Proposes a constitutional amendment establishing the right to make medical decisions, including decisions on gender-affirming care
HJR69 is a proposed Missouri constitutional amendment that would create a new right for individuals to make and carry out their own medical decisions without government interference, so long as the decision is made freely, is supported by a licensed physician, and is consistent with widely accepted, evidence-based standards of care. The resolution would place the measure before voters at the next general election in 2026, or at a special election called by the governor.
The amendment expressly states that the right includes, for adults age 18 and older, the ability to make gender-affirming care decisions. It specifically lists cross-sex hormone treatment and a wide range of gender-affirming medical procedures, including chest surgery, facial surgeries, genital surgeries, voice-related surgeries, reproductive surgeries, fertility preservation, hairline advancement, and body hair removal. It also prohibits the state from burdening, penalizing, prohibiting, interfering with, or discriminating against a person exercising the right, or against those who assist in providing that care, unless the state can show it is using the least restrictive means to advance the individual’s health under evidence-based standards of care.
If adopted, HJR69 would amend Article I of the Missouri Constitution and limit state and local government authority to regulate or restrict covered medical decisions. It would create a constitutional protection that could affect existing or future laws, rules, licensing actions, enforcement policies, and public funding decisions involving medical care, especially gender-affirming care for adults. The measure would also potentially constrain state agencies and political subdivisions from taking actions that could be viewed as interfering with protected medical decisions or with providers and other entities assisting those decisions.
Based on the bill text and caption, the measure appears to be framed as a broad medical autonomy proposal with a specific focus on protecting gender-affirming care. There is no recorded committee transcript or vote history in the provided materials, so no formal legislative debate or roll-call sentiment is available. The language suggests support from sponsors for expanding individual medical freedom, while the specificity of the gender-affirming care provisions indicates the bill is likely intended to address a politically contested area of health policy.
The main point of contention is likely the inclusion of explicit constitutional protection for adult gender-affirming care, including hormone treatment and surgical procedures. Supporters would likely emphasize bodily autonomy, physician-supported decision-making, and limits on government interference, while opponents may object to elevating these procedures into the state constitution or to restricting state regulation of medical practice. Another possible area of dispute is the bill’s standard that state action must use the least restrictive means to advance health, which could be seen as limiting the state’s ability to regulate medical care more broadly.