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

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

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.

READ MORE: What to know about gender-affirming care in Mississippi

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.

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Crystal Springs commercial painter says police damaged his eyesight

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mississippitoday.org – Mina Corpuz – 2024-11-22 12:21:00

CRYSTAL SPRINGS – Roger Horton has worked decades as a commercial painter, a skill he’s kept up with even with the challenge of having what his wife has called “one good eye.” 

It hasn’t stopped him from being able to complete detailed paint jobs and create straight lines without the help of tape. But last year following a head injury, he and others said people have been pointing out a change in his work. Horton says the sight in his right eye is clouded, like he is looking underwater.

Affected vision, short term memory and periods of irritability – potential symptoms of concussion – followed after he was arrested last September. During an encounter with several police officers, Horton alleges more than one slammed his head into a cruiser and placed handcuffs on so tight that he started to bleed. 

“(The officer) was kind of rough with me and all, and he takes my head and I said, ‘What’d I do?’” he recalled recently. 

Horton ended up being convicted of two misdemeanor charges and has paid off the fines, but a year later he still has questions about the arrest and treatment by the police. 

To date, he has not seen a doctor to evaluate his eye and check for vision or cognitive issues. Horton and his wife Rhonda don’t have a car, and transportation to doctor’s appointments in the Jackson area remains a challenge. 

The Hortons have lived in Crystal Springs all their lives, and they have lived in the home the past five years that belonged to Rhonda’s mother. 

More than a quarter of all people in Crystal Springs live below the poverty line, and that includes the couple. Rhonda Horton said it’s hard to make a living because there aren’t a lot of jobs, but they support themselves as painters. 

That’s how they met Yvonne Florczak-Seeman, who lived in Illinois and purchased her first historical property in Crystal Springs in 2019. She splits her time between the two states. 

“We painted that porch bar and the rest is history,” Rhonda Horton said, adding that they went on to complete detailed work on mantles, kitchen cabinets and a cigar room at Florczak-Seeman’s North Jackson Street residence. 

Over the years, the couple built a relationship with Florczak-Seeman, who is seeking to open a women’s empowerment center called the Butterfly Garden, in the building next to city hall. 

Yvonne Florczak-Seeman poses for a portrait at her business, The Butterfly Garden, in Crystal Springs, Miss., Tuesday, Oct. 1, 2024. Credit: Eric Shelton/Mississippi Today

Florczak-Seeman has supported the couple numerous times, including helping them pay a late water bill and offering them work. She called them talented painters and hired them again to paint the interior of the future center, located at East Railroad Avenue. 

In pieces, Rhonda Horton told Florczak-Seeman about her husband’s arrest and later the injuries she said he sustained from it. Florczak-Seeman had questions about the encounter and other potential injustices at play, so she offered to help. 

“I just want them to pay for what they’ve done not just to him, but everybody,” Rhonda Horton said. “That’s what I want, justice.” 

The Arrest

On Sept. 24, 2023, Horton was walking home from a friend’s house when officers approached him. One grabbed his arms to handcuff him, and he remembers them cutting his wrist and causing it to bleed.

Then, he said, a second officer slammed his head into the top of the police car, followed by another officer who slammed his head again. During the encounter, a bag of marijuana that Horton said he found fell out of his pocket onto the ground. 

An officer put Horton in the back of the cruiser and took him to the station where Horton asked to speak to the police chief and call his wife. He said the police took his phone and clothes.

Afterward, he was taken to the Copiah County Detention Center in Gallman. 

Police Chief Tony Hemphill disputed Horton’s allegation of mistreatment, saying he did not sustain any injuries that required hospitalization. He said Horton’s wrist was cut while he resisted arrest. 

“He was not brutalized and targeted,” Hemphill said. “If he had just complied, he wouldn’t have had to come up there (to jail) that night.”

Two police reports from the night of the September 2023 arrest detail how officers had responded to a possible assault and were given the description of a white man. While in the area, they encountered Horton — the only person who fit that description. 

Hemphill said a mother called police after her daughter told her she was assaulted. He said officers approached Horton on the street and tried to talk with him to rule him out as a suspect. 

