Jefferson City – The Missouri Supreme Court upheld Senate Bill 49, Missouri's discriminatory ban on gender-affirming medical care for transgender adolescents and Medicaid coverage restrictions for transgender people of all ages. The decision in E.N. v. Kehoe allows the state to continue denying transgender Missourians access to medically necessary health care.
The ACLU of Missouri, Lambda Legal, and Bryan Cave Leighton Paisner LLP argued that SB 49 unconstitutionally discriminates against transgender individuals by denying them access to medically necessary treatments that remain available to non-transgender people, while interfering with fundamental rights to medical decision-making and parental autonomy.
"Today's decision allows the state to continue to enforce a harmful ban that singles out transgender Missourians and denies them compassion and equal access to medically necessary health care," said Gillian Wilcox, Director of Litigation at the ACLU of Missouri. " The decision not only allows the state to target transgender Missourians access to health care but also leaves everyone's health care options at the whims of politicians, should the care you depend on ever fall into the political arena."
“We are deeply disappointed by today's ruling, which allows Missouri to continue violating the fundamental constitutional rights of transgender Missourians,” said Nora Huppert, Senior Attorney at Lambda Legal. “This discriminatory law invades the private relationship between patients, their families, and their doctors, denying transgender people access to safe and effective medical care. The Missouri Constitution protects the autonomy, equal rights, and opportunity for all people, and this law falls short of those principles. We will continue to explore every legal avenue to protect the rights and health of transgender people in Missouri.”
Senate Bill 49, which took effect on August 28, 2023, bans transgender adolescents from receiving gender-affirming medical care, prohibits Medicaid coverage for gender-affirming care for transgender people of any age, and threatens health care professionals with the loss of their medical licenses for providing such care to minors.
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In July 2023, Lambda Legal, the ACLU of Missouri, and Bryan Cave Leighton Paisner LLP filed E.N. v. Kehoe in Cole County Circuit Court on behalf of three families of transgender young people, medical providers, and the organizations PFLAG National and GLMA: Health Professionals Advancing LGBTQ+ Equality. After the court denied preliminary relief and later refused to halt enforcement following a two-week trial in October 2024, advocates appealed to the Missouri Supreme Court on January 16, 2025.
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