Mississippi Today
In the Mississippi Bible Belt, a family wrestles with raising trans kids in the Mormon church
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This article was copublished with The 19th, a nonprofit newsroom covering gender, politics, and policy. Sign up for The 19th’s newsletter here.
Marie and Brian Bauman held hands as they walked into the quiet worship hall of a north Mississippi church and situated themselves in the front row. Five of their seven kids settled on either side of them.
Most of the few dozen, mostly white, congregants of the Church of Jesus Christ of Latter Day Saints were dressed for a typical Sunday. The women wore dresses and skirts; the men, collared shirts and ties. But one member of the Baumans stood out: Jack, who wore pants, a tuxedo shirt dotted with silver lightning bolts and a lilac tie. Black nail polish was chipping off of his fingernails.
Ever since he could talk, Jack stated he was a boy. He invented new names for himself — first to use at home, then at school and church. Now 11 years old, Jack is one of a few thousand transgender or gender-nonconforming children in Mississippi growing up in a time when state lawmakers are increasingly hostile toward them.
That Sunday in February marked 40 days since House Republicans passed House Bill 1125 to ban transgender youth in Mississippi from receiving gender-affirming care, which lawmakers repeatedly likened to child abuse and a violation of God’s will, despite every major medical association supporting the treatment. Gov. Tate Reeves would soon make it law, a decision supported by many, but not all, in the Baumans’ largely conservative congregation.
The impending ban made the Baumans fearful for Jack’s health, safety and well-being. It also stirred up painful memories of the time in 2020 when their eldest daughter, Aria, came out as trans as a young adult, only to be told by church leaders that she’d be removed if she wore a dress to church again.
Ever since then, this family, whose names have been changed to protect them from retaliation, has grappled with a contradiction underscored by the surge of anti-trans bills in America: whether it’s possible to raise trans kids in a faith with a strict binary view of gender. Marie and Brian are choosing this path, but many religious families are not.
The family bowed their heads as an elderly member of the church, referred to as a brother, began speaking at the lectern. He is perceived by the family as one of the more accepting members of the congregation, sometimes sending the kids Cow Tales and other candy, but his speech quickly turned into a righteous counsel.
“We see evil crying and carnality covering the earth,” the brother said. “Liars, thieves, adulterers, homosexuals, murderers scarcely seek to hide their abominations from our view. Iniquity abounds, there is no peace on earth. We see evil forces everywhere uniting to destroy the family, to ridicule morality and decency.”
Jack yawned. Curled over a hymn book, he traced a tiny portrait of Jesus in black ink on a program.
“I want you to know that I love each and every one of you,” the brother said, wrapping up. “I’ve had my trials, we’ve all had trials, but together we can face them, we can deal with them and we can work through them.”
Marie hoped that could be the case for her family. She didn’t know at the time that Aria had all but left the church. Her second-oldest child, who like Aria and Jack is also gender-nonconforming, was inching away, too.
At that moment in the sanctuary, Marie hoped that by staying in the church, she might convince other Mormons to become more accepting.
“We’re taught that we’re in families to learn to be more Christ-like,” she said. “One of our core beliefs is that in the afterlife, we can’t take anything with us but we take our relationships. If my relationship with my kids is bad, how can I take anything with me?”
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After worship, it was time for Sunday school. In the Baumans’ church, like other Mormon churches, most classes are sorted by gender.
The men gathered alone in the large hall. Kids rushed out into the hallway, heading to their lessons, and the women followed. But Marie did not go with them. She found it difficult to participate in theological discussions with other congregants after what happened with Aria. She was happiest teaching the kids music, but it wasn’t time for that yet, so she waited on a couch in the hallway. A framed portrait of Jesus Christ hung nearby.
As a Mormon trying to raise gender-nonconforming kids, Marie says she sees contradictions in the church’s teachings.
