Shira Berkowitz, Senior Director of Public Policy & Advocacy of the Missouri LGBTQ+ advocacy group PROMO, spoke about state-level LGBTQ+ rights and advocacy work at the Gephardt Institute on Oct. 17.

In late August, Missouri banned gender-affirming care for minors who were not already receiving treatment. The Washington University Transgender Center took this ban a step further and banned gender-affirming care for minors who were receiving care prior. The ban on gender-affirming care for minors may only be the start of limitations we will see in transgender medical care.

“We’re going to see a bill this year, it’s going to have legs so it will be scary, that’s going to try to take away the value and the understanding of DEI in med school curriculum,” said Berkowitz. 

DEI prevents discrimination in healthcare on the basis of race, gender, age, ability, and orientation according to the Washington University School of Medicine. The bills that Berkowitz is referring to, HB 489 and HB 1196, will not require medical schools to integrate DEI beliefs and practices into their curriculum. 

“The goal is to produce a generation of physicians that cannot care for the wide population and don’t know what gender-affirming care is,” said Berkowitz.

Berkowitz has a personal connection to this legislation as someone who is part of the trans community. They are a native St. Louisian and received their undergraduate degree and MFA in printmaking, which allowed for them to get involved in not-for-profit organizations in Missouri. 

Berkowitz came out as trans while they worked at the Central Reform Congregation (CRC), a faith organization that funds many not-for-profit organizations in Missouri, Berkowitz said. 

“All inequities lead back to health inequity,” said Berkowtiz.

Many districts in Missouri are also resisting anti-discrimination laws for the LGBTQ+ community, according to Berkowitz. When they first joined PROMO, they hoped to pass non-discrimination laws in the majority of municipalities in Missouri, especially because of their own experience as a member of the LGBTQ+ community. 

“I was very optimistic and eager to be on a team that was going to pass the Missouri Non-Discrimination Act in two years, and five years later I have not done that,” said Berkowitz.

St. Louis City and County both have non-discrimination acts but they do not have much legal significance, as it is legal to fire anyone at will in Missouri. However, there is still value in non-discrimination legislation in these areas.

“It sends a message that they’re safe to be queer in St. Louis,” said Berkowitz.

Berkowitz and their colleagues at PROMO have also been able to secure some legislative wins for the LGBTQ+ community. 

PROMO is destigmatizing HIV through their legislative strides. PROMO helped make post-exposure prophylaxis, a preventative HIV treatment taken 72 hours after exposure, an over-the-counter medication so there are fewer barriers for HIV patients to the treatment they need. 

The upcoming district elections also make it possible to pass impactful legislation that furthers LGBTQ+ rights in the future according to Berkowitz.

“If we can convince that many voters who are disenfranchised, don’t want to vote, [or] don’t vote, to get their voice to elect in a district where you can flip them, then we easily gain the majority,” said Berkowitz. 

According to Berkowitz, if this flip happens, non-discrimination protections will become the standard in the state of Missouri.

These hopes depict a large part of the story of LGBTQ+ advocacy work in Missouri according to Berkowitz.

“There’s so much progress that’s been made and such a long way to go.”