Missouri MO
BanSB 49 / Mo. Rev. Stat. § 191.1720 prohibits gender-transition surgery and, until 28 August 2027, puberty blockers and cross-sex hormones for minors. The Missouri Supreme Court upheld it on 13 January 2026.
Last verified: 13 Oct 2026
Medical care for minorsBan
SB 49 / Mo. Rev. Stat. § 191.1720 prohibits gender-transition surgery and, until 28 August 2027, puberty blockers and cross-sex hormones for minors. The Missouri Supreme Court upheld it on 13 January 2026.
RSMo § 191.1720
Medicaid and CHIPFederal funding ended (minors)
State Medicaid policy excludes gender-transition procedures for all ages. A federal CMS final rule (13 Aug 2026) prohibits federal Medicaid and CHIP funding for these procedures for patients under 18 (Medicaid) and under 19 (CHIP).
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employee coverageNo explicit policy
State employee health plan documents do not explicitly address gender-transition procedures.
No primary source located; treat as unverified
SportsSex-based
State law requires school athletic teams designated for girls or women to be limited to students of the female sex (K-12 and higher education).
RSMo § 163.048 (SB 165, 2023)
FacilitiesNo state law
No state law requires restrooms or changing facilities to be used according to biological sex.
No state law identified (statute review, Oct 2026)
Pronouns and parent noticeNo state law
No state law requires schools to notify parents about a student's gender identity or name and pronoun requests.
No state law identified (statute review, Oct 2026)
CurriculumNo state law
No state law specifically addresses instruction on sexual orientation or gender identity.
No state law identified (statute review, Oct 2026)
Definition of sexNo state law
No state statute defines sex in biological terms across state law.
No state law identified (statute review, Oct 2026)
Identity documentsBirth-certificate sex changed only with surgery and court order
Birth-certificate sex changed only with surgery and court order; driver's licence sex change needs surgery, court order or amended birth certificate.
Mo. Ann. Stat. § 193.215(9) (2006), and
Shield lawNone
No shield statute identified.
No shield statute identified
AdultsRestricted (funding)
Adult access is limited through public funding rules: Medicaid exclusion at all ages.
Physicians Provider Manual | Missouri Department of Social Services (mydss.mo.gov)
DetransitionNo state law
No state law provides an extended limitations period or other remedy specific to detransitioners.
No state law identified
PrisonsCase-by-case
Pending billsNo active bills
No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.
LegiScan search, checked 13 Oct 2026 (adjourned legislature)
LitigationResolved/ongoing
Missouri Supreme Court upheld SB 49 on 13 January 2026.
E.N. v. Kehoe, No. SC100933 (Mo. 13 Jan 2026)
Key datesDate
28 Aug 2027: puberty-blocker and cross-sex hormone sections of SB 49 sunset unless renewed.
RSMo § 191.1720
Sources
- RSMo § 191.1720 →
- 42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406) →
- Official source: mydss.mo.gov →
- RSMo § 163.048 (SB 165, 2023) →
- Mo. Ann. Stat. § 193.215(9) (2006), and →
- MDOC Procedure IS5-3.3; Policy D1-8.13 →
- LegiScan search, checked 13 Oct 2026 (adjourned legislature) →
- E.N. v. Kehoe, No. SC100933 (Mo. 13 Jan 2026) →