Out Leadership’s Business Climate Index for the 50 United States is an assessment of states’ performance on LGBTQ+ inclusion. It measures the impact government policies and prevalent attitudes have on the LGBTQ+ people residing in each state, quantifying the economic imperatives for inclusion and the costs of discrimination. It equips business leaders and policymakers with a clear sense of the most impactful steps states can take to make themselves more hospitable to forward-thinking, innovative, inclusive businesses.
out of a possible 100 points
Missouri’s nondiscrimination laws do not cover sexual orientation or gender identity, though many jurisdictions have passed protections locally. Changing gender markers on a birth certificate requires a court order. The state had also required proof of surgery, but a successful 2013 court challenge to that requirement has left the law in the state unclear; de facto, transgender people are required by state judges with jurisdiction to have had surgery in order to change their markers.
Missouri does not have a ban against conversion therapy. There are no prohibitions on LGBT+ people fostering or adopting in the state, and there are also measures preventing discrimination in adoption.
The state’s senators and governor have established anti-LGBT+ voting records and vocally oppose LGBT+ interests, though Governor Mike Parson has also said that gay people should not be fired on the basis of sexual orientation. Bills that would allow for religious exemptions to nondiscrimination statutes have been introduced in Missouri’s state legislature multiple times, but have not been adopted.
Hate crimes legislation is inclusive of sexual orientation and gender identity in Missouri. Medicaid does not cover transgender healthcare, and the state does not ban private insurance companies from excluding transgender healthcare coverage.
27% of transgender employees reported being mistreatment such as being forced to use a restroom not matching gender in the last year. 27% of LGBT+ individuals in Missouri reported food insecurity, almost double that of their non LGBT+ peers (14%). 27% of LGBT+ individuals in Missouri report making less than $24,000 per year. LGBT+ unemployment (9%) is more than double that of the non-LGBT+ population.
Download this report to learn how and why Out Leadership created the LGBTQ+ Business Climate Index for the 50 U.S. States, with important details about our methodology, including our data standards and practices. NOTE: *HIV criminalization laws are discriminatory and ineffective. These laws fail to account for advances made in treating and controlling HIV, may deter people from getting tested and seeking treatment, and can exacerbate the stigma targeting people living with HIV and LGBTQ+ people.Our Methodology
The legal and cultural situation for LGBTQ+ people varies widely across the country. This map, based on each state's total Business Climate Score, illustrates the states where LGBTQ+ people are empowered to participate more fully and openly in the economy, and the states that are lagging behind.
Our partnerships make our work possible. The first State LGBTQ+ Business Climate Index released in 2019 was funded by a grant from the Gill Foundation. The Index is based on data graciously shared by the Movement Advancement Project and the Williams Institute. Ropes & Gray is our pro bono legal partner for the CEO Business Briefs globally, and their research informs this Index. FCB partnered with us to conduct original market research into American attitudes toward LGBTQ+ workplace inclusion, informing the Regional Context section of the State CEO Briefs. America Competes supported the development of the scoring for the Risk Assessments, particularly for the Future Risk score.
Out Leadership and FCB partnered on original market research into the attitudes of American workers on LGBT+ inclusion, which fielded in 2019 and 2020. These briefs as a whole will be updated on an ongoing basis by Out Leadership because we recognize the ever-changing nature of policy on the local, state, and national level.
Only 50.8% of LGBT+ workers in the Midwest are out at work. They are only slightly more comfortable being open with their managers than other regions (14% more likely), but they are the least likely to cover their identity at work (17% less likely than nationwide). This could be due to the Midwest having the lowest rates for observing microaggressions (23% less likely) and hearing or engaging in negative conversations on average. However, workers in this region do not typically go out of their way to do business with inclusive companies (21% less likely than the nation as a whole). This is primarily driven by those who live in more rural areas where respondents were 85% less likely to do business with companies that are inclusive.
