Missouri's Attorney General Fraudulently Practices Medicine Without a License
And needs to be reported.
I’m getting sick of pointing the following out: ambitious state politicians love to play doctor in the creepiest way. I intend the following article to be referenced in any legal cases against Andrew Bailey, the elected attorney general of the state of Missouri, who is not—and I checked—a physician.
This matters, because according to Missouri state law:
334.010. Unauthorized practice of medicine and surgery prohibited — practice of medicine across state lines, definition — sports-related medical services, inapplicability. — 1. It shall be unlawful for any person not now a registered physician within the meaning of the law to practice medicine or surgery in any of its departments, to engage in the practice of medicine … or to profess to cure and attempt to treat the sick and others afflicted with bodily or mental infirmities.
And of course if that sounds vague, the law of the state assures is it is not:
(1986) This section is not void for vagueness on account of its failure to expressly define "practice of medicine"
And to be clear he didn’t do the following:
334.040. Examination of applicants, how conducted, grades required, time limitations, extensions. — 1. Except as provided in section 334.260, all persons desiring to practice as physicians and surgeons in this state shall be examined as to their fitness to engage in such practice by the board. All persons applying for examination shall file a completed application with the board upon forms furnished by the board.
I am being legal-y and pedantic because this human is a lawyer and KNOWS better, or legally, should. He shouldn't practice medicine.
And even if he had a license the behavior I will illuminate would serve to revoke the license anyways, based on:
(8) Any conduct for which the board may discipline that constitutes a serious danger to the health, safety, or welfare of a patient or the public.
And for anyone who wants to get the ball rolling by forwarding this article to the authorities in the state of Missouri, that action would legally trigger an investigation into The AG:
334.240. Investigation and commencement of prosecutions. — Upon receiving information that any provision of sections 334.010, 334.190 and 334.250has been or is being violated, the secretary of the board or other person designated by the board shall investigate, and upon probable cause appearing, the secretary shall, under the direction of the board, file a complaint with the administrative hearing commission or appropriate official or court.
So why such a fuss? Cause the guy issued this emergency order today:
As a result, the attorney general finds that this emergency action is needed because of a compelling governmental interest and a need to protect the public health, safety, and welfare. ..,,This emergency rule was filed April 13, 2023, becomes effective April 27, 2023, and expires February 6, 2024.
(1) “Covered Gender Transition Intervention” or “Intervention” means the provision or prescription of any puberty-blocking drugs, cross-sex hormones, or surgery, for the purpose of transitioning gender, decreasing gender incongruence, or treating gender dysphoria
Now, again being pedantic, but Tony is asserting as a Non-Physician that he is going to go ahead and direct the practice of medicine in a state in which it is a crime to do so without a medical license in very specific ways.
The first wildly egregious way in which he chooses to force the practice of medicine is to mandate that doctors have to legally say a ton of nonsense to patients much of which is not in keeping with the standard of care,1 which is bad enough.
But here is the part that is utterly absurd, and as a child and adult psychiatrist and a member of the team that curated the educational module which is documentation of a national standard of care produced by the American Academy of Child and Adolescent Psychiatry (AACAP), I can definitely say is not appropriate medical practice:
The non-physician Anthony Bailey has emergency ordered the following additional medical care, which is expressly not a standard of care: physicians are never to provider gender affirming care including hormones to individuals of ANY AGE unless we follow this malpractice as mandatory guidance:
It is an unfair, deceptive, fraudulent, or otherwise unlawful practice for any person or health organization to provide a covered gender transition intervention to a patient (or refer a patient for such an intervention)
if the person or health organization:
(D) Fails to ensure that the patient has received a full psychological or psychiatric assessment, consisting of not fewer than 15 separate, hourly sessions (at least 10 of which must be with the same therapist) over the course of not fewer than 18 months to explore the developmental influences on the patient’s current gender identity and to determine, among other things, whether the person has any mental health comorbidities;
(E) Fails to ensure that any psychiatric symptoms from existing mental health comorbidities of the patient have been treated and resolved
(F) Fails to ensure that the patient has received a comprehensive screening to determine whether the patient has autism;
(G) Fails, with respect to a patient who is a minor, to ensure that the patient has received a comprehensive screening (at least annually) for social media addiction or compulsion and has not, for at least the six months prior to beginning any intervention, suffered from social media addiction or compulsion;
(Which I will note doesn’t have diagnostic standards)
(H) Fails to ensure (at least annually) that the patient is not experiencing social contagion with respect to the patient’s gender identity;
(Which is also political hay but not medicines)
The above are the regulatory equivalent of demanding a unicorn bless each an every sandwich before a dolphin plays a game of texas hold ‘em and looses to Bill Gates before any medical care can take place.
When you tell doctors what to do in their medical practice, you need to have a medical license. This guy doesn't. No amount of political ambition will make that true.
Mandating, and I want to highlight this because this is absurd, that psychiatric issues be treated to “resolution” is not a standard in medicine—it's not even a standard of psychiatric care. It is not a standard in the care of gender dysphoria, which can often exacerbate psychiatric symptoms. This is medically unsound and a danger to the public health of the people of the state of Missouri.
Anthony Bailey is practicing medicine without a license.
His emergency order constitutes a serious danger to the health, safety, or welfare of a patient in that his rules effectively abruptly discontinue or prohibit gender affirming care.
As I have established, that is a report that needs to be made to the following authorities:
Missouri Board of Healing Arts
3605 Missouri Boulevard P.O. Box 4 Jefferson City, Missouri, 65109 Phone Number: (573) 751-0098 Press 2 to file complaints.
