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Missouri lawmakers consider extending proposed ban on gender-affirming care to adults

Lawmakers this week suggested that gender-affirming care be off-limits to individuals younger than 25 years old.

Story at a glance

  • Missouri legislators this week said gender-affirming care should not be made available to young adults younger than 25 years old, citing brain maturity.

  • Research suggests that the part of the brain responsible for executive functions like decision making is not fully developed before the age of 25.

  •  Other research has found that early gender-affirming interventions are associated with better outcomes for transgender and nonbinary adults.

Missouri lawmakers this week while debating a bill seeking to restrict access to gender-affirming care for minors suggested access to medical interventions like hormones be withheld from transgender and nonbinary individuals until at least their 25th birthday.

During a public hearing Thursday for Missouri’s House Bill 2649, Laurie Haynes, a psychologist, testified that she believes young adults under the age of 25 are unable to fully comprehend the “dramatic and drastic and irreparable” changes their bodies will undergo if they receive gender-affirming medical treatments like puberty blockers or hormone therapies.

Haynes on Thursday also said she supported conversion therapy.

Medical research has suggested that the prefrontal cortex – the part of the brain responsible for executive functions like decision making – is not fully developed until roughly the age of 25.


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Currently, the bill, which is officially titled the Save Adolescents from Experimentation (SAFE) Act, only applies to individuals younger than 18 years old. Missouri physicians and health care providers under the bill would be prevented from providing or recommending gender-affirming care to patients who are minors.

On Thursday Rep. Nick Schroer (R) argued that the legislature had previously invoked brain maturity in deciding whether the state should raise the age for being charged as an adult in criminal cases from 17 to 18.

“The brains of especially males are still developing into their twenties and I don’t understand why that’s not part of the discussion here,” he said.

It’s an argument made by lawmakers and officials in other conservative states, and Florida’s Health Department this week said gender-affirming care in any form – including social transition – should not be made available to children younger than 18 years old, citing brain maturity.

But other research has found that early gender-affirming interventions can improve the mental health and wellbeing of transgender and nonbinary people into adulthood. 

A recent study published in the Journal of the American Medical Association found that receiving gender-affirming care, including puberty blockers and hormones, between the ages of 13 and 20 was associated with 60 percent lower odds of moderate or severe depression and 73 percent lower odds of suicidality.

Another study, published late last year by researchers at The Trevor Project, found that, among transgender or nonbinary minors, hormone therapy was associated with nearly 40 percent lower odds of recent depression or a suicide attempt over the last year.

Published on Apr 22,2022