“There were so many places where the choices that were made were terrible — hey,” she said, interrupting herself as the branch president, one of the leaders who had told Aria she should not wear a dress to church again, stopped to say hello. She continued as he walked away: “I find it difficult that you can say we should love everyone and then get up and say just because you’re trans that makes you inherently evil.”
Still, she holds onto the belief that Mormonism, which prohibits women from serving in ecclesiastical roles, could become accepting of her children. But even she recognizes that she might be doing some mental gymnastics.
“We talk about personal revelation, and I could be wanting to believe things so badly that I really believe that,” she said.
“Personal revelation” is a kind of epiphany in Mormon doctrine. It’s divine intervention, a direct message from God. Like many Mormons, it has played a significant role in the life of Marie and her family. It motivated the family to move from Utah to Mississippi in 2017, joining roughly 22,000 other Mormons in the state, according to the church. A new congregation was starting in the state’s northern Hill County, and the Baumans’ wanted to be in a place they felt needed them.
Living in the Bible Belt was an adjustment for everyone, but especially for Aria. Though Mississippi and Utah have a nearly identical breakdown of registered Democrats to Republicans, the Baumans’ new town was tiny, with more Baptist churches than restaurants. It felt more conservative than the Utah college town Aria had left behind.
Growing up, Aria remembers feeling uneasy any time she heard about LGBTQ+ issues in the church, like when LDS leadership campaigned against marriage equality or instituted policies calling on Mormon children to renounce their gay parents. It wasn’t until Aria made queer friends in school, right before the family left Utah, that she understood why these issues bothered her — and started to consider coming out as trans.
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But during that 2017 summer in rural Mississippi, more than 1,500 miles away from those friends, there was a discussion between congregants at her new church that triggered Aria. She recalled it was “about how awful everything was because the world was getting more progressive and queer people were becoming more acceptable.”
After the discussion, she ran out into the parking lot hyperventilating. She knew it would probably be safe to tell Marie, who had followed her, why she was so upset — Jack had already come out by then. But she couldn’t bring herself to.
“It was scary,” Aria said. “It affirmed coming out was not safe.”
The family’s move coincided with Donald Trump’s presidency and a nationwide rise in anti-trans bills and policies targeting bathrooms, sports teams, libraries and the classroom. Marie followed these bills closely and joined support groups for trans Mormons and their loved ones. She was looking for ways to advocate for Jack, motivated by family lore of relatives who were suffragettes.
“We are always dragging the church behind the culture,” she said.
By the time the legislative session started this past January, Marie was invested. She joined a Zoom call with other parents of trans kids in Mississippi and learned that lawmakers had already introduced at least 31 bills targeting the LGBTQ+ community. Many of these were inspired by model legislation from right-wing Christian groups like the Alliance Defending Freedom, which has argued that “when culture refuses to acknowledge the fundamental truth that we are created male and female in the image of God, everyone loses.”
Marie observed that outside of a handful of parents and activists, few in Mississippi were advocating for the trans community. At a protest in mid-February, a couple of progressive faith leaders spoke out against the bill.
But they weren’t represented by any lawmaker who has the power to pass legislation inside the Capitol. Republicans, who maintain a supermajority, fell in line to back HB 1125 when it was introduced. Gov. Reeves had signaled it was a priority during his yearly State of the State address. The Democrats’ then-presumptive nominee for governor, Brandon Presley, remained silent about the bill. And when Democratic lawmakers did ask questions about the bill, they repeatedly failed to call out the inaccurate information about gender-affirming care that Republicans gave in response.
“We’re talking about the total and complete removal of parts that God gave you and trying to reverse that,” one of the bill’s handlers, Sen. Joey Fillingane, said during a Senate committee hearing.
In the classroom that Sunday in February, as another mom helped Marie set up folding chairs in preparation for the music lesson, they talked about HB 1125 and how it could affect Jack.
Marie has been thinking about trans issues since Jack was a little kid. She decided years ago that she would be open about her family with anyone who asked, a philosophy that stemmed from a quote she’d read from a motivational speaker: “It’s hard to hate up close.” But she also understands that for many people, especially other members of her congregation, this is new. The common talking points from politicians about parents “coaching” their parents to be trans — comments that infuriate her — can stick with people.
