Missouri's Battle Over Abortion and Gender-Affirming Care

Missouri's legal system is currently grappling with a contentious issue: the wording of a proposed constitutional amendment that aims to ban most abortions. The debate has intensified as abortion rights advocates argue that the summary of this amendment is misleading and violates rules against combining multiple subjects in a single ballot measure. At the heart of the controversy is the inclusion of a ban on gender-affirming care for minors, which opponents argue is a separate issue from abortion. This has led to a legal challenge, with a state appeals court set to hear arguments over whether the summary accurately reflects the amendment's true intent. Last year, Missouri voters enshrined the right to abortion in the state constitution. In response, the GOP-dominated legislature proposed a new constitutional amendment to reimpose an abortion ban. Proponents of abortion rights filed a lawsuit, arguing that the summary did not clearly state that the amendment would repeal the existing abortion rights amendment. A Cole County judge initially agreed and ordered the Secretary of State to rewrite the summary. After a second attempt, the judge deemed the new summary "fair and sufficient. " However, attorneys representing Dr. Anna Fitz-James, who submitted the language for the reproductive rights initiative petition, believe the current language is still deceptive. They argue that the summary fails to inform voters that a right is being eliminated and replaced with fewer rights. The case is now before the Western District Court of Appeals, with attorneys for Fitz-James asking the higher court to remove the amendment from the ballot or rewrite the summary. The ballot language is complex and open to interpretation. It mentions guaranteeing women's medical care for emergencies, ensuring safety during abortions, requiring parental consent for minors, and prohibiting sex-change procedures for children. If approved, the amendment would allow abortions for medical emergencies, fetal anomalies, rape, and incest, but with unclear provisions for proving assault. Attorneys Chuck Hatfield and Tori Schafer argue that the amendment violates a statute preventing ballot measures from encompassing more than one subject. They contend that gender-affirming health care is separate from reproductive health care and that combining them is a tactic to make the amendment more popular. The attorney general's office, representing the Secretary of State, argues that the interpretation of the single-subject rule is too narrow. They contend that gender-affirming health care includes procedures that frequently render children sterile, thus justifying its inclusion in the amendment. Fitz-James' attorneys argue that the current wording obscures the fact that the proposed amendment would ban most abortions. They believe most voters will not understand the reference to Article 1, Section 36 of the Missouri Constitution or the phrase "approved in 2024. " The attorney general's office counters that voters are intelligent enough to understand the context. The case has even delved into the use of a semicolon in the ballot language, with both sides presenting their arguments on grammar. Regardless of the appeals court's decision, the case is likely to end up in the hands of the Missouri Supreme Court, ensuring that the debate over abortion and gender-affirming care will continue.