Text of MO SB 1200 (2026)

EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted and is intended to be omitted in the law. SECOND REGULAR SESSION SENATE BILL NO. 1200 103RD GENERAL ASSEMBLY INTRODUCED BY SENATOR HUDSON. 4146S.01I KRISTINA MARTIN, Secretary AN ACT To repeal section 191.1720, RSMo, and to enact in lieu thereof one new section relating to gender transition procedures. Be it enacted by the General Assembly of the State of Missouri, as follows: Section A. Section 191.1720, RSMo, is repealed and one 1 new section enacted in lieu thereof, to be known as section 2 191.1720, to read as follows: 3 191.1720. 1. This section shall be known and may be 1 cited as the "Missouri Save Adolescents from Experimentation 2 (SAFE) Act". 3 2. For purposes of this section, the following terms 4 mean: 5 (1) "Biological sex", the biological indication of 6 male or female in the context of reproductive potential or 7 capacity, such as sex chromosomes, naturally occurring sex 8 hormones, gonads, and nonambiguous internal and external 9 genitalia present at birth, without regard to an 10 individual's psychological, chosen, or subjective experience 11 of gender; 12 (2) "Cross-sex hormones", testosterone, estrogen, or 13 other androgens given to an individual in amounts that are 14 greater or more potent than would normally occur naturally 15 in a healthy individual of the same age and sex; 16 SB 1200 2 (3) "Gender", the psychological, behavioral, social, 17 and cultural aspects of being male or female; 18 (4) "Gender transition", the process in which an 19 individual transitions from identifying with and living as a 20 gender that corresponds to his or her biological sex to 21 identifying with and living as a gender different from his 22 or her biological sex, and may involve social, legal, or 23 physical changes; 24 (5) "Gender transition surgery", a surgical procedure 25 performed for the purpose of assisting an individual with a 26 gender transition, including, but not limited to: 27 (a) Surgical procedures that sterilize, including, but 28 not limited to, castration, vasectomy, hysterectomy, 29 oophorectomy, orchiectomy, or penectomy; 30 (b) Surgical procedures that artificially construct 31 tissue with the appearance of genitalia that differs from 32 the individual's biological sex, including, but not limited 33 to, metoidioplasty, phalloplasty, or vaginoplasty; or 34 (c) Augmentation mammoplasty or subcutaneous 35 mastectomy; 36 (6) "Health care provider", an individual who is 37 licensed, certified, or otherwise authorized by the laws of 38 this state to administer health care in the ordinary course 39 of the practice of his or her profession; 40 (7) "Puberty-blocking drugs", gonadotropin-releasing 41 hormone analogues or other synthetic drugs used to stop 42 luteinizing hormone secretion and follicle stimulating 43 hormone secretion, synthetic antiandrogen drugs to block the 44 androgen receptor, or any other drug used to delay or 45 suppress pubertal development in children for the purpose of 46 assisting an individual with a gender transition. 47 SB 1200 3 3. A health care provider shall not knowingly perform 48 a gender transition surgery on any individual under eighteen 49 years of age. 50 4. (1) A health care provider shall not knowingly 51 prescribe or administer cross-sex hormones or puberty- 52 blocking drugs for the purpose of a gender transition for 53 any individual under eighteen years of age. 54 (2) Until March 1, 2027, the provisions of this 55 subsection shall not apply to the prescription or 56 administration of cross-sex hormones or puberty-blocking 57 drugs for any individual under eighteen years of age who was 58 prescribed or administered such hormones or drugs prior to 59 August 28, 2023, for the purpose of assisting the individual 60 with a gender transition. 61 [(3) The provisions of this subsection shall expire on 62 August 28, 2027.] 63 5. The performance of a gender transition surgery or 64 the prescription or administration of cross-sex hormones or 65 puberty-blocking drugs to an individual under eighteen years 66 of age in violation of this section shall be considered 67 unprofessional conduct and any health care provider doing so 68 shall have his or her license to practice revoked by the 69 appropriate licensing entity or disciplinary review board 70 with competent jurisdiction in this state. 71 6. (1) The prescription or administration of cross- 72 sex hormones or puberty-blocking drugs to an individual 73 under eighteen years of age for the purpose of a gender 74 transition shall be considered grounds for a cause of action 75 against the health care provider. The provisions of chapter 76 538 shall not apply to any action brought under this 77 subsection. 