The Missouri Supreme Court unanimously upheld a law barring minors from receiving cross-sex hormones, puberty blockers and gender transition surgeries and prohibiting Medicaid coverage of gender-affirming care for all ages.
The decision, written by Judge Kelly Broniec, affirms a 2024 Cole County Circuit Court ruling from that sided with the state on all counts. Both courts rejected arguments that the law should be subject to heightened scrutiny, a standard of review reserved for statutes that classify based on sex or are discriminatory in nature.
“There is no fundamental right to seek care the legislature has prohibited,” Broniec wrote.“Because (the law) does not infringe on a fundamental right, rational-basis review is appropriate.”
Under rational-basis review, a statute is presumed sensible unless challengers can show the law is arbitrary and irrational.
In their arguments, challengers represented by the ACLU of Missouri and LGBTQ+ rights law firm Lambda Legal alleged that the law discriminates on the basis of sex and transgender status. The court’s rejection of this argument was key to upholding the ban.
The law “classifies only based on medical use and age,” Broniec wrote, aligning with a U.S. Supreme Court decision that upheld Tennessee’s gender-affirming-care ban in June and a decision from the 8th U.S. Circuit Court of Appeals that upheld Arkansas’ gender-affirming care restrictions in August.
Challengers attempted to differentiate Missouri’s ban from the case precedents, arguing that Missouri’s Constitution offered more protections than the U.S. Constitution. These arguments were “not persuasive,” Broniec wrote in a footnote.
