Mississippi Today

Mississippi Medicaid: Gender-affirming care for kids is not ‘safe and effective’

Published

2 years ago

February 17, 2023

Mississippi Medicaid: Gender-affirming care for kids is not ‘safe and effective’

by Molly Minta, Kayleigh Skinner and Kate Royals, Mississippi Today
February 16, 2023

The Mississippi Division of Medicaid is the first state agency to take a public position on gender affirming care to transgender children, stating there is not enough medical literature to support that it is a “safe and effective treatment for gender dysphoria.”

Drew Snyder, Mississippi Division of Medicaid executive director, gives a presentation during a Senate Medicaid hearing at the state Capitol in Jackson, Miss., Wednesday, November 9, 2022.

In a letter to managed care companies that contract with Medicaid, Executive Director Drew Snyder wrote that the agency concurs with its counterpart in Florida that there is not enough evidence that “sex reassignment through medical intervention” is safe. Florida’s report was released in June of last year.

Snyder did not respond to a call and text to his personal cell phone Thursday afternoon. His letter was addressed to executives of Molina Healthcare of Mississippi, UnitedHealthCare Community & State MS and Magnolia Health Plan. Communications officials with the three companies did not immediately respond to requests for comment.

“As the care coordination organizations for the majority of children and adolescents enrolled in Mississippi Medicaid, your input is welcome on approaches to effectively address any health needs without posing risky side effects or irreversible changes,” he wrote.

It’s unclear if Snyder’s letter has any effect on what services are currently covered, or why he reached out to the managed care companies instead of providers of gender-affirming care. If the agency does opt to exclude this treatment, it would join a handful of states already doing so. Alaska, Arizona, Arkansas, Florida, Kentucky, Missouri, Nebraska, Ohio, Tennessee and Texas all have Medicaid policies that specifically exclude transgender health coverage, according to the Movement Advancement Project.

The Feb. 15 letter first reported by the Magnolia Tribune comes as a bill is working its way through the Legislature that would ban this kind of treatment for trans minors in Mississippi. House Bill 1125 would prevent the state’s roughly 2,400 trans kids and their families from getting hormone therapy or puberty blockers in the state.

Snyder’s letter contradicts the advice and position of major medical associations in the U.S. on gender-affirming care. It is evidence-based, and not considered “experimental” by the majority of the medical community.

Also known as the “Regulate Experimental Adolescent Procedures” (REAP) Act, the bill bans Mississippi doctors from performing gender-confirmation surgery or prescribing drugs such as puberty blockers or hormones to those under 18.

The bill would allow for the doctors’ licenses to be revoked and create a “civil claim of action” for them to be sued with a 30-year statute of limitations. It would prohibit insurers or Medicaid from reimbursing families for such procedures and would strip doctors who provide them of the state’s generous tort claims protections.

Gender-affirming care, or “sex reassignment” as Mississippi officials have called it, refers to a broad range of interventions, from medical treatment to psychological and social support, that aims to affirm an individual’s gender identity, especially when it is different from the one they were assigned at birth, according to the World Health Organization.

Decades of research support gender-affirming care as the proper treatment for gender dysphoria, the distress trans people can experience when their physical features do not match their gender identity.

Research has repeatedly shown that gender-affirming care significantly boosts the chances that trans kids will live to see adulthood. A study published last year in the peer-reviewed Journal of the American Medical Association found that over the course of a year, gender-affirming care was associated with 60% reduced odds of moderate to severe depression and 73% less odds of suicidal thoughts.

Stacie Pace, the co-owner of Spectrum: The Other Clinic, said that the two main international medical organizations that write guidelines for gender-affirming care — the World Professional Association for Transgender Health and the Endocrine Society — cite hundreds of references and are easy to find on the internet.

“All it takes is just a quick Google, and all this research is right there in front of you,” she said.

There are three main forms of gender-affirming medical treatment: Puberty blockers, which are only for kids, hormone therapy and gender-confirmation surgery. In Mississippi, there is no clinic that performs any kind of gender-confirmation surgery on minors, according to in-state providers of gender-affirming care.

Puberty blockers are medications that pause puberty in kids. Research has shown the effects are reversible. While hormone therapy can cause some permanent effects, such as a deeper voice, it typically takes at least a year for this to occur, Pace said.

