Missouri Attorney General Andrew Bailey, a self-described “constitutional conservative” who has sought to restrict access to reproductive and gender-affirming health care, will remain the state’s top prosecutor.

Bailey, a Republican endorsed by former President Donald Trump, defeated Democrat Elad Gross in the state’s attorney general race per The Associated Press. Missouri Gov. Mike Parsons (R) first appointed Bailey to the role in January 2023.

Throughout his 20 months in office, Bailey has made national headlines for using his powers as attorney general to launch investigations into a children’s hospital that provided gender-affirming care; a gym that welcomed transgender patrons; and the big-box retailer Target, accusing it of selling “woke” merchandise. He also took legal action against clinics run by Planned Parenthood, one of the largest providers of reproductive care in the country.

In October, Bailey announced his latest investigation: He’s pursuing Google for allegedly “censoring conservative speech.”

“Google is waging war on the democratic process. It’s time to fight back,” he wrote in a post on X (formerly Twitter).

A spokesperson for Google told Reuters that Bailey’s allegations are “totally false.”

That same month, Bailey, along with Kansas Attorney General Kris Kobach and Idaho Attorney General Raúl Labrador, filed a lawsuit against the Food and Drug Administration in order to try to reinstate restrictions on mifepristone, one of the two pills taken as part of a medication abortion.

They argued in the suit that access to mifepristone has resulted in lowered “birth rates for teenaged mothers,” which they said caused harm to states in the form of a decreased population and a “diminishment of political representation and loss of federal funds.”

During his tenure as state attorney general, Bailey has repeatedly leveraged his powers to probe institutions that run counter to the beliefs of the GOP. One of his first actions in office was to investigate the Washington University Pediatric Transgender Center in St. Louis, after a former caseworker, Jamie Reed, accused the center of malpractice. Bailey granted Reed whistleblower protection and began requesting patients’ medical records; later he also sought out information on therapists and social workers who worked with trans youth.

Though a Missouri judge found that Bailey’s office didn’t have any right to private medical information, that hasn’t stopped him from making life difficult for transgender Missourians. Last year, he signed an emergency rule that created a burdensome set of requirements for trans people of all ages seeking medical care.

Katy Erker-Lynch, the executive director of PROMO, a Missouri LGBTQ+ advocacy group, told Kansas City NPR affiliate KCUR that Bailey’s actions have “created a hostile environment for medical providers where they are afraid to stay and practice medicine.”

In April, a Democratic-led Senate Finance Committee report named Bailey an official who was “weaponizing their oversight authorities for their own political gain, at the expense of LGBTQIA+ people and their families.”

Now, with his victory, Bailey will be able to continue restricting access to gender-affirming and reproductive health care, rolling back diversity programs and Title IX protections and keeping exonerated people incarcerated in the deep-red state.