HB 1125 wasn’t a problem for Jack yet, Marie explained to the other mom. Jack’s “social transition” was flexible, meaning that sometimes he went by he/him pronouns and wore masculine clothes, and sometimes he didn’t, a decision Marie let him lead. But if puberty started to harm Jack’s mental health, then the law would become a barrier to the care that Marie would seek.
“Jack currently is not on any hormone blockers, but it’s something we’ve talked about if her mental health is affected,” Marie said.
“I can understand how somebody who has no experience with it might say, ‘No, you shouldn’t let kids have these kinds of hormones,’” the mom replied. “I get that because, I mean, I’m a mom.”
“Right,” Marie said.
“But I’ve watched Jack grow up, so it’s not like I can sit here and say she’s coached into that. Like, I see this. So to deny care, like it’s detrimental for her,” the mom trailed off. “It’s complicated.”
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Support like that from congregants was new to Marie. Officially, the LDS church’s stance on trans people is outlined in a document called “the General Handbook.” It advises against transitioning and states that trans Mormons who do would likely face “membership restrictions” that range from no longer being allowed to teach a class to being removed from the congregation entirely.
These guidelines can push queer people away from the church. There are many examples of LGBTQ+ Mormons who have been ostracized by their churches or disavowed by family members who’ve decided the religion is not compatible with acceptance. It’s a particular issue for the rising generation of Mormons: For the increasing number of millennials who’ve left, the church’s stance on LGBTQ+ issues was the third biggest reason.
Yet these rules aren’t fixed, and LDS leadership has changed its stance on social issues in the past, often through personal revelation. Notably, that’s how church leaders decided Black people could hold certain leadership positions in the 1970s. It wasn’t until the 1980s, amid a cultural recoil to the feminist movement and a rise in LGBTQ+ activism, that the church leadership started to insist gender was an immutable characteristic, said Taylor Petrey, a professor at Kalamazoo College who has studied the development of Mormon thought on gender and sexuality.
An important backdrop to the leadership’s positions on social issues, Petrey said, is a desire to dilute the religion’s stereotype, gained from the practice of polygamy, as sexually deviant.
The church often takes “a strong position in favor of a very rigid sexual morality because of that memory of what it meant to be on the outside of American sexual norms,” he said. “They cling very closely to heterosexuality, to patriarchy, to a kind of white, heteronormative family as the new image of sexuality that the church wants to promote.”
Strategy has also played a role in the changing norms. In 2008, the church famously backed California’s Proposition 8, a referendum that banned same-sex marriage. Leadership at the highest levels urged members to vote for it; according to some estimates, members spent more than $20 million in support.
The backlash was fierce. There were protests outside Mormon temples across the country; a popular gay rights blogger called for tourists to boycott skiing in Utah. The church backtracked and, a few years later, supported an anti-discrimination law in Utah, with some religious carve-outs, that protected LGBTQ+ people. Then last year, the church went further, backing a bill in Congress to protect same-sex marriage.
Petrey added that the General Handbook is not compulsory; congregations can deviate from it based on their members’ needs and expectations.
“Family unity, family, love, family harmony are such prioritized values that when the church or society is seen as causing a rift or is potentially a source of pain, many Latter Day Saints are like, ‘Well, I’ve been taught all my life that the family is the most important thing,’” Petrey said. “‘I’m going to choose my family.’”
That thinking is one reason why Aria stayed in the church despite feeling increasingly wary. Aria also knew that if she came out, she would risk severing her ties to her family, possibly forever. In Mormon doctrine, families stay together in the afterlife, as long as they’ve remained in the church in good standing.
