 鈥 erase trans people,鈥 said Katy Erker-Lynch, the executive director of Missouri鈥檚 LGBTQ advocacy group PROMO. 鈥淚t鈥檚 a very clear attempt that鈥檚 manifesting through book bans, censorship of curriculum, anti-woke investing and (diversity, equity and inclusion) bills.鈥
Last year, regarding transgender people were passed by the General Assembly that were centerpieces in the national conversation.
They got help.
One, , was Missouri鈥檚 version of a law by the Family Research Council, a group 鈥渄edicated to articulating and advancing a family-centered philosophy of public life.鈥
鈥淔amily Research Council has been actively recommending state (SAFE) Save Adolescents from Experimentation Act-style bills based on the model legislation we developed, which aims to protect children from harmful, irreversible gender transition procedures,鈥 the group said in a
The Missouri law halted access to gender-affirming puberty blockers and other hormone treatment for transgender people under 18, with an exception for kids already receiving treatment in Missouri. That law will go away in 2027 unless lawmakers revisit it.
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The conservative think tank Heritage Foundation and Do No Harm when the bill was introduced last year.
But when threatened its passage, politicians in other branches of government acted unilaterally to block gender-affirming care for minors in Missouri.
Attorney General Andrew Bailey, who has appeared in from the Family Research Council, an last March that called gender transitions 鈥渆xperimental.鈥 His action triggered a litany of requirements before a patient can receive forms of gender-affirming care in Missouri, essentially blocking patient access.
Just hours before, the Missouri Freedom Foundation PAC at the state Capitol, by the Family Research Council, urging lawmakers to support the SAFE Act, which would later become the Missouri law cutting off gender-affirming care for transgender minors.
After two weeks of inaction on the legislation, the bill was finalized in the Senate afternoon.
Since the Missouri laws went into effect, University of Missouri Health Care and the Washington University Transgender Center have gender-affirming care to their minor patients, driving some families to to get care.
Medical professionals widely see gender-affirming care as lifesaving. WPATH noted in its updated a 鈥済rowing body of evidence鈥 that providing care to gender-diverse youth leads to positive outcomes.
The group added there is still limited data on the 鈥渓ong-term physical, psychological and neurodevelopmental outcomes in youth鈥 who get gender-affirming care and that further long-term studies are underway to examine the impact.
How conservative groups promote their views of transgender rights in Missouri
What鈥檚 driving the trend in Missouri to pass anti-transgender laws? Americans havethe idea that sexuality ranges across a spectrum, said Scott McCoy, the deputy legal director for LGBTQ rights and special litigation at the Southern Poverty Law Center. That organization classifies some of the groups authoring model legislation as .
But when it comes to transgender people and the idea of a spectrum of gender identity, that Americans have less familiarity and understanding. At the same time, the number of children diagnosed with gender dysphoria has surged. A Reuters found that over 42,000 Americans aged 6-17 were diagnosed with gender dysphoria in 2021, compared to just over 15,000 in 2017.
鈥淲hat (these groups are) desperate to do is push back against these advances,鈥 McCoy said. 鈥淭hey went to the place where they have great influence, and to some extent undue influence, and that鈥檚 the state legislatures.鈥
The promotes a of governance 鈥 and lobbies for it, pushing in at for bans on gender-affirming care for minors.
The group also runs what it calls Statesmen Academy, which convenes legislators for training on 鈥淧olicy According to the Bible鈥 and 鈥淐hristian Statesmanship in Practice.鈥 The group has as one of the states which have passed a law that it barring gender-affirming care for minors.
The , an Arizona-based conservative group, uses the courts to advance its positions and provides legal advice for lawmakers on religious freedom, marriage, family and parental rights.
鈥淲e鈥檝e been happy to provide legal advice on the best way to craft those鈥 bills, said , senior counsel and the director of the at the ADF. 鈥淎nd to help make sure that lawmakers taking up this issue have solid legal advice.鈥
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How public opinion has transformed amid focus on transgender Missourians
Polling from the Public Religion Research Institute , Americans believe with increasing certainty that there are only two gender identities, growing from 59% of Americans in 2021 to 65% in 2023. It found that 90% of Republicans think that way, while 44% of Democrats feel the same.