That’s when Horton began “fighting, pulling away, and kicking against (the officer’s) patrol vehicle, trying to run,” according to a police report from the night and Hemphill. Horton denies doing any of that. 

The next day police took Horton from the county jail to the Crystal Springs police station. There, police informed him a teenage girl reported being assaulted. After learning about the assault allegation, Horton remembered feeling shocked and saying it couldn’t be true because he was not on the street where the alleged incident took place. 

Hemphill confirmed the police investigated the assault allegation and found it not credible, meaning Horton wouldn’t face any related charges. He said he communicated this to Horton and his wife early on and since then, which the couple disputes. 

As Horton was being arrested and detained, his wife grew worried because she had just spoken with him on the phone and expected him to arrive home shortly. Rhonda Horton and her adult son started calling Roger’s phone, each not getting an answer. 

Then during one of the calls by her son, someone who did not identify himself answered Roger’s phone and said, ‘Your daddy’s dead’ and then hung up, Rhonda Horton said. 

She was starting to assume the worst had happened. Rhonda Horton wouldn’t have confirmation her husband was alive until he called from the county jail in the early morning. 

The next morning as she talked with the police chief, Rhonda Horton asked the chief about who answered the phone and told her son that Roger was dead. The chief told her the person who answered must have been from the county. 

Hemphill later told Mississippi Today that he did not know about the call and that type of behavior by his staff “is not going to be tolerated.” Similarly, Copiah County Sheriff Byron Swilley said he had not heard about it and could not say whether a member of his department made the comment to Rhonda and Roger Horton’s son. 

A Sept. 25, 2023, citation signed by Hemphill, shared with Mississippi Today, summoned Roger Horton to municipal court for the misdemeanor charges of possession of marijuana and resisting arrest and directed him not to have contact with the alleged victim in the assault case. No contact orders are typically for cases such as domestic violence and sexual assault and they are set by a judge.

LaKiedra Kangar, who works in municipal court services, said the no contact order was put in place because of the assault allegation. She confirmed Horton was not charged with the offense following the police department’s investigation of the allegation. 

Weeks passed. Roger Horton went to court for the misdemeanor charges, to which he pleaded guilty.  Felony assault charges were not part of the hearing. Municipal Court Judge Matthew Kitchens ordered Roger to pay over $900 in fines for the misdemeanors. 

Horton was able to pay for some of the fine through at least 10 hours worth of court-ordered community service, which he said involved painting buildings for the city. 

Months later after learning about Horton’s arrest and how he said the police treated him, Florczak-Seeman said she wanted to know more. Horton didn’t have access to his arrest documents, so she accompanied him and his wife to the police department to ask for them. 

The first visit, Horton asked but did not receive the arrest report. Florczak-Seeman asked if he had a fine for any of the charges, which police said Horton did even after completing some community service hours. Florczak-Seeman paid for the remaining balance and had him work for her for two days to pay that off. 

This year, they went to the police department a second time so Horton could ask for his arrest paperwork. An officer told him he didn’t need it and that the rape allegation had been investigated and found not to be credible, Horton told Mississippi Today. 

Florczak-Seeman asked why Horton couldn’t receive the report. She said Hemphill asked if she was Horton’s attorney, and Florczak-Seeman clarified she was his representative. 

The chief left for a few minutes and returned with two pieces of paper and handed them to Horton. Hemphill told Mississippi Today he did not recall whether he was the one who handed the report to Horton. 

Florczak-Seeman took the document from Horton and began to read it as they stood in the lobby. She said she was horrified to see the name of the alleged, underage victim and her address in the report.

Hemphill said the victim’s personal information should have been restricted and not doing so was an oversight. 

After reading the report, Florczak-Seeman went down the street to the mayor’s office at city hall to explain what happened, and how she believed the mayor had grounds to fire the police chief because he provided that document to Roger with the alleged victim’s information. 

Crystal Springs Mayor Sally Garland Credit: Crystal Springs website

Mayor Sally Garland confirmed she had a conversation with Florczak-Seeman about the police chief’s employment. 

