Medical care for minorsBan▾
MedicaidFederal funding ended (minors)▾
Medicaid doesn't pay for sex-change procedures at any age. A federal CMS rule ends federal Medicaid and CHIP money for puberty blockers, cross-sex hormones and surgery for minors.
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employeesNo explicit policy▾
State-employee plans have no explicit rule on sex-change procedures.
SportsSex-based▾
Girls' sports are protected: state law keeps males out of girls' and women's teams (K-12 and higher education).
RSMo § 163.048 (SB 165, 2023)
FacilitiesNo state law▾
No state law keeps males out of women's and girls' bathrooms and changing rooms.
No state law identified (statute review, Oct 2026)
Pronouns and parent noticeNo state law▾
No state law requires schools to tell parents if their child socially transitions at school.
No state law identified (statute review, Oct 2026)
CurriculumNo state law▾
No state law on gender-identity lessons; local school boards decide.
No state law identified (statute review, Oct 2026)
Sex definitionNo state law▾
No state law defines male and female by biology.
No state law identified (statute review, Oct 2026)
ID markersBirth-certificate sex changed only with surgery and court order▾
Birth-certificate sex changed only with surgery and court order; licence sex change needs surgery, court order or amended birth certificate.
Mo. Ann. Stat. § 193.215(9) (2006), and
Shield lawNone▾
No shield law.
No shield statute identified
AdultsRestricted (funding)▾
Adults: no taxpayer money for sex-change procedures (Medicaid exclusion at all ages).
Physicians Provider Manual | Missouri Department of Social Services (mydss.mo.gov)
DetransitionNo state law▾
No special right for detransitioners to sue.
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)