In Noe v. Parson, (MO Cir. Ct., Nov. 25, 2024), a Missouri state trial court upheld the constitutionality of Missouri's ban on gender transition surgery for minors and its 4-year moratorium on puberty-blocking drugs and cross-sex hormones for minors for the purpose of treating gender dysphoria. It also upheld the state's ban on the use of state Medicaid funds for gender transition procedures. The decision, reflected in a 74-page opinion setting out extensive findings of fact and conclusions of law, comes in a facial challenge to Missouri's Save Adolescents from Experimentation (SAFE) Act. The court said in part:
This Court finds an almost total lack of consensus as to the medical ethics of adolescent gender dysphoria treatment....
Furthermore, the credible evidence shows that a vast majority of children who are diagnosed with gender dysphoria outgrow the condition....
Critically, Plaintiffs made the strategic decision to bring a facial challenge to the entirety of several provisions, meaning they must establish that "no set of circumstances exists under which the [provisions] would be valid."... They chose not to seek an as-applied exception, a carve-out exception, to the regulation. The Constitution does not permit a single judge to nullify the results of democratically enacted legislation where, as here, there is a medical dispute about the safety or efficacy of those interventions....
There is nothing arbitrary or irrational ... about putting in place a 4-year pause on interventions that medical authorities across the world have said lack any substantial evidentiary support....
Lambda Legal and ACLU of Missouri said they will appeal the decision. Missouri Independent reports on the decision.