But Pace added that many other side effects of hormone therapy, like increased muscle mass or the development of breast tissue, will disappear over time if a patient ceases treatment.

“It will take about as long as it took for it to occur, but it will go away,” she said.

Alex Mills, a pharmacist who has worked with trans people, said he was confused by the letter. While a minority of his patients are on Medicaid, he hasn’t heard of Medicaid covering prescriptions for hormone therapy for trans adults since he started working in Jackson three years ago. If Medicaid covered prescriptions for his outspoken patients, Mills said they would tell him.

“I feel like they’re just kind of jumping on the bandwagon,” he said. “It’s an irrelevant comment, because they (Medicaid) haven’t been covering (hormone therapy), so I’m just confused why they’re even saying this. Just to say it?”

Mills said Medicaid has covered medical visits, but that he doesn’t know if it has covered puberty blockers, which can be pricey – up to $1,500 for a single shot that lasts a month. Hormone therapy is cheaper, so Mills recommends patients use GoodRx coupons to make their prescriptions more affordable.

At Spectrum, Pace said just one youth patient is currently on Medicaid. But of the clinic’s roughly 1,000 adult patients, about half are Medicaid beneficiaries.

The Division of Medicaid has not taken a stance on other issues being considered by the Legislature. One of those is extending postpartum care from 60 days to one year for new mothers, which Speaker of the House Philip Gunn said he has asked the agency to do.

When a committee tasked with advising Medicaid about health and medical care services voted unanimously in October to recommend that the Legislature extend postpartum coverage, the Division of Medicaid still did not take a stance.

The State Board of Medical Licensure, which would enforce the bill’s provision revoking providers’ licenses, has not responded to questions from Mississippi Today. The University of Mississippi Medical Center, which has provided gender-affirming care to trans kids at its LGBTQ-focused TEAM Clinic, said earlier this month that “we have no comment for now.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Did you miss our previous article…
https://www.biloxinewsevents.com/?p=209008

Up Next

College baseball is back, so whose turn is it in Mississippi?

Don't Miss

FBI investigates Rankin County deputies who lawyers say left Michael Corey Jenkins in the hospital

Mississippi Today

Early voting proposal killed on last day of Mississippi legislative session

Published

12 hours ago

April 3, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-04-03 13:02:00

by Taylor Vance, Mississippi Today
April 3, 2025

Mississippi will remain one of only three states without no-excuse early voting or no-excuse absentee voting.

Senate leaders, on the last day of their regular 2025 session, decided not to send a bill to Gov. Tate Reeves that would have expanded pre-Election Day voting options. The governor has been vocally opposed to early voting in Mississippi, and would likely have vetoed the measure.

The House and Senate this week overwhelmingly voted for legislation that established a watered-down version of early voting. The proposal would have required voters to go to a circuit clerk’s office and verify their identity with a photo ID.

The proposal also listed broad excuses that would have allowed many voters an opportunity to cast early ballots.

The measure passed the House unanimously and the Senate approved it 42-7. However, Sen. Jeff Tate, a Republican from Meridian who strongly opposes early voting, held the bill on a procedural motion.

Senate Elections Chairman Jeremy England chose not to dispose of Tate’s motion on Thursday morning, the last day the Senate was in session. This killed the bill and prevented it from going to the governor.

England, a Republican from Vancleave, told reporters he decided to kill the legislation because he believed some of its language needed tweaking.

The other reality is that Republican Gov. Tate Reeves strongly opposes early voting proposals and even attacked England on social media for advancing the proposal out of the Senate chamber.

England said he received word “through some sources” that Reeves would veto the measure.

“I’m not done working on it, though,” England said.

Although Mississippi does not have no-excuse early voting or no-excuse absentee voting, it does have absentee voting.

To vote by absentee, a voter must meet one of around a dozen legal excuses, such as temporarily living outside of their county or being over 65. Mississippi law doesn’t allow people to vote by absentee purely out of convenience or choice.

Several conservative states, such as Texas, Louisiana, Arkansas and Florida, have an in-person early voting system. The Republican National Committee in 2023 urged Republican voters to cast an early ballot in states that have early voting procedures.