By the time she was gearing up in 2020 for her mission, a rite-of-passage for Mormons that involves volunteer service or proselytizing, Aria knew she was trans. But she hadn’t come out yet, even as she was growing away from the church. A conversation with a family member who left the church inspired her to explore other forms of spirituality like paganism; its dramatic nature was attractive to her as a former theater kid. In Mississippi, she got close to a non-denominational pastor. She told him she was trans and, right after, he assaulted her.
“I kind of just went back deep in the closet,” she said.
Her mission loomed. It came with some added pressure: Aria and her parents thought she would be the first Mormon from north Mississippi to go on a mission since the late 1980s and possibly the first ever from the area to complete one. Her understanding was that a woman who went before her died before she could finish.
She had to prepare for it. Missionaries are expected to keep their hair cropped, but Aria’s hair was long and curly, so she burned locks of it in the woods. She tied herself blindfolded to a stake outside the family’s home, a ritual she said was meant to create a division in her life between her mission and “everything else.”
But the night before she was set to get on the plane to the Pacific Northwest, she broke down and told Marie that she was trans. Marie encouraged her to try to do the mission anyway.
“There is nothing you’ve said that makes you unworthy to serve,” Marie said she told Aria.
So Aria went. Away from home, her antidepressants stopped working. Her panic attacks became more frequent. Soon, it all became too much to wear the elder’s uniform of pants, a white button-up and a tie. She could no longer pretend like everything was OK. She made plans for suicide. But before that, Aria talked to a church therapist who helped her get a plane ticket home.
In the weeks that followed, Aria came out to her dad via letters, because that was easier than speaking the words. That October, she told her sister Sabrina, who is now 8 years old, when they were quarantined together after a COVID exposure in the bedroom they shared. She was touched when Sabrina suggested they both wear dresses to church that Sunday.
Sabrina wasn’t called to church that day — during the pandemic, congregants who were not needed stayed home — but Aria was asked to teach a primary class. So she donned a sage green wrap dress patterned with white flowers. She didn’t think it would be an issue because a few nights earlier, she’d worn a feminine vampire costume to a church Halloween party.
At service, only one person said something to her: A kid in her primary class asked why she was wearing a dress. She asked him why he wasn’t.
But a few days later, the branch president invited Aria to his house. Another leader was there. They told her she had been disruptive and warned that if she wore a dress again, she would be “exported out,” meaning removed from the church. She would be welcome back if she wore a pantsuit, the branch president said.
Aria left in tears.
The next week, church was awkward for Marie and Brian. Even though no one said anything to them about Aria, it felt like everyone knew what had happened.
“There was this weird thing, like almost a pity,” Marie said of the aftermath at church. “Like, ‘I’m sorry your child is doing this.’ And I just kept thinking, ‘I don’t feel bad about this. I feel bad that you feel bad about this.’”
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On the way home in their golden minivan, the family went over what they had learned that day at church that day in February. The three teenagers had just watched a YouTube video, well-known to many Mormons, about a bespectacled housewife who judges her neighbor’s dirty clothesline. One day, she is astonished — her neighbor’s laundry is clean. Then her husband informs her that actually, she had been looking at the woman’s home through her own dirty kitchen windows. He had washed them.
The video ends with a lesson from the LDS president who notes, “thus the commandment, ‘judge not.’”
At home, Jack and Sabrina pulled on rain boots and ran around the family’s hilly property, the family’s older rescue dog bounding after them. They showed off the chicken coops, their goats with Russian names and a tree that Jack called “Whomping Willow,” but the priority was looking at the hogs. The babies had been castrated the day before, their tails still limp from the alcohol. The parents were plopped in the mud.
“You can tell which one is a girl, because the girl has,” Jack paused. “You’re going to have to explain this, Sabrina. I don’t want to say it out loud.”
“What?” Sabrina asked. “Both of them have nipples.”
“But hers are bigger,” Jack said.
Out of all seven children, Jack and Sabrina had spent the bulk of their childhood in Mississippi. At school, Jack was sometimes called by the name Marie and Brian gave him, sometimes by the one he chose; it depended on the teacher. The routine he has adopted — switching between pronouns — was growing uncomfortable, he said.
