Missouri tightens gender change ID requirements, adding proof of surgery or court order.

Missouri's Revenue Department has introduced stricter requirements for changing gender on state-issued IDs, requiring proof of gender-affirmation surgery or a court order. Previously, only a doctor's approval was needed. This change has faced criticism from LGBTQ+ rights advocacy group PROMO, who claim it was implemented without prior announcement. Missouri is among 24 states with laws restricting or banning gender-affirming medical care for minors.