She said she reviews all complaints about city officials, and Garland said she goes to the department head to get a better understanding of the situation. If she determines there are potential grounds for termination, a hearing would be scheduled with the Board of Aldermen, and the group would vote on that decision.   

Garland did not find grounds for termination, and Hemphill remains police chief. 

A Strange Visit

The Hortons and Florczak-Seeman hadn’t given much thought about the 2023 arrest, until weeks ago when a teenaged girl suddenly showed up in Florczak-Seeman’s yard. 

At the end of September at the North Jackson Street home, Florczak-Seeman heard screaming and found the teenage girl who came onto her property. She asked what was wrong, and the teenager said she was chased by a dog, which Florczak-Seeman and Rhonda Horton did not see. 

The teenager asked for a soda, and Rhonda Horton went inside to get one. Florczak-Seeman asked where the teenager lived, and she gave an answer that Florczak-Seeman said conflicted with what two girls who were standing nearby on the public sidewalk said she told them. 

Then Florczak-Seeman asked the teenager’s name and recognized it as the name of the alleged victim on Horton’s arrest record. Immediately, Florczak-Seeman said she turned to Horton and told him to stay back, and she told the teenager to get off her property, which she did. 

At the moment, they were not able to verify whether the teenager was the alleged victim from the report. Neither the Hortons nor Florczak-Seeman had seen her before, and they only knew her name from the arrest report.

“That didn’t make sense at all,” Rhonda Horton told Mississippi Today. 

Florczak-Seeman called 911 to report the situation and ask for police to come, which they did not. Hemphill told Mississippi Today a dispatcher informed him about the call with Florczak-Seeman, including details with the teenage girl and how she wanted to report the girl for trespassing. 

Florczak-Seeman is one of the people who have noticed a difference in Horton’s vision. It’s clear when comparing the detailed and clean paint job Roger completed at her Jackson Street property in 2019 and the center where he painted last year.

During an interview at the center in October, Florczak-Seeman pointed to the ceiling and noted spots that Horton did not paint. She remembers telling him about them and realized that he couldn’t see them. 

“The spots on my ceiling are still not painted, and they’re not painted as a reminder of the injustices that happened in this situation and why I got involved,” Florczak-Seeman said. 

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

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Central, south Mississippi voters will decide judicial runoffs on Tuesday

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mississippitoday.org – Taylor Vance – 2024-11-22 11:16:00

Some Mississippi voters head to the polls Tuesday to decide who should represent them on the state’s highest courts. 

Polls will be open from 7 a.m. to 7 p.m. on Tuesday. Absentee voting has begun, and in-person absentee voting at county circuit clerk’s offices ends at noon on Saturday. 

In the Jackson Metro area and parts of central Mississippi, incumbent Supreme Court Justice Jim Kitchens will compete against Republican state Sen. Jenifer Branning of Neshoba County. In areas on the Gulf Coast, Jennifer Schloegel and Amy St. Pé will face each other for an open seat on the Court of Appeals. 

Candidates for judicial offices in Mississippi are technically nonpartisan, but political parties and trade associations often contribute money to candidates and cut ads for them, which has increasingly made  them almost as partisan as other campaigns. 

In the Central District Supreme Court race, GOP forces are working to oust Kitchens, one of the dwindling number of centrist jurists on the high Court. Conservative leaders also realize Kitchens is next in line to lead the court as chief justice should current Chief Justice Mike Randolph step down.

Kitchens is one of two centrist members of the high court and is widely viewed as the preferred candidate of Democrats, though the Democratic Party has not endorsed his candidacy. 

Kitchens, first elected to the court in 2008, is a former district attorney and private-practice lawyer. On the campaign trail, he has pointed to his experience as an attorney and judge, particularly his years prosecuting criminals and his rulings on criminal cases. 

In an interview on Mississippi Today’s ‘The Other Side’ podcast, Kitchens said his opponent, who primarily practices real estate law, would be at a “significant disadvantage” because the state Supreme Court often reviews criminal cases and major civil lawsuits that are sent to them on appeal. 