“I don’t know, I mean, I was born a girl but I want to be a boy,” Jack said.
“Jack is a girl at school and a boy at home,” Sabrina said.
“It’s weird,” Jack said. He announced the tour was over.
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As Brian prepped chicken soup for dinner, Marie sat on the family’s velvet green couch and scrolled through her phone, searching for her favorite family photo. It shows the family standing hand-in-hand, eyes squinting in the bright sun, surrounded by dense, green vines. Aria is wearing the same dress she wore to church and fingerless, black-and-gray striped gloves.
Ever since the incident with church leaders, Marie said, Aria had been drifting away from the church. She tried attending service at a congregation in Tennessee, but the hour-long drive was tiring. The branch president came to the family’s house to try to apologize, but Aria had a panic attack. As he talked to Marie, Aria sat on the porch until she was finally calm enough to meet with him.
By fall 2021, she decided to move back to Utah to be closer to her queer friends and to try college again at a state university. In civics class one day, Aria listened to a conversation about how much money church leadership had poured into opposing same-sex marriage in California. It struck her that this wasn’t just the actions of people like her mom or other church congregants; who are, in Aria’s view, “apologetics” who don’t know better. The church’s support of Proposition 8 was an organized campaign to oppose her rights and the rights of people like her, Aria said. Still, it hurt to realize that her parents supported that campaign through tithings.
She had a revelation: “It finally hit me that it couldn’t be true, that it couldn’t be for me, that I was never going to fit within Christianity.”
“I came to the conclusion that either the church was wrong in every way, and I shouldn’t be associated with it, or the church was right and if that’s the case, then God hates me anyway so I might as well leave,” she said.
All this led Aria to tell Marie in mid-February that she was considering having her name purged from church records, a step that would completely sever her relationship with Mormonism. In March, she made it official.
Marie said she knew she could not dissuade Aria. She cites the varying viewpoints of congregants like the brother, or even the branch president. And she understands why Aria thinks it’s hypocritical of her to pay tithings to the church even as she disagrees with its stance on LGBTQ+ issues.
But, she said, she’s not responsible for how the church spends its money.
“I’m not going to be held responsible for that in the afterlife, whoever is mishandling it now — it is on them,” she said.
If Aria can’t be part of the church, Marie said she understands. Mormons are more conservative, and she said that often, the church’s culture is misunderstood as a substitute for doctrine.
“I may have issues with church policy but that doesn’t change my faith in the doctrine,” Marie said. “I don’t want to be doing mental gymnastics, and I hope that’s not what I’m doing. I do make a distinction between the church as an institution and the gospel of Jesus Christ.”
As for Jack, Marie said she and her husband haven’t told him about the bill yet, to avoid causing undue anxiety or make him feel like a path forward is foreclosed as long as they live in Mississippi.
As Marie talked, Jack and his siblings passed around a piece of paper, playing a game in which each person contributes a sentence to a short story. Jack handed the final result — a story about an animal that is ostracized by its family but ultimately finds a way to survive. Was it about them?
Jack grinned. “Maybe.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1898
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Feb. 22, 1898
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Frazier Baker, the first Black postmaster of the small town of Lake City, South Carolina, and his baby daughter, Julia, were killed, and his wife and three other daughters were injured when a lynch mob attacked.
When President William McKinley appointed Baker the previous year, local whites began to attack Baker’s abilities. Postal inspectors determined the accusations were unfounded, but that didn’t halt those determined to destroy him.
Hundreds of whites set fire to the post office, where the Bakers lived, and reportedly fired up to 100 bullets into their home. Outraged citizens in town wrote a resolution describing the attack and 25 years of “lawlessness” and “bloody butchery” in the area.
Crusading journalist Ida B. Wells wrote the White House about the attack, noting that the family was now in the Black hospital in Charleston “and when they recover sufficiently to be discharged, they) have no dollar with which to buy food, shelter or raiment.
