“If someone is disappointed in Missouri because they can’t harm kids here, we are better if they are gone,” Sen. Bill Eigel, a Weldon Spring Republican who is eyeing a campaign for governor in 2024, said Thursday.

Such statements raise questions about whether Republicans are trying to drive people out of the state who differ with them, and whether the unwelcoming message could ultimately help the GOP maintain its grip on power in the Show-Me State and elsewhere.

When the conservative-leaning U.S. Supreme Court overturned Roe v. Wade over the summer, leaving abortion rights up to the states, U.S. Sen. Josh Hawley, R-Mo., predicted more self-sorting among voters that would ultimately benefit Republicans.

“I would predict that the effect is going to be that more and more red states are going to become more red, purple states are going to become red and the blue states are going to get a lot bluer,” Hawley told reporters. “And I would look for Republicans as a result of this to extend their strength in the Electoral College. And that’s very good news.”

Sen. Greg Razer, D-Kansas City, said Thursday he wouldn’t blame families with transgender children if they left the state.

“The majority party of the Missouri State Senate,” Razer said, “is directing the strong arm of this government to reach in — and against the advice of every major medical organization in this country, against the advice of mental health professionals, and over the objection of parents — are banning a medical treatment needed by a small number of misunderstood children.”

‘I’d love for them to stay’

After debate Thursday, Senate President Pro Tem Caleb Rowden, R-Columbia, said the ban on certain medical treatment for their children shouldn’t be the only factor parents take into consideration when deciding whether to leave Missouri.

The legislation exempts adolescents currently receiving puberty blockers or hormone therapy from the ban, as well as anyone who begins treatment before the law would take effect Aug. 28.

The ban on puberty blockers and hormone therapies lasts into August 2027, unless legislators renew it sometime in the future.

“I think it’s a decision that they have to make,” Rowden said when asked whether the families in question should leave. “I’d love for them to stay in Missouri.”

He said Razer and others have mentioned people who began their transition process after they turned 18.

“I don’t know that putting this pause on it until they reach that age of majority is the be-all-end-all,” Rowden said. “I understand their concern, and I think there are a lot of other great things about the state.”

But Kim Hutton, co-founder of St. Louis-based TransParent and mother of a 19-year-old son who is transgender, said legislators were sending the message that certain children “are not worthy of medical care” in Missouri.

“There is nothing greater about our state than our children,” Hutton responded. “There’s nothing greater to the parent of a transgender child than their child. … And Caleb, and any other politician that is voting ‘yes’ on these bills, is saying our children are not worthy of medical care that will make their life better.”

She said she’s heard “from people who are actually already interviewing and looking outside of Missouri.

One concern mentioned is that by banning puberty blockers, which stop a child from growing into a body that they feel dysphoric in, lawmakers were increasing the need for surgeries later on in life.

“We knew that we wanted to get at the testosterone and the estrogen for minors,” Rowden said. “Most docs … said ‘well we’re not gonna put kids on puberty blockers for six years; it’s not good for them.’ So, you know, it was part of the conversation.”

After the vote, Razer said concessions in the bill — including the grandfather clause for patients taking puberty blockers or hormone therapy before Aug. 28 — likely reduced the pressure on families whose children are currently receiving care. He said if Democrats continued to filibuster, Republicans would’ve forced a vote on a “much worse bill.”

“I wish I could’ve stood on that floor until they gave up, but the truth is, they were going to force me to sit,” Razer said. “We would’ve gotten a much worse bill. And those families would’ve had a much easier decision to make on whether or not to stay.”

What’s next?

Peverill Squire, political science professor at the University of Missouri-Columbia, predicted unwelcoming messages such as Eigel’s would eventually backfire.

“My guess is that this approach to politics will be self-defeating in the long run,” Squire said Friday. “Many of the issues that the Republicans are promoting may have less support in suburban areas than they realize.

He said focus on such wedge issues damage the state’s reputation nationally, with a possible negative effect on economic development. He said areas where there is high support for these issues “are not the areas that are apt to grow over the coming years.”

“Overall, snide comments encouraging people to leave does not seem like a winning strategy,” Squire said. “Senator Eigel’s comment reflects the arrogance of legislative super-majorities.”

During debate on the bill, Razer predicted Republicans weren’t finished with the issue, saying they would go after parents who seek out treatment despite the bill for child abuse.

He cited legislation the Idaho House approved last year to charge parents who take minors outside the state for gender-affirming care with a felony.

“Parents of trans kids: don’t come to the Capitol with your kids. Don’t tell these people who you are,” Razer said.

Meanwhile, it was unclear whether providers of gender-affirming care would move to Illinois if treatment is limited in Missouri.

Dr. Colleen McNicholas, chief medical officer for Planned Parenthood of the St. Louis Region and Southwest Missouri, said the group is “always” looking to provide the “best access” to patients.

While abortion is almost completely outlawed in Missouri, Planned Parenthood still provides other services including gender-affirming care. Its website says patients at least 16 years old may access hormone replacement therapy through Planned Parenthood.

“If you are 16 or 17, there are additional requirements. You will need to have a parent or guardian with you during your visit,” the group’s website says.

Planned Parenthood refers patients younger than 16 to the Transgender Center at St. Louis Children’s Hospital — the clinic that has been the subject of intense scrutiny since Jamie Reed, a former case manager, alleged substandard care last month.

“As patients are calling, as folks are becoming more and more and increasingly, justifiably concerned about their ability to access care here in Missouri, we will work with them to make sure that they do have some options,” McNicholas said Wednesday.

Senate Minority Leader John Rizzo, D-Independence, said the Senate was focusing on “conspiracy theory legislation” instead of addressing the state’s infrastructure and workforce needs. He said the Republicans needed to “keep people in constant fear” to win elections.

He said families with trans children “are legitimately worried” about living in Missouri. “There’s a lot of people on a lot of different issues — not just the trans issues — that are really worried about where our state’s headed,” Rizzo said.

But Rowden said a large majority of the state agrees with the GOP on the transgender health care issue. He said that since coming to the Legislature in 2013, Republicans have always had a two-thirds majority in the Legislature.

“If the positions that we are taking are so extreme, my assumption is we wouldn’t be maintaining those majorities,” Rowden said.

The legislation is Senate Bill 49.