The Republican-led backlash against rights and health care for transgender children is expanding to adults. Missouri’s Republican Attorney General Andrew Bailey issued an emergency ruling Thursday that requires adults to receive 18 months of psychological therapy and to demonstrate “a persistent and intense pattern of gender dysphoria” before they are allowed to undergo gender-affirming care. In a statement, Bailey said the ruling was “necessary due to the skyrocketing number of gender transition interventions.” Critics of the guidelines responded by saying that gender-affirming care has been shown to be medically effective. “The Attorney General’s so-called emergency rule is based on distorted, misleading, and debunked claims and ignores the overwhelming body of scientific and medical evidence supporting this care,” the ACLU and Lambda Legal said in a joint statement.