“I’m sure she has an academic knowledge about the circuit courts that she perhaps learned in law school or perhaps has been to some seminars, but she does not have the hands-on trial experience that I have,” Kitchens said. “And that’s so important to the work that I do.” 

Branning, a private-practice attorney, was first elected to the Legislature in 2015. She has led the Senate Elections and Transportation committees. During her time at the Capitol, she has been one of the more conservative members of the Senate leadership, voting against changing the state flag to remove the Confederate battle emblem, voting against expanding Medicaid to the working poor and supporting mandatory and increased minimum sentences for crime.

While campaigning for the judicial seat, she has pledged to ensure that “conservative values” are always represented in the judiciary, but she has stopped short of endorsing policy positions — which Mississippi judicial candidates are prohibited from doing. 

Branning declined an invitation to appear on Mississippi Today’s podcast. 

“Mississippians need and deserve Supreme Court justices that are constitutionally conservative in nature,” Branning said in a recent interview with radio station SuperTalk Mississippi. “And by that, I mean justices that simply follow the law. They do not add or take away.”

The two candidates have collectively raised around $187,00 and spent $182,00 during the final stretch of the campaign, according to campaign finance reports filed with the Secretary of State’s office. 

Since she initially qualified in January, Branning has raised the most amount of money at $879,871, with $250,000 of that money coming from a loan she gave her campaign. She spent around $730,000 of that money. Several third party groups have supported her campaign. 

Kitchens has raised around $514,00 since he qualified for reelection. He’s spent roughly $436,000 of that money, and some of his top contributors have been trial attorneys. 

For the open Court of Appeals seat, Schloegel and St Pe, two influential names on the Gulf Coast, are working to turn out their voters in a close election. 

Schloegel is a Chancery Court judge in Harrison, Hancock and Stone counties. St. Pé  is an attorney in private practice, a municipal court judge in Gautier, and a city attorney for Moss Point. 

Schloegel has raised roughly $214,000 since she qualified, and has spent almost that same amount of money this election cycle. St. Pé has raised around $480,000 this year and spent approximately $438,067 during that timeframe. 

Whoever wins the race, it ensures that a woman will fill the open seat. After the election, half of the judges on the 10-member appellate court will be women, the most number of women who have served on the court at one time. 

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

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On this day in 1961

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mississippitoday.org – Jerry Mitchell – 2024-11-22 07:00:00

Nov. 22, 1961

Credit: Courtesy: Georgia Tourism & Travel

Five Black students, made up of NAACP Youth Council members and two SNCC volunteers from Albany State College, were arrested after entering the white waiting room of the Trailways station in Albany, Georgia. 

The council members bonded out of jail, but the SNCC volunteers, Bertha Gober and Blanton Hall declined bail and “chose to remain in jail over the holidays to dramatize their demand for justice,” according to SNCC Digital Gateway. The president of Albany State College expelled them. 

Gober became one of SNCC’s Freedom Singers and wrote the song, “We’ll Never Turn Back,” after the 1961 killing of Herbert Lee in Mississippi. The tune became SNCC’s anthem. 

After her release from jail, Gober joined other students, and police arrested her and other demonstrators. Back in the same jail, she sang to the police chief and mayor to open the cells, “I hear God’s children praying in jail, ‘Freedom, freedom, freedom.’” 

Albany State suspended another student, Bernice Reagon, after she joined SNCC. She poured herself into the civil rights movement and later formed the Grammy-nominated a cappella group Sweet Honey in the Rock to educate and empower the audience and community. 

“When I opened my mouth and began to sing, there was a force and power within myself I had never heard before,” a power she said she did not know she had. 

Other members of the Freedom Singers included Cordell Reagon, Bernice Johnson, Dorothy Vallis, Rutha Harris, Bernard Lafayette and Charles Neblett. On the third anniversary of the sit-in movement in 1963, they performed at Carnegie Hall. 

“This is a singing movement,” SNCC leader James Forman told a reporter. “The songs help. Without them, it would be ugly.” 

Today, the Albany Civil Rights Institute houses exhibits on these protesters, Martin Luther King Jr. and others who joined the Albany Movement.

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

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