鈥淚t鈥檚 really a story of Republican prioritization of this issue,鈥 said Melissa Deckman, a political scientist and the institute鈥檚 CEO. 鈥淎 lot of Americans probably didn鈥檛 think about transgender issues four, five, six, years ago, to the extent that we鈥檙e talking about them now.鈥
LGBTQ topics, especially access to gender-affirming care, have been in the center of a since 2021.
鈥淲hen political leaders begin to talk about these issues at length,鈥 Deckman said, 鈥渢hat can often change the attitudes or priorities of partisans.鈥
A nationwide June 2021 from the Global Sport Institute at Arizona State University found 32% of respondents felt that transgender athletes should be limited to competition by their sex assigned at birth, while 30% said they should be able to compete against athletes with the same gender identity. Another 28% felt that transgender athletes should compete in a third category.
Compare that to an August 2023 from St. Louis University and YouGov, which found that 67% of Missourians (including 95% of Republicans) opposed allowing transgender students to play on teams that match their gender identity.
Still, a recent Pew Research Center poll found that roughly two-thirds of Americans support protecting transgender people from discrimination in jobs, housing and public spaces.
The SLU poll of Missouri also found that 63% of respondents opposed allowing minors to receive gender-affirming care.
Studies show that gender-affirming care was associated with over a 12-month period.
Since 2003, Republicans have controlled the state and . In 2022, the party gained control of all statewide
In 2022, Republicans ran for 151 seats across the General Assembly. Of those seats, 73 had. That meant that once a candidate won their primary, they were essentially guaranteed election.
鈥淚n primary elections, you can get the most committed partisans,鈥 Deckman said. 鈥淥n the Republican side, it鈥檚 folks who are far more conservative and are often more religious.鈥
And in an election year, lawmakers are motivated by their political aspirations to appeal to their base of voters, PROMO鈥檚 Erker-Lynch said.
鈥淪o many of these senators, in particular, are running for higher office,鈥 Erker-Lynch said. 鈥淭hey think that if they can appear to be, in my opinion, the most hateful, that they will appeal to their base the most.鈥
And with a nationwide consensus, including in Missouri, that access to abortion should be legal, political experts see the topic of gender-affirming care as one that can activate base voters.
鈥淲hen they didn鈥檛 have the pro-life position to motivate their base of voters to the polls,鈥 SPLC鈥檚 McCoy said, 鈥渢hey needed another issue.鈥
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What鈥檚 ahead for transgender laws in Missouri
Conservative groups want to renew the ban on gender-affirming care for minors.
One , sponsored by Rep. Brad Hudson, a Cape Fair Republican, would continue the ban and prohibit medical professionals from being required to perform sex reassignment surgery or gender identity transitioning if it goes against their moral, ethical or religious beliefs. The bill would also require public school locker rooms and bathrooms to be designated for and used by male or female students only.
Do No Harm testified on Jan. 17.
, a pastor, is running for the state鈥檚 33rd Senate District, home to Lake of the Ozarks, for the seat currently held by Republican Sen. Karla Eslinger.
Rep. Adam Schnelting filed a bill that he said was vetted, called the 鈥淒efining SEX Act,鈥 which would place definitions of female, male, girl, boy, woman, man, mother and father in state statute.
Schnelting, a St. Charles Republican, is a minister and Realtor who is running to represent outgoing Sen. Bill Eigel鈥檚 seat in the 23rd Senate District.
The General Assembly in 2024 is focused on issues like constitutional amendments and passing what has become a to fund Medicaid reimbursement in Missouri. Both topics are closely tied to abortion politics in Missouri.
The conservative group Freedom Principle of Missouri is using research from the Heritage Foundation in their legislative lobbying.
鈥淲e鈥檙e facing an uphill battle with this,鈥 Byron Keelin, the group鈥檚 president, said of passing further legislation this year. 鈥淚f the legislature doesn鈥檛 act 鈥 and depending on who the next governor is 鈥 they may take some action via executive order, too.鈥
Ultimately, Deckman said, the issue is driven by activists within the Republican Party.
鈥淚t鈥檚 certainly really being driven by conservative activists who feel very passionately about this issue,鈥 she said. 鈥淭hat polarization has had the impact of affecting general public opinion.鈥
This story was originally published by , an online news outlet focused on local, in-depth journalism in the public interest.