How conflicting state and federal laws on gender-affirming care put ‘hospitals in a bind’

The families of two transgender boys filed a federal lawsuit against the University of Missouri this month in an attempt to reverse its decision to stop providing gender-affirming care to minors.

University of Missouri Health’s decision was a reaction to a state law that bars minors from beginning gender-affirming care.

By halting the prescriptions of puberty blockers and hormones to minors for gender transition purposes, the plaintiffs argue the university health system unconstitutionally discriminates on the basis of sex and disability status.

“Because the Affordable Care Act prohibits discrimination on the grounds of sex or disability, we have all kinds of protections for various disabilities,” said Jenkins & Kling attorney Nicole Gorovsky. “Some of the legislation in this area has really put these hospitals in a bind.”

An interesting question at the heart of this case, Gorovsky said, is whether gender dysphoria counts as a disability under the Americans with Disabilities Act. If they can demonstrate that, she added, the plaintiffs’ case has a solid path.

“Gender dysphoria is this concept that you don't feel that you were born in the body that you belong in, and the definition of disability under the ADA is a physical or mental impairment that substantially limits one or more major life activities of the individual,” she said.

Patti Williams, attorney and founder of Lex Valorem, said she sees how untreated gender dysphoria could limit one’s daily living.