Glenda Starke wears a transgender flag as a counterprotest during a rally in favor of a ban on gender-affirming health care legislation, March 20, 2023, at the Missouri Statehouse in Jefferson City, Mo. Minors in Missouri soon will be required to undergo 18 months of therapy before receiving gender-affirming health care under an emergency rule released Thursday, April 13, 2023, by the state's Republican attorney general. (AP Photo/Charlie Riedel, File)