78 SB 1200 4 (2) An action brought pursuant to this subsection 79 shall be brought within fifteen years of the individual 80 injured attaining the age of twenty-one or of the date the 81 treatment of the injury at issue in the action by the 82 defendant has ceased, whichever is later. 83 (3) An individual bringing an action under this 84 subsection shall be entitled to a rebuttable presumption 85 that the individual was harmed if the individual is 86 infertile following the prescription or administration of 87 cross-sex hormones or puberty-blocking drugs and that the 88 harm was a direct result of the hormones or drugs prescribed 89 or administered by the health care provider. Such 90 presumption may be rebutted only by clear and convincing 91 evidence. 92 (4) In any action brought pursuant to this subsection, 93 a plaintiff may recover economic and noneconomic damages and 94 punitive damages, without limitation to the amount and no 95 less than five hundred thousand dollars in the aggregate. 96 The judgment against a defendant in an action brought 97 pursuant to this subsection shall be in an amount of three 98 times the amount of any economic and noneconomic damages or 99 punitive damages assessed. Any award of damages in an 100 action brought pursuant to this subsection to a prevailing 101 plaintiff shall include attorney's fees and court costs. 102 (5) An action brought pursuant to this subsection may 103 be brought in any circuit court of this state. 104 (6) No health care provider shall require a waiver of 105 the right to bring an action pursuant to this subsection as 106 a condition of services. The right to bring an action by or 107 through an individual under the age of eighteen shall not be 108 waived by a parent or legal guardian. 109 SB 1200 5 (7) A plaintiff to an action brought under this 110 subsection may enter into a voluntary agreement of 111 settlement or compromise of the action, but no agreement 112 shall be valid until approved by the court. No agreement 113 allowed by the court shall include a provision regarding the 114 nondisclosure or confidentiality of the terms of such 115 agreement unless such provision was specifically requested 116 and agreed to by the plaintiff. 117 (8) If requested by the plaintiff, any pleadings, 118 attachments, or exhibits filed with the court in any action 119 brought pursuant to this subsection, as well as any 120 judgments issued by the court in such actions, shall not 121 include the personal identifying information of the 122 plaintiff. Such information shall be provided in a 123 confidential information filing sheet contemporaneously 124 filed with the court or entered by the court, which shall 125 not be subject to public inspection or availability. 126 7. The provisions of this section shall not apply to 127 any speech protected by the First Amendment of the United 128 States Constitution. 129 8. The provisions of this section shall not apply to 130 the following: 131 (1) Services to individuals born with a medically- 132 verifiable disorder of sex development, including, but not 133 limited to, an individual with external biological sex 134 characteristics that are irresolvably ambiguous, such as 135 those born with 46,XX chromosomes with virilization, 46,XY 136 chromosomes with undervirilization, or having both ovarian 137 and testicular tissue; 138 (2) Services provided when a physician has otherwise 139 diagnosed an individual with a disorder of sex development 140 and determined through genetic or biochemical testing that 141 SB 1200 6 the individual does not have normal sex chromosome 142 structure, sex steroid hormone production, or sex steroid 143 hormone action; 144 (3) The treatment of any infection, injury, disease, 145 or disorder that has been caused by or exacerbated by the 146 performance of gender transition surgery or the prescription 147 or administration of cross-sex hormones or puberty-blocking 148 drugs regardless of whether the surgery was performed or the 149 hormones or drugs were prescribed or administered in 150 accordance with state and federal law; or 151 (4) Any procedure undertaken because the individual 152 suffers from a physical disorder, physical injury, or 153 physical illness that would, as certified by a physician, 154 place the individual in imminent danger of death or 155 impairment of a major bodily function unless surgery is 156 performed. 157 ✓