(A) Fails to assess (at least annually) whether the patient continues to have gender
dysphoria;
(B) Fails to obtain informed consent by disclosing conspicuously—on its website,
physically in writing, and orally in person by the prescribing provider—to the patient and (if the patient is a minor) to the patient’s parents or legal guardians, by means of information that includes language materially identical to each point below, that:
1. The use of puberty blocker drugs or cross-sex hormones to treat gender dysphoria
has been described as experimental by researchers and is not approved by the
Food and Drug Administration (FDA);8
2. The use of puberty blocker drugs or cross-sex hormones to treat gender dysphoria
has been recognized by medical authorities in Europe, after independent reviews, to be experimental or lacking sufficient evidence and has been substantially restricted in countries such as Sweden, Finland, Norway, and the United Kingdom;9
3. The U.S. Agency for Healthcare Research and Quality has determined, “There is a lack of current evidence-based guidance for the care of children and adolescents who identify as transgender, particularly regarding the benefits and harms of pubertal suppression, medical affirmation with hormone therapy, and surgical affirmation”;10
4. A study spanning 5 decades of almost 5,000 transgender people who had received cross-sex hormones, regardless of treatment type, nevertheless showed a “two- fold increased mortality risk,” which “did not decrease over time”;11
5. An article in the International Review of Psychiatry found that, according to ten different studies, the vast majority of children, 85.2%, experiencing gender dysphoria grew to become comfortable with their natal sex, and the Endocrine Society found that “the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/gender incongruent in adolescence”;12
6. A scientific article in the Journal of Infant, Child, and Adolescent Psychotherapy concluded that “encouraging mastectomy, ovariectomy, uterine extirpation, penile disablement, tracheal shave, the prescription of hormones which are out of line with the genetic make-up of the child, or puberty blockers, are all clinical practices which run an unacceptably high risk of doing harm”;13
7. Sweden’s National Board of Health and Welfare (“NBHW”) recently declared that, at least for minors, “the risks of puberty suppressing treatment with GnRH-analogues and gender-affirming hormonal treatment currently outweigh the possible benefits”;14
8. A systematic review of the evidence by researchers in Europe regarding natal boys concluded that there is “insufficient evidence to determine the efficacy or safety of hormonal treatment” and that certain hormonal interventions can potentially cause or worsen depression;15
9. One scientific study noted that an individual whose friend identifies as transgender is “more than 70 times” as likely to similarly identify as transgender, suggesting that many individuals may “incorrectly believe themselves to be transgender and in need of transition” because of social factors”;16
10. A follow-up study recently determined, “Youths with a history of mental health issues were especially likely to have taken steps to socially and medically transition”;17
11. A study of 1,655 parental reports found that “parents tended to rate their children as worse off after transition” and “that parents believed gender clinicians and clinics pressured the families toward transition”;18
12. The FDA has issued a warning that puberty blockers can lead to brain swelling and blindness;19
13. Puberty is associated with profound developmental maturation of the brain, and researchers have expressed concern that interruption of normally timed puberty may therefore be harmful to the brain;20
14. Multiple observational studies conclude that nearly all children prescribed puberty blockers for gender dysphoria have later been prescribed cross-sex hormones. For example, an independent review of gender transition interventions based on data from multiple countries determined that “almost all children and young people who are put on puberty blockers go on to sex hormone treatment”;21
15. After performing a systematic review, the Endocrine Society was unable to draw any conclusions on whether hormone therapy reduces death by suicide among individuals identifying as transgender;22
16. A summary of available evidence written by medical societies “from around the globe” found that “there are no proven methods to preserve fertility in early pubertal transgender adolescents”;23
17. Researchers have suggested that allowing a child to go through puberty without medical intervention may resolve gender dysphoria, whereas puberty suppression may improperly influence and worsen gender dysphoria;24
18. Puberty suppression presents a risk of stunted growth and failure to attain normal peak bone density;25
19. There is a lack of understanding in the medical community of the causes of gender dysphoria, as well as an admission that more research is needed to fully understand the effects, especially long-term effects, of puberty suppression and cross-sex hormone treatment;26
20. A significant number of children and adolescents who begin gender transition interventions desist in their desire to transition, although the actual number is unknown because of low rates of follow up;27
21. The Endocrine Society has acknowledged that children experiencing gender dysphoria are more likely to identify with their natal sex if they do not socially transition;28
22. The World Professional Association for Transgender Health (“WPATH”) has acknowledged, “In most children, gender dysphoria will disappear before, or early in, puberty”;29 and
23. Many medical, hormonal, or surgical transition interventions are irreversible.30
(C) Fails to ensure that, for at least the 3 most recent consecutive years, the patient has
exhibited a medically documented, long-lasting, persistent and intense pattern of
gender dysphoria
Just, wow. In a bad way. This is such bad policy development, never mind the legal issues you have raised.
Owen, you are beating a dead horse. This fight started with the advent of managed care medicine. The first volley was in Seattle in 1992. https://www.spokesman.com/stories/1995/sep/24/feds-drop-investigation-of-alternative-doctor/. I just happened to be there when the attack took place. I was also present at the end of that same week, Friday evening in Dallas, TX for an association meeting. I do not remember the name of the association, but was geared toward the recognition of Alternative Medicine, now called complementary medicine. However, I can tell you that these kinds of attacks against the government for intruding into the practice of medicine, starting in AZ, were adjudicated with the same arguments. And were defeated.
I particularly remember these were raised against IMEs and other 3rd party administrators who were backed by the State. Back then, just as now, they actually control the care of patients. They were Dx patients that they never examined.
Remember, The Medical Community is a potent force in Any State Capital. But also remember, the law is not logical. It is the law. And those who write the laws can and will interpret them any way they see fit for Party in Power.
And as you can readily observe by what is happening in the courts TODAY, they won't interfere with the other branches of government in a territorial dispute.
Harvey Loomstein, PhD.