Missouri has a highly restrictive legislative landscape for transgender individuals. In 2023, the state enacted Senate Bill 49 (SAFE Act) banning gender-affirming care for minors and Senate Bill 39 restricting transgender student sports participation. Numerous anti-trans bills have been introduced in subsequent years, with 67 tracked in 2025 alone.
2023:
- Senate Bill 49 (SB 49, "Missouri Save Adolescents from Experimentation (SAFE) Act"): Enacted June 7, 2023, effective August 28, 2023
- Bans gender-affirming care for minors, including hormone therapy (estradiol, testosterone, puberty blockers) and sex reassignment surgery
- Expires August 28, 2027, after Democratic filibuster compromise
- Upheld by Missouri circuit judge in November 2024 despite ACLU lawsuits
- Senate Bill 39 (SB 39): Passed alongside SB 49
- Bars transgender students from sports not matching their birth certificate sex
- Applies to all public/private schools with state funding penalties
2024:
- New rule requiring proof of gender reassignment surgery or court order to change gender markers on birth certificates
2023:
- 43 tracked anti-trans bills across healthcare, education, sports, performance, other, and birth certificates
2024:
- 47 tracked anti-trans bills impacting education, healthcare, performance, bathrooms, other, marriage, sports, and civil rights
2025:
- 67 tracked anti-trans bills across 10 categories: healthcare, education, other, sports, bathroom, civil rights, marriage, performance, birth certificates, and child abuse
- Key provisions mirror SB 49: bans gender transition surgery, cross-sex hormones, and puberty blockers for those under 18
2026 (Early Session):
- House bills propose separating public restrooms/changing rooms by sex assigned at birth (egg/sperm reproductive definitions)
- Affects schools, universities, public buildings, and private schools
- Enforcement via lawsuits or funding cuts; heard March 2026
| Name |
Party |
Chamber |
Key Actions |
| No specific politicians identified in search results for anti-trans bills |
|
|
|
| Date |
Event |
| June 7, 2023 |
SB 49 (SAFE Act) and SB 39 enacted |
| August 28, 2023 |
SB 49 takes effect |
| November 2024 |
Missouri circuit judge upholds SB 49 despite ACLU lawsuits |
| 2024 |
New rule on birth certificate gender marker changes |
| 2025 |
67 anti-trans bills tracked |
| March 2026 |
House bills on restroom separation heard |
- KCUR - Missouri House Transgender Bathroom Restrictions
- Wikipedia - Missouri Senate Bill 49
- Trans Legislation Tracker 2025/MO
- Trans Legislation Tracker 2023/MO
- Missouri Senate News - SB 49
- Trans Legislation Tracker 2024/MO
- Missouri Senate News - SB 39
Last updated: 2026-04-02