Unless otherwise noted, all comparisons for more or less likely are compared to the National results. Regional results are based off of 1,500 respondents (LGBT+ and Non-LGBT+ responses have been weighted to be age-representative for each audience in each region). National results are based off of 600 respondents representative of each audience (LGBT+ vs Non-LGBT+).
States in the Midwest region included: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, North Dakota, Missouri, Nebraska, Ohio, South Dakota, and Wisconsin
Current Legal Status of LGBT+ people
Legal status of the Lesbian, Gay and Bisexual Community
Currently, sexual orientation and gender identity are not protected classes under Missouri’s nondiscrimination laws. While there is no protection from discrimination for LGBT+ people at the state level, at least 17 municipalities have adopted ordinances protecting people from discrimination on the basis of their sexual orientation and gender identity.
Missouri does not have any law to protect state employees from discrimination on the basis of sexual orientation or gender identity.
While Missouri’s nondiscrimination law does not extend protection against discrimination based on sexual orientation, the Missouri Department of Social Services (DSS) prohibits discrimination against DSS employees, DSS applicants, and foster care youth on the basis of sexual orientation. This policy does not explicitly extend to gender identity.
There are no laws in Missouri preventing LGBT+ individuals from becoming a foster parent. However, because there is no state law prohibiting discrimination based on sexual orientation or gender identity, LGBT+ individuals could still face discrimination when applying to become a foster parent.
Missouri’s hate crime law provides for enhanced penalties for crimes committed and motivated by sexual orientation. For purposes of the hate crime statute, Missouri defines sexual orientation as “male or female heterosexuality, homosexuality or bisexuality by inclination, practice, identity or expression, or having a self-image or identity not traditionally associated with one’s gender.”
There is no explicit prohibition in the law against an LGBT+ person or couple petitioning to adopt a child in Missouri, as the law uses gender-neutral language. Nor is there any explicit prohibition against an LGBT+ partner adopting a partner’s child. However, no Missouri court has confronted either issue.
Missouri law allows “any person” to petition to adopt a child. A petitioner may be single or married and, if married, the “spouse” may join in the petition to adopt.
Missouri law makes it a Class B felony for an individual with HIV to recklessly expose another to the HIV virus without that person’s knowledge and consent.
Conversion therapy is legal in Missouri, but three cities have banned it locally.
Legal status of the Transgender Community
Transgender individuals in Missouri may receive gender-affirming surgery and legally change their names and gender markers.
While there are no state-specific requirements for transgender individuals to be eligible for gender confirmation surgery, at least one medical center requires potential patients to have been diagnosed with gender dysphoria or to have been evaluated by a healthcare professional experienced in gender issues who certifies that the individual would benefit from the surgery.
A transgender individual may receive a legal name change in Missouri by petitioning the court for a name change. Within 20 days of the petition being granted, the applicant must publish notice of the name change in a newspaper at least three times in the county in which the applicant resides. If there is no newspaper in that county, they can publish it in a newspaper in St. Louis. This notice requirement may be waived if the applicant is a victim of domestic violence or child abuse.
In order to change a gender marker on a birth certificate, a trans person must submit certified court orders indicating their correct gender identity and legal name change. To obtain a court order formally recognizing a transgender individual’s correct gender identity, he or she must petition the county circuit court. (Corrected gender recognition may also be part of the name-change petition.) Before the petition can be granted, Missouri law requires proof that the individual’s sex “has been changed by surgical procedure.” However, in May 2013, a Missouri court found that it was proper to grant an applicant’s petition to formally recognize her correct gender identity notwithstanding the fact that she had not undergone gender affirming surgery. The court noted that a surgical requirement may be “unsuitable, dangerous, or unnecessary” to the applicant in certain circumstances. Transgender individuals may therefore be able to legally change gender markers without surgery if his or her physician attests that such surgery is “unsuitable, dangerous, or unnecessary.”