McKinley ordered an investigation that led to charges against 13 men, but no one was ever convicted. The family left South Carolina for Boston, and later that year, the first nationwide civil rights organization in the U.S., the National Afro-American Council, was formed.
In 2019, the Lake City post office was renamed to honor Frazier Baker.
“We, as a family, are glad that the recognition of this painful event finally happened,” his great-niece, Dr. Fostenia Baker said. “It’s long overdue.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Memorial Health System takes over Biloxi hospital, what will change?
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by Justin Glowacki with contributions from Rasheed Ambrose, Javion Henry, McKenna Klamm, Matt Martin and Aidan Tarrant
BILOXI – On Feb. 1, Memorial Health System officially took over Merit Health Biloxi, solidifying its position as the dominant healthcare provider in the region. According to Fitch Ratings, Memorial now controls more than 85% of the local health care market.
This isn’t Memorial’s first hospital acquisition. In 2019, it took over Stone County Hospital and expanded services. Memorial considers that transition a success and expects similar results in Biloxi.
However, health care experts caution that when one provider dominates a market, it can lead to higher prices and fewer options for patients.
Expanding specialty care and services
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One of the biggest benefits of the acquisition, according to Kristian Spear, the new administrator of Memorial Hospital Biloxi, will be access to Memorial’s referral network.
By joining Memorial’s network, Biloxi patients will have access to more services, over 40 specialties and over 100 clinics.
“Everything that you can get at Gulfport, you will have access to here through the referral system,” Spear said.
One of the first improvements will be the reopening of the Radiation Oncology Clinic at Cedar Lake, which previously shut down due to “availability shortages,” though hospital administration did not expand on what that entailed.
“In the next few months, the community will see a difference,” Spear said. “We’re going to bring resources here that they haven’t had.”
Beyond specialty care, Memorial is also expanding hospital services and increasing capacity. Angela Benda, director of quality and performance improvement at Memorial Hospital Biloxi, said the hospital is focused on growth.
“We’re a 153-bed hospital, and we average a census of right now about 30 to 40 a day. It’s not that much, and so, the plan is just to grow and give more services,” Benda said. “So, we’re going to expand on the fifth floor, open up more beds, more admissions, more surgeries, more provider presence, especially around the specialties like cardiology and OB-GYN and just a few others like that.”
For patient Kenneth Pritchett, a Biloxi resident for over 30 years, those changes couldn’t come soon enough.
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Pritchett, who was diagnosed with congestive heart failure, received treatment at Merit Health Biloxi. He currently sees a cardiologist in Cedar Lake, a 15-minute drive on the interstate. He says having a cardiologist in Biloxi would make a difference.
“Yes, it’d be very helpful if it was closer,” Pritchett said. “That’d be right across the track instead of going on the interstate.”
Beyond specialty services and expanded capacity, Memorial is upgrading medical equipment and renovating the hospital to improve both function and appearance. As far as a timeline for these changes, Memorial said, “We are taking time to assess the needs and will make adjustments that make sense for patient care and employee workflow as time and budget allow.”
Unanswered questions: insurance and staffing
As Memorial Health System takes over Merit Health Biloxi, two major questions remain:
- Will patients still be covered under the same insurance plans?
- Will current hospital staff keep their jobs?
Insurance Concerns
Memorial has not finalized agreements with all insurance providers and has not provided a timeline for when those agreements will be in place.
In a statement, the hospital said:
“Memorial recommends that patients contact their insurance provider to get their specific coverage questions answered. However, patients should always seek to get the care they need, and Memorial will work through the financial process with the payers and the patients afterward.”
We asked Memorial Health System how the insurance agreements were handled after it acquired Stone County Hospital. They said they had “no additional input.”
What about hospital staff?
According to Spear, Merit Health Biloxi had around 500 employees.
“A lot of the employees here have worked here for many, many years. They’re very loyal. I want to continue that, and I want them to come to me when they have any concerns, questions, and I want to work with this team together,” Spear said.