Yet some Republican leaders in Mississippi have ardently opposed early voting legislation over concerns that it undermines election security.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

Mississippi Legislature approves DEI ban after heated debate

Published

1 day ago

April 2, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-04-02 16:34:00

by Michael Goldberg, Mississippi Today
April 2, 2025

Mississippi lawmakers have reached an agreement to ban diversity, equity and inclusion programs and a list of “divisive concepts” from public schools across the state education system, following the lead of numerous other Republican-controlled states and President Donald Trump’s administration.

House and Senate lawmakers approved a compromise bill in votes on Tuesday and Wednesday. It will likely head to Republican Gov. Tate Reeves for his signature after it clears a procedural motion.

The agreement between the Republican-dominated chambers followed hours of heated debate in which Democrats, almost all of whom are Black, excoriated the legislation as a setback in the long struggle to make Mississippi a fairer place for minorities. They also said the bill could bog universities down with costly legal fights and erode academic freedom.

Democratic Rep. Bryant Clark, who seldom addresses the entire House chamber from the podium during debates, rose to speak out against the bill on Tuesday. He is the son of the late Robert Clark, the first Black Mississippian elected to the state Legislature since the 1800s and the first Black Mississippian to serve as speaker pro tempore and preside over the House chamber since Reconstruction.

“We are better than this, and all of you know that we don’t need this with Mississippi history,” Clark said. “We should be the ones that say, ‘listen, we may be from Mississippi, we may have a dark past, but you know what, we’re going to be the first to stand up this time and say there is nothing wrong with DEI.'”

Legislative Republicans argued that the measure — which will apply to all public schools from the K-12 level through universities — will elevate merit in education and remove a list of so-called “divisive concepts” from academic settings. More broadly, conservative critics of DEI say the programs divide people into categories of victims and oppressors and infuse left-wing ideology into campus life.

“We are a diverse state. Nowhere in here are we trying to wipe that out,” said Republican Sen. Tyler McCaughn, one of the bill’s authors. “We’re just trying to change the focus back to that of excellence.”

The House and Senate initially passed proposals that differed in who they would impact, what activities they would regulate and how they aim to reshape the inner workings of the state’s education system. Some House leaders wanted the bill to be “semi-vague” in its language and wanted to create a process for withholding state funds based on complaints that almost anyone could lodge. The Senate wanted to pair a DEI ban with a task force to study inefficiencies in the higher education system, a provision the upper chamber later agreed to scrap.

The concepts that will be rooted out from curricula include the idea that gender identity can be a “subjective sense of self, disconnected from biological reality.” The move reflects another effort to align with the Trump administration, which has declared via executive order that there are only two sexes.

The House and Senate disagreed on how to enforce the measure but ultimately settled on an agreement that would empower students, parents of minor students, faculty members and contractors to sue schools for violating the law.

People could only sue after they go through an internal campus review process and a 25-day period when schools could fix the alleged violation. Republican Rep. Joey Hood, one of the House negotiators, said that was a compromise between the chambers. The House wanted to make it possible for almost anyone to file lawsuits over the DEI ban, while Senate negotiators initially bristled at the idea of fast-tracking internal campus disputes to the legal system.

The House ultimately held firm in its position to create a private cause of action, or the right to sue, but it agreed to give schools the ability to conduct an investigative process and potentially resolve the alleged violation before letting people sue in chancery courts.

“You have to go through the administrative process,” said Republican Sen. Nicole Boyd, one of the bill’s lead authors. “Because the whole idea is that, if there is a violation, the school needs to cure the violation. That’s what the purpose is. It’s not to create litigation, it’s to cure violations.”

If people disagree with the findings from that process, they could also ask the attorney general’s office to sue on their behalf.

Under the new law, Mississippi could withhold state funds from schools that don’t comply. Schools would be required to compile reports on all complaints filed in response to the new law.

Trump promised in his 2024 campaign to eliminate DEI in the federal government. One of the first executive orders he signed did that. Some Mississippi lawmakers introduced bills in the 2024 session to restrict DEI, but the proposals never made it out of committee. With the national headwinds at their backs and several other laws in Republican-led states to use as models, Mississippi lawmakers made plans to introduce anti-DEI legislation.

The policy debate also unfolded amid the early stages of a potential Republican primary matchup in the 2027 governor’s race between State Auditor Shad White and Lt. Gov. Delbert Hosemann. White, who has been one of the state’s loudest advocates for banning DEI, had branded Hosemann in the months before the 2025 session “DEI Delbert,” claiming the Senate leader has stood in the way of DEI restrictions passing the Legislature.

