Trans Resource Navigator

Missouri

ID documents
Restrictive
Care
Restrictive
Shield lawA state law that protects patients and providers of gender-affirming care from investigations, subpoenas, or extradition attempts by states that ban that care.
No

Missouri is one of the harder states for trans people.

More about Missouri

A name change is possible in circuit court, but the new name must be published in a newspaper three times, and the only waiver is for abuse survivors. Changing the sex on a Missouri birth certificate takes a court order saying the sex was changed "by surgical procedure", and the Department of Revenue no longer uses its old gender-change form for licenses. Since August 28, 2023, the SAFE Act (SB 49) bars hormones, puberty blockers, and surgery for gender transition for anyone under 18 (with a grandfather clause), MO HealthNet (Medicaid) does not pay for this care at any age, and prisons may not provide gender transition surgery. Adults with private insurance or who pay cash can still get hormone therapy. November 3, 2026 ballot: Amendment 3 would write the ban on care for minors into the state constitution.

This state’s pages are drafts written from official sources and not yet checked by a person. What this means

Your documents, in order

Most people go in this order, because each office checks the one before it. On every document, updating your name and changing your gender marker are separate questions with separate answers.

  1. Legal name changeState court
    Name
    LimitedNewspaper notice required, hearing sometimes
  2. Social SecurityFederal, same in every state
    Name
    YesAfter your legal name change
    Gender marker
    NoCannot be changed right now
  3. Driver's license / state IDMissouri DMV
    Name
    YesAfter your legal name change
    Gender marker
    LimitedM or F offered
  4. US passportFederal, same in every state
    Name
    YesAfter your legal name change
    Gender marker
    NoCannot be changed right now
  5. Birth certificateOnly if born in Missouri
    Name
    YesAfter your legal name change
    Gender marker
    LimitedM or F with proof of surgery

Born somewhere other than Missouri? Your birth certificate follows the state where you were born. Choose your birth state

Gender-affirming care

Adults
Limited
Under 18
Banned
Adults in Missouri can get hormone therapy, but MO HealthNet (Medicaid) will not pay for hormones or surgery for gender transition at any age, and state prisons may not provide gender transition surgery.Find clinics, health centers, telehealth, and ways to pay

Local help

Statewide organizations

  • PROMO (Missouri's statewide LGBTQ+ advocacy organization)[7]

    Statewide advocacy group. Its Transgender Justice page explains SB 49, where adults and youth can still get care, and lists local trans groups across Missouri.

    • Free

    Serves: Statewide

  • Legal Services of Eastern Missouri[8]

    Free civil legal aid for people with low income in St. Louis and eastern Missouri, including help with Medicaid and other public benefits. Name changes are not a listed practice area, so ask at intake. Apply online or call 314-534-4200 or 800-444-0514 (phone intake Monday, Wednesday, and Thursday, 9 am to 1 pm).

    • Free
    314-534-4200701 Market Street, Suite 1100, St. Louis, MO 63101

  • ACLU of Missouri[9][10]

    Civil liberties group that co-counseled the state-court challenge to SB 49 and tracks anti-trans legislation in Missouri.

    • Free

  • Trans Lifeline[7]

    Peer support hotline run by and for trans people, 877-565-8860. PROMO also lists it for Missouri.

    • Free
    877-565-8860
Sources for this page (10)

Sources

10 sources. Numbers in the text, like [1], point here.

  1. RSMo 191.1720, Missouri Save Adolescents from Experimentation (SAFE) ActMissouri Revisor of Statutes, Law. accessed
    “The provisions of this subsection shall expire on August 28, 2027.”
  2. RSMo 208.152, MO HealthNet covered servicesMissouri Revisor of Statutes, Law. accessed
    “There shall be no payments made under this section for gender transition surgeries, cross-sex hormones, or puberty-blocking drugs.”
  3. RSMo 193.215, amendment of vital recordsMissouri Revisor of Statutes, Law. accessed
    “Upon receipt of a certified copy of an order of a court of competent jurisdiction indicating the sex of an individual born in this state has been changed by surgical procedure and that such individual's name has been changed, the certificate of birth of such individual shall be amended.”
  4. RSMo 527.290, notice of name changeMissouri Revisor of Statutes, Law. accessed
  5. Missouri state profileMovement Advancement Project, Organization. accessed
  6. 2026 ballot measures (Amendment 3, HCS HJR 73)Missouri Secretary of State, Official page. accessed
    “Prohibit gender transition procedures for minors?”
  7. Transgender JusticePROMO, Organization. accessed
  8. Get Help NowLegal Services of Eastern Missouri, Organization. accessed
  9. ACLU of MissouriOrganization. accessed
  10. E.N. v. Kehoe (formerly Noe v. Parson)Lambda Legal, Organization. accessed