‘Everybody’s afraid.’ Doctors warn of chilling effect as Missouri, Kansas target transgender care

Kansas City-based endocrinologist Brandon Barthel has provided care for transgender adults for six years, including helping them go through hormone therapy.

When he sees patients and talks to colleagues these days, he sometimes hears fear.

The onslaught of legislation across Missouri, Kansas and much of the country targeting gender-affirming care has unsettled the region’s small community of providers and the patients who turn to these doctors, counselors and others to help them navigate difficult questions of gender and sex.

Barthel worries the measures have created a chilling effect on doctors and other professionals, who fear the loss of funding if too much attention is drawn to the care they provide. And patients are worried, he said, because they view the legislation as an attack on their existence and their ability to access medical care.

“Everybody’s afraid,” Barthel said.

Republican lawmakers in both Missouri and Kansas have filed legislation to prevent doctors from providing gender transition surgeries or hormone therapies to minors. They have also pursued legislation to ban transgender athletes from women’s sports and bar transgender women from female designated spaces, including bathrooms and locker rooms, and transgender men from male designated spaces.

Interviews with doctors, transgender individuals and family members in Kansas and Missouri reveal an atmosphere of alarm over the attacks on transgender care. Collectively, they are concerned about the potential for the legislation to cast a pall over providers and patients – even if the measures never become law.

“That terror, that very real, ‘Oh, we’re in danger, we’re in very real, very immediate danger’ – that kind of seeps through the community whether or not these bills pass,” said Adam Kellogg, a transgender 19-year-old University of Kansas student who hopes to one day work as a counselor for transgender individuals.

“Because we know the sentiment is there enough for it to be acceptable to put these bills into committee or even on the House or Senate floor.”

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