The Missouri House on Tuesday approved the first round of a pair of bills that would limit participation in health care and sports for the state’s transgender youth.

Members of the Republican-led House approved legislation that would prevent transgender children under 18 from accessing gender-affirming care such as puberty blockers and hormone treatments. The vote was 106-45.

Two Republicans, Rep. Chris Sander, R-Lone Jack, and House Floor Leader John Patterson, R-Lee, voted against Summit’s bill. No other vote was Democrat.

The House also gave preliminary approval to legislation barring transgender athletes from participating on sports teams that align with their gender identity.

The bill would apply to public and charter schools in grades 6 through 12 This will also apply to public and private post-secondary educational institutions House members voted 107-41 on that bill. Two of those were Rep. Sander and Rep. Tony Lovasco, R-O’Fallon. A Democrat, Rep. Alan Gray, D-St. Lewis, voted yes.

Both bills need another vote before moving to the Missouri Senate.

Rep. Brad Hudson, R-Cape Fair, a sponsor of the gender-affirming health care legislation, said the bill is about protecting children.

The legislation was amended to reflect some of the language included in the Senate version.

The biggest Senate addition, however, is the expiration date of bans on certain treatments, such as hormones And puberty blockers as well as allowing transgender children who are already receiving this treatment to receive it are not included.

Instead, Hudson says they’re aiming for a six-month window to prevent trans kids from getting that treatment.

“It’s a reasonable off ramp for kids who have some of these drugs. We want to get them off them as quickly as possible,” Hudson said.

Speaking after the Senate bill passed three weeks ago, Senate President Caleb Rowden said he hoped the House understood how difficult it was for the Senate to pass its version.

Gender-affirming care includes medical and mental health care treatment as well as social support.

The practice is supported by multiple medical associations, including the American Academy of Pediatrics and the American Medical Association.

Rep. Ashley Aoun, D-Kansas City, one of many Democrats who spoke out against the bill, read comments from a transgender child and her parents on the House floor. The child wrote that the care she received was life-saving.

“These are the kids you’re making laws for. A man with this feeling and a family who love him deeply and who want him to be here and know that he cannot be here without this care,” Aoun said. “You all hold a super majority in this state. Stop punching down.”

Republicans who have spoken out in support of the legislation have repeatedly used the age of trans children as a reason to delay transition-related health care.

“This bill is about protecting children under 18 and giving them the freedom to choose their path at 18,” said Rep. Cindy Bucheit-Courtaway, R-Festus.

Rep. Jamie Johnson, D-Kansas City, spoke with families who have repeatedly traveled to Jefferson City to speak out against the law.

“I just want to say to the families who are in this organization, who will be affected by this law. I’m so proud of your kids for coming here to fight for their existence and their right to exist in this state,” Johnson said.

House members spent more than two hours debating the legislation, excluding transition-related health care. Members were given less than thirty minutes to debate a bill that would ban transgender athletes from participating on sports teams consistent with their gender identity.

Like other House bills, the legislation does not have the four-year expiration date included in the Senate version.

Rep. Jamie Berger, R-Benton, who sponsored the bill, said it was the right thing to do to address fairness in sports.

The Missouri State High School Activities Association already has guidelines for transgender athletes participating in sports, as does the NCAA for college sports.

Shortly after the House adjourned after voting to approve the first round of both bills, members of the House Common Law Committee met to hear testimony on Senate bills addressing the same issues. It is unclear when the full House will consider these bills.

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