She explained that there will be a 90-day transitional period where all employees are integrated into Memorial Health System’s software.
“Employees are not going to notice much of a difference. They’re still going to come to work. They’re going to do their day-to-day job. Over the next few months, we will probably do some transitioning of their computer system. But that’s not going to be right away.”
The transition to new ownership also means Memorial will evaluate how the hospital is operated and determine if changes need to be made.
“As we get it and assess the different workflows and the different policies, there will be some changes to that over time. Just it’s going to take time to get in here and figure that out.”
During this 90-day period, Erin Rosetti, Communications Manager at Memorial Health System said, “Biloxi employees in good standing will transition to Memorial at the same pay rate and equivalent job title.”
Kent Nicaud, President and CEO of Memorial Health System, said in a statement that the hospital is committed to “supporting our staff and ensuring they are aligned with the long-term vision of our health system.”
What research says about hospital consolidations
While Memorial is promising improvements, larger trends in hospital mergers raise important questions.
Research published by the Rand Corporation, a nonprofit, nonpartisan research organization, found that research into hospital consolidations reported increased prices anywhere from 3.9% to 65%, even among nonprofit hospitals.
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The impact on patient care is mixed. Some studies suggest merging hospitals can streamline services and improve efficiency. Others indicate mergers reduce competition, which can drive up costs without necessarily improving care.
When asked about potential changes to the cost of care, hospital leaders declined to comment until after negations with insurance companies are finalized, but did clarify Memorial’s “prices are set.”
“We have a proven record of being able to go into institutions and transform them,” said Angie Juzang, Vice President of Marketing and Community Relations at Memorial Health System.
When Memorial acquired Stone County Hospital, it expanded the emergency room to provide 24/7 emergency room coverage and renovated the interior.
When asked whether prices increased after the Stone County acquisition, Memorial responded:
“Our presence has expanded access to health care for everyone in Stone County and the surrounding communities. We are providing quality healthcare, regardless of a patient’s ability to pay.”
The response did not directly address whether prices went up — leaving the question unanswered.
The bigger picture: Hospital consolidations on the rise
According to health care consulting firm Kaufman Hall, hospital mergers and acquisitions are returning to pre-pandemic levels and are expected to increase through 2025.
Hospitals are seeking stronger financial partnerships to help expand services and remain stable in an uncertain health care market.
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Source: Kaufman Hall M&A Review
Proponents of hospital consolidations argue mergers help hospitals operate more efficiently by:
- Sharing resources.
- Reducing overhead costs.
- Negotiating better supply pricing.
However, opponents warn few competitors in a market can:
- Reduce incentives to lower prices.
- Slow wage increases for hospital staff.
- Lessen the pressure to improve services.
Leemore Dafny, PhD, a professor at Harvard and former deputy director for health care and antitrust at the Federal Trade Commission’s Bureau of Economics, has studied hospital consolidations extensively.
In testimony before Congress, she warned: “When rivals merge, prices increase, and there’s scant evidence of improvements in the quality of care that patients receive. There is also a fair amount of evidence that quality of care decreases.”
Meanwhile, an American Hospital Association analysis found consolidations lead to a 3.3% reduction in annual operating expenses and a 3.7% reduction in revenue per patient.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Adopted people face barriers obtaining birth certificates. Some lawmakers point to murky opposition from judges
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When Judi Cox was 18, she began searching for her biological mother. Two weeks later she discovered her mother had already died.
Cox, 41, was born in Gulfport. Her mother was 15 and her father didn’t know he had a child. He would discover his daughter’s existence only when, as an adult, she took an ancestry test and matched with his niece.
It was this opaque family history, its details coming to light through a convergence of tragedy and happenstance, that led Cox to seek stronger legal protections for adopted people in Mississippi. Ensuring adopted people have access to their birth certificates has been a central pillar of her advocacy on behalf of adoptees. But legislative proposals to advance such protections have died for years, including this year.
