Washington University the second Missouri provider to stop transgender care for minors

Washington University in St. Louis joined University of Missouri Health as the latest provider of care to transgender minors to announce it is canceling pre-existing prescriptions for puberty blockers or hormone-replacement therapy.

A new state law restricting access to gender-affirming care bars those under 18 from beginning new treatments. But in a compromise with opponents of the ban, lawmakers grandfathered in patients who had begun a medical transition before the law went into effect on Aug. 28.

But a provision of the statute allows those who received care as a minor to bring a cause of action against their doctor 15 years after treatment or their 21st birthday, whichever is later. Typically, patients in Missouri have two years to file a medical malpractice lawsuit.

Washington University cited this provision as the reason for its change in services.

“Missouri’s newly enacted law regarding transgender care has created a new legal claim for patients who received these medications as minors,” the university said in a statement. “This legal claim creates unsustainable liability for health-care professionals and makes it untenable for us to continue to provide comprehensive transgender care for minor patients without subjecting the university and our providers to an unacceptable level of liability.”

MU Health Care, when it announced it was stopping minors’ puberty blocker and hormone prescriptions, also spoke of legal risks.

“Health care providers face significant legal liability for prescribing or administering cross-sex hormones or puberty-blockings drugs to existing minor patients under the new cause of action,” MU Health’s public relations manager Eric Maze said in a statement.

Both MU Health and Washington University are continuing to provide other gender-affirming-care services, like therapy, that are allowed under state law.

Washington University said it would send referrals for its patients to continue their medical care elsewhere.

Missouri Attorney General Andrew Bailey sent a letter to a handful of health care providers offering gender-affirming care for minors, warning them of the new law.

Children’s Mercy in Kansas City, after receiving a letter from Bailey informing them of the law, told KSHB-TV it was “complying with the new law.”

“The care, privacy, and wellbeing of the patients we serve remains our top priority. We acknowledge receipt of the letter published by the attorney general,” a spokesperson for the hospital wrote in a statement to the television station.

Southampton Healthcare, located in St. Louis, joined a lawsuit against the new state law in hopes it could continue to provide gender-affirming care to new and existing patients.

Planned Parenthood of the St. Louis Region and Southwest Missouri will continue the hormone-replacement therapy of patients over 16 years old who are grandfathered into the new law.

“Like all Missourians, transgender and gender non-conforming youth have the right to access life-saving and life-affirming care at the health provider of their choice,” Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, said in a statement. “Planned Parenthood, in compliance with the law, will continue providing gender-affirming hormone therapy to patients who want and need it, including young patients who have started care with another provider.”

AIDS Project of the Ozarks and Planned Parenthood of the Great Plains also received a letter from the attorney general but have not issued a statement since the new law’s effective date.

Planned Parenthood of the Great Plains, while it offered cross-sex hormones for patients ages 16 and older, did not have any minor patients receiving gender-affirming care in August, so the clinics do not have any patients grandfathered into the new law.

Health care providers came under renewed scrutiny this year when a former employee of the Washington University Transgender Center at St. Louis Children’s Hospital alleged patients were rushed into cross-sex hormones and puberty blockers without taking into account mental health. Parents and patients that have received treatment at the transgender center dispute the whistleblower’s story, which was launched nationwide in February.

Lawmakers, while deciding whether to restrict children’s access to puberty blockers, often referenced the whistleblower’s testimony.

A lawsuit filed by the ACLU of Missouri and Lambda Legal in August seeking to undo new law is still ongoing.

This story has been updated following response from Planned Parenthood of the Great Plains.