After obtaining a legal name change, transgender individuals may change their name on their Missouri driver’s license or identification card by presenting a document demonstrating their current name, such as a certified court order of name change, a valid US passport, or a Social Security or Medicare Card.
Individuals may also change their gender marker on their driver’s license by filing a completed Gender Designation Change Request Form, which requires the individual’s healthcare provider to certify the individual’s gender identity and that it “can reasonably be expected to continue as such in the foreseeable future.”
Missouri’s state Medicaid (MO HealthNet) does not cover transition-related healthcare services, and the state does not ban private insurance companies from restricting coverage for transition-related healthcare.
Government statements and actions
There are multiple anti-LGBT+ bills before the state legislature in the 2020 session, including ones that would force student athletes to participate in sports according to their biological sex, and another that would require parental permission to teach LGBT+-related topics in schools.
Missouri lawmakers recently rejected a proposal to amend the House’s existing internal rules covering equal employment opportunities and discrimination to include sexual orientation and gender identity.
Two “bathroom bills” were introduced in the Missouri General Assembly in 2017 and again in 2018. One bill would have required transgender students at public school to use restrooms, locker rooms, and shower facilities corresponding to their gender at birth, while the second bill would have broadened the application to all persons and public buildings. Neither bill was enacted into law.
In February 2019, the Missouri Supreme Court held that a transgender student who was denied access to the bathroom and locker room corresponding with his gender identity could sue the school district for sex discrimination under Missouri’s nondiscrimination law.
In 2016, a Senate Joint Resolution was introduced in the Missouri General Assembly which would have prohibited imposing penalties on religious organizations for denying services to LGBT+ individuals based on a “sincere religious belief” that marriage is between a man and a woman. The resolution was ultimately defeated in the House as a result of a 39-hour filibuster, the longest such filibuster in memory.
A similar bill was introduced in February 2018. The bill went one step further than the 2016 resolution by prohibiting the imposition of penalties on individuals, as well as religious organizations. The bill would also have prohibited adverse decisions related to accreditation, certification, or licensing based on religious beliefs related to marriage, family or sexuality. The bill also, notably, contained nondiscrimination protections for sexual orientation and gender identity, the first time a religious exemptions bill in Missouri had done so. The bill did not move to committee or to debate.
In mid-January 2018, The Youth Mental Health Preservation Act was introduced in the Missouri General Assembly. It sought to prohibit licensed medical professionals from engaging in conversion therapy of a minor. The bill targeted “any practices or treatments that seek to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.” The bill was not adopted during the 2018 session. The bill was reintroduced in the General Assembly on January 9, 2019 and remains stalled in committee. St Louis City passed a resolution supporting the act in February, 2019.
In December 2017, the Chief of the Department for Children and Families’ spoke out against discrimination of same-sex couples in adoption and foster care cases and announced a “zero tolerance” policy for discrimination based on sexual orientation in such cases.
For more context around these scores, and to learn more about the criteria we used to assess how state laws, actions and attitudes toward LGBTQ+ people create business and talent risks, please visit www.outleadership.com/staterisk.
Socio-cultural Environment of LGBT+ people
Status of LGBT+ Organizing and Community
At least three adoption and/or foster care agencies in Missouri support LGBT+ adoption. One has been identified as a “Leader in Supporting and Serving LGBTQ Youth and Families” by All Children – All Families (ACAF). The remaining two agencies are working with the Human Rights Campaign to review their policies and practices so as to be fully supportive of LGBT individuals and families.
More than half of the homeless population of Kansas City, including children, identifies as LGBT+, and the Kansas City Center for Inclusion is confident that trend is consistent across the state.
Cultural Views of the LGBT+ Community
In 2016, a lesbian couple was denied a spot in a retirement home based on their sexual orientation. In 2019, a judge ruled that the refusal was legal because there are no laws preventing LGBT+ discrimination in housing in the state.