Last month, the Missouri Department of Revenue updated the process that Missourians must go through to change gender markers on a state ID by requiring proof of gender affirming surgery or a court order.
Advocates and health law experts say the new regulations could create serious problems for transgender, nonbinary and intersex people in the state.
For transgender people living in Missouri, like 24-year old Amariah Hardwick, policy changes like the newly implemented one from the Department of Revenue can make a significant impact. Hardwick began her transition as a transgender woman at age 17.
At at the time, she lived in Detroit, Michigan. She would later move to St. Louis to pursue her degree at Harris-Stowe State University.
But when she got to Missouri, she says the culture shock hit hard. She lost access to parts of her health care, and experienced discrimination.
“I came there to be empowered by getting a degree, but I felt so powerless because my voice isn't heard. I'm not affirmed here. I'm not seen as something that's equivalent to humanity,” Hardwick said.
Now, Hardwick is 24. She has her degree, she’s a national advisory board member for transgender advocacy group Transformations — and she’s moving out of Missouri.
“I don't have the bandwidth at 24 years old and still trying to survive and make things happen for myself, to make sure that a community is moving as a whole,” Hardwick said. “That's a disservice to myself, and I need to make sure that I'm safe and affirmed.”
She says that it’s not sustainable to live as a transgender woman in a state that regularly introduces policies and legislation that targets trans and gender non-conforming people — like a new policy from the Missouri Department of Revenue.
Early in August, the Department of Revenue eliminated form 5532, which was a document signed by a medical or social service provider that allowed Missourians to request a change in gender. Instead, there’s a new process.
Department of Revenue officials declined a taped interview for this story, but in a statement e-mailed to KBIA, said: “Customers are required to provide either medical documentation that they have undergone gender reassignment surgery, or a court order declaring gender designation to obtain a driver license or nondriver ID card denoting gender other than their biological gender assigned at birth.”
Robert Fischer is the communications director for PROMO Missouri, a statewide LGBTQ+ advocacy organization, and said the change came as a shock.
“They came very quietly, and it seems to have been done extremely secretively,” Fischer said.
Though the Department of Revenue hasn’t officially stated why the change was made, Fischer says that the decision “aligns perfectly” with an incident that occurred in Ellesville which prompted Missouri Attorney General Andrew Bailey to open an investigation into Lifetime Fitness after a transgender woman was allegedly allowed to use the locker room facilities.
In a notice of investigation, Bailey wrote:
“While it might be considered fashionable in certain corporate boardrooms to pretend that biology is irrelevant, the American heartland still lives in reality. Missourians recognize that allowing adult men to openly invade and disrobe in spaces set aside for women and young girls is indefensible and places political correctness above public safety.”
Dr. Gary Wright, an assistant professor of science education and vice president of Columbia-area LGBTQ+ advocacy organization The Center Project, said that science has yet to show evidence that having transgender people in restrooms creates unsafe environments.
“There isn't data to support that claim. It's sort of this mass hysteria that typically conservatives latch onto to justify their anti LGBTQ rhetoric,” Wright said.
Additionally, Wright said that from a scientific perspective, gender and sex are not one in the same, and said policies that require transgender people to have surgery exclude a large portion of the transgender, nonbinary and intersex community.
“Gender identity being so personal, so intrinsic shouldn't be necessarily represented through genitalia changes or hormone changes or anything of that nature,” Wright said. “Being trans — there's no singular way to exist as a trans or non-binary person.”
A recent Nationwide study published in the Journal of the American Medical association estimated the amount of transgender individuals who underwent Gender Affirming Surgery at about 52%.
Marcia McCormick is a professor at St. Louis University School of Law who specializes in sexuality and the law. McCormick says that because many transgender people choose not to undergo surgery, policies that require surgery can create hardship for transgender and gender non-conforming people.
“Focusing on surgery really limits who can even change their gender designation in a way that means that, you know, half or fewer of transgender people can even ever take advantage of this, and it pushes people towards surgery that may not want it as the only way to change their gender,” McCormick said.
Additionally, the policy uses “gender reassignment surgery” as a broad term, even though there are a variety of surgeries that fit under this umbrella. McCormick said it’s unclear what degree of surgery is required to change a gender marker. Plus, she said the policy leaves intersex Missourians in a “gray area."
According to the Intersex Society of North America, intersex is “a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.” McCormick said policies requiring “reassignment surgery” inherently leave out intersex people — especially those whose anatomy doesn’t line up with traditional “male” or “female” characteristics.
“Some intersex people identify as female, some identify as male, some identify as non-binary. It's going to depend in part on what their birth certificate says. So whatever their birth certificate says is what they are stuck with,” McCormick said. “And if their birth certificate doesn't have a sex, then presumably they've already gone through some Department of Revenue process to sort of assign them a sex.”
At the Center Project, Wright said he initially suggested that people with questions about how to change their gender markers pursue a passport — which has different regulations around changing one’s gender. Additionally, people can choose to put “x” on their passport instead of choosing male or female — an option not available to Missourians.
But McCormick at SLU Law said all Americans will need a “Real ID,” which is obtained at the state level, to board planes and bypass TSA with state issued driver's licenses and IDs beginning next year.
“There are a number of things that (the REAL ID Act) requires about the information that is gathered from a person for issuance of a driver's license and the connection of that information with federal information. And one of the things that's required to be on identification is a gender designation,” McCormick said.
Though passports will still be an accepted form of identification to bypass TSA under the REAL ID Act, they are more expensive to obtain than a standard driver’s license or state ID.
The last option for Missourians to change their gender is to obtain a certified court order. McCormick said that this process is extremely lengthy and complicated, and could be very expensive. Though hiring a lawyer is not required, McCormick said it can make the process significantly easier in many ways.
For now, Missourians attempting to change their gender markers on state issued IDs must attempt to present adequate documentation of “gender reassignment surgery” or pursue a court order that declares their gender.