Cox said the failure is an example of discrimination against adopted people in Mississippi — where adoption has been championed as a reprieve for mothers forced into giving birth as a result of the state’s abortion ban.
“A lot of people think it’s about search and reunion, and it’s not. It’s about having equal rights. I mean, everybody else has their birth certificate,” Cox said. “Why should we be denied ours?”
Mississippi lawmakers who have pushed unsuccessfully for legislation to guarantee adoptees access to their birth certificate have said, in private emails to Cox and interviews with Mississippi Today, that opposition comes from judges.
“There are a few judges that oppose the bill from what I’ve heard,” wrote Republican Sen. Angela Hill in a 2023 email.
Hill was recounting opposition to a bill that died during the 2023 legislative session, but a similar measure in 2025 met the same fate. In an interview this month, Hill said she believed the political opposition to the legislation could be bound up with personal interest.
“Somebody in a high place doesn’t want an adoption unsealed,” Hill said. “I don’t know who we’re protecting from somebody finding their birth parents,” Hill said. “But it leads you to believe some people have a very strong interest in keeping adoption records sealed. Unless it’s personal, I don’t understand it.”
In another 2023 email to Cox reviewed by Mississippi Today, Republican Rep. Lee Yancey wrote that some were concerned the bill “might be a deterrent to adoption if their identities were disclosed.”
The 2023 legislative session was the first time a proposal to guarantee adoptees access to their birth certificates was introduced under the state’s new legal landscape surrounding abortion.
In 2018, Mississippi enacted a law that banned most abortions after 15 weeks. The state’s only abortion clinic challenged the law, and that became the case that the U.S. Supreme Court used in 2022 to overturn Roe v. Wade, its landmark 1973 ruling that established a nationwide right to abortion.
Roe v. Wade had rested in part on a woman’s right to privacy, a legal framework Mississippi’s Solicitor General successfully undermined in Dobbs v. Jackson Women’s Health Organization. Before that ruling, anti-abortion advocates had feared allowing adoptees to obtain their birth certificates could push women toward abortion rather than adoption.
Abortion would look like a better option for parents who feared future contact or disclosure of their identities, the argument went. With legal access to abortion a thing of the past in Mississippi, Cox said she sees a contradiction.
“Mississippi does not recognize privacy in that matter, as far as abortions and all that. So if you don’t acknowledge it in an abortion setting, how can you do it in an adoption setting?” Cox said. “You can’t pick and choose whether you’re going to protect my privacy.”
Opponents to legislation easing access to birth certificates for adoptees have also argued that such proposals would unfairly override previous affidavits filed by birth parents requesting privacy.
The 2025 bill, proposed by Republican Rep. Billy Calvert, would direct the state Bureau of Vital Records to issue adoptees aged 21 and older a copy of their original birth certificate.
The bill would also have required the Bureau to prepare a form parents could use to indicate their preferences regarding contact from an adoptee. That provision, along with existing laws that guard against stalking, would give adoptees access to their birth certificate while protecting parents who don’t wish to be contacted, Cox said.
In 2021, Cox tried to get a copy of her birth certificate. She asked Lauderdale County Chancery Judge Charlie Smith, who is now retired, to unseal her adoption records. The Judge refused because Cox had already learned the identity of her biological parents, emails show.
“With the information that you already have, Judge Smith sees no reason to grant the request to open the sealed adoption records at this time,” wrote Tawanna Wright, administrator for the 12th District Chancery Court in Meridian. “If you would like to formally file a motion and request a hearing, you are certainly welcome to do so.”
In her case and others, judges often rely on a subjective definition of what constitutes a “good cause” for unsealing records, Cox said. Going through the current legal process for unsealing records can be costly, and adoptees can’t always control when and how they learn the identity of their biological parents, Cox added.
After Cox’s biological mother died, her biological uncle was going through her things and came across the phone number for Cox’s adoptive parents. He called them.
“My adoptive mom then called to tell me the news — just hours after learning I was expecting my first child,” Cox said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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