The Missouri Supreme Court heard arguments Wednesday over the constitutionality of a law barring transgender minors from accessing gender-affirming care.
The plaintiffs in the original lawsuit are seeking a reversal of a decision by a Cole County circuit judge last November in favor of the law.
Missouri lawmakers originally passed the legislation in 2023. It bars transgender minors from gender-affirming care such as puberty blockers and hormone therapy.
It also prohibits transgender athletes through the collegiate level from participating on sports teams that align with their gender identity.
Missouri is one of dozens of states to pass similar legislation in the past several years.
Arguing on behalf of the appellants, attorney Nora Huppert said the trial court ignored the two fundamental rights that are at issue with this case. One is the individual right to autonomy over decisions on one's health and welfare, she said. The other is a parent's authority to seek medical care for children "subject to a physician's independent judgment."
"These rights are separate and distinct, but they overlap and interact," Huppert said.
This appeal before the Missouri Supreme Court comes months after the U.S. Supreme Court upheld a similar law in Tennessee that bars transgender minors from attaining gender-affirming care.
Representing the state, Solicitor General Louis Capozzi, said the circuit court got the ruling right the first time. He quoted the Supreme Court's ruling as reason to uphold the law.
"States have 'wide discretion to pass legislation in areas where there is medical and scientific uncertainty.' That rule easily settles appellant's challenge," Capozzi said.
Huppert said the U.S. Supreme Court's recent ruling does not constrain the case in the Missouri Supreme Court because the state's constitution can provide greater protection than the federal constitution in this case.
She also said Missouri's law is structured differently than the law passed in Tennessee.
"It does not speak in terms of medical condition or diagnosis or medical use. It classifies on the basis of gender transition and thus targets transgender people," Huppert said.
Huppert said the additional measures that prohibit state Medicaid programs from covering gender-affirming care for adults and stop transgender athletes from participating on sports teams aligning with their identity further prove the law is discriminatory.
"This law is one that does not classify based on medical use, but targets a gender transition, which is a defining feature of transgender people and the state's inability to proper a legitimate motive that explains both provisions, shows that it is motivated by discriminatory purpose," Huppert said.
In the U.S. Supreme Court's majority 6-3 opinion issued in June, Chief Justice John Roberts said that because the law applied to transgender people of both genders, it did not immediately trigger the equal protection clause of the U.S. Constitution.
Capozzi also pushed back on the notion that Missouri's law is different from those in Tennessee and Arkansas.
"In particular, the Arkansas and Missouri statutes are almost identical. The definitions of gender and gender transition are verbatim identical between the two statutes, and functionally, all three statutes ban the same procedures," Capozzi said.
On the Medicaid claims, Capozzi said the state does not have to pay for services that people may end up not wanting, citing people who decide to "detransition."
The Trump administration recently ordered the NIH to research trans "regret" and "detransition."
However, many researchers say there is a solid amount of research showing a low level of regret after transitioning.
Capozzi closed by saying questions on gender-affirming health care services should be left to the General Assembly.
The Missouri Supreme Court will rule on the case at a later date.
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