During the first Senate floor debate over the chamber’s DEI legislation during this year’s legislative session, Hosemann seemed to be conscious of these political attacks. He walked over to staff members and asked how many people were watching the debate live on YouTube.

As the DEI debate cleared one of its final hurdles Wednesday afternoon, the House and Senate remained at loggerheads over the state budget amid Republican infighting. It appeared likely the Legislature would end its session Wednesday or Thursday without passing a $7 billion budget to fund state agencies, potentially threatening a government shutdown.

“It is my understanding that we don’t have a budget and will likely leave here without a budget. But this piece of legislation …which I don’t think remedies any of Mississippi’s issues, this has become one of the top priorities that we had to get done,” said Democratic Sen. Rod Hickman. “I just want to say, if we put that much work into everything else we did, Mississippi might be a much better place.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

House gives Senate 5 p.m. deadline to come to table, or legislative session ends with no state budget

Published

1 day ago

April 2, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-04-02 16:13:00

by Taylor Vance, Mississippi Today
April 2, 2025

The House on Wednesday attempted one final time to revive negotiations between it and the Senate over passing a state budget.

Otherwise, the two Republican-led chambers will likely end their session without funding government services for the next fiscal year and potentially jeopardize state agencies.

The House on Wednesday unanimously passed a measure to extend the legislative session and revive budget bills that had died on legislative deadlines last weekend.

House Speaker Jason White said he did not have any prior commitment that the Senate would agree to the proposal, but he wanted to extend one last offer to pass the budget. White, a Republican from West, said if he did not hear from the Senate by 5 p.m. on Wednesday, his chamber would end its regular session.

“The ball is in their court,” White said of the Senate. “Every indication has been that they would not agree to extend the deadlines for purposes of doing the budget. I don’t know why that is. We did it last year, and we’ve done it most years.”

But it did not appear likely Wednesday afternoon that the Senate would comply.

The Mississippi Legislature has not left Jackson without setting at least most of the state budget since 2009, when then Gov. Haley Barbour had to force them back to set one to avoid a government shutdown.

The House measure to extend the session is now before the Senate for consideration. To pass, it would require a two-thirds majority vote of senators. But that might prove impossible. Numerous senators on both sides of the aisle vowed to vote against extending the current session, and Lt. Gov. Delbert Hosemann who oversees the chamber said such an extension likely couldn’t pass.

Senate leadership seemed surprised at the news that the House passed the resolution to negotiate a budget, and several senators earlier on Wednesday made passing references to ending the session without passing a budget.

“We’ll look at it after it passes the full House,” Senate President Pro Tempore Dean Kirby said.

The House and Senate, each having a Republican supermajority, have fought over many issues since the legislative session began early January.

But the battle over a tax overhaul plan, including elimination of the state individual income tax, appeared to cause a major rift. Lawmakers did pass a tax overhaul, which the governor has signed into law, but Senate leaders cried foul over how it passed, with the House seizing on typos in the Senate’s proposal that accidentally resembled the House’s more aggressive elimination plan.

The Senate had urged caution in eliminating the income tax, and had economic growth triggers that would have likely phased in the elimination over many years. But the typos essentially negated the triggers, and the House and governor ran with it.

The two chambers have also recently fought over the budget. White said he communicated directly with Senate leaders that the House would stand firm on not passing a budget late in the session.

But Senate leaders said they had trouble getting the House to meet with them to haggle out the final budget.

On the normally scheduled “conference weekend” with a deadline to agree to a budget last Saturday, the House did not show, taking the weekend off. This angered Hosemann and the Senate. All the budget bills died, requiring a vote to extend the session, or the governor forcing them into a special session.

If the Legislature ends its regular session without adopting a budget, the only option to fund state agencies before their budgets expire on June 30 is for Gov. Tate Reeves to call lawmakers back into a special session later.

“There really isn’t any other option (than the governor calling a special session),” Lt. Gov. Delbert Hosemann previously said.

If Reeves calls a special session, he gets to set the Legislature’s agenda. A special session call gives an otherwise constitutionally weak Mississippi governor more power over the Legislature.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.