(Photo Credit: University of Mississippi Medical Center)
During the 2023 legislative session, Mississippi lawmakers passed a bill to restrict gender transitioning services to minors.
The University of Mississippi Medical Center (UMMC) opened the TEAM Clinic in September of 2019. TEAM serves as the clinical arm of the UMMC Center for Gender and Sexual Minority Health. TEAM operates every first Friday of the month for a half day. It is by appointment only.
The clinic offers primary care, “gender-affirmative” medicine, HIV/STD screening and treatment as well as behavioral health services and surgical referrals for adults. It is modeled after the Fenway Institute in Boston, Massachusetts. The institute was designed to address barriers encountered by the LGBTQ community when accessing healthcare.
In the most recent Joint Legislative Committee on Performance Evaluation and Expenditure Review, or PEER report, the committee reviewed clinic practices. The PEER Committee is composed of seven members of the House of Representatives appointed by the Speaker of the House and seven members of the Senate appointed by the Lieutenant Governor.
The PEER report concluded that because the clinic only has limited operations and treats a small portion of individuals, UMMC could consider integrating services provided by TEAM Clinic back into the regular care setting.
If this recommendation is followed, staff who have elected to complete the training could then be provided with an LGBTQ distinction on their badge or staff profile. Patients would then be aware if seeking care from a professional with the specific distinction.
In the UMMC response to the report, Vice Chancelor Louanne Woodward thanked PEER for their professionalism in the review.
“UMMC concurs with the overview of TEAM Clinic operations provided in the brief. We will continue to operate in compliance with applicable law and regulation while working toward our goal to create a Healthier Mississippi,” wrote Woodward.
The Center for Gender and Sexual Minority Health, which established the clinic, does not have a physical location. It serves as a resource with online tools through UMMC for training and education for staff and students who provide services.
According to the report, the clinic seeks to improve the health and well-being of individuals in the LGBTQ community. When it opened, the clinic served all ages. However, as of October 7, 2022, TEAM Clinic no longer provides services to minors.
The hospital reported that any services that were being provided by the clinic to minors are now part of regular care. Data shows that the clinic served 66 individuals under 18 (before eliminating that coverage), 136 between the ages of 18 to 30 and 96 people over 30.
UMMC used a portion of a grant provided by the Women’s Foundation of Mississippi, around $40,000, in opening the clinic. Additional grant funding came from the Manning Family Fund and LGBTQ Fund of Mississippi. From FY 2020 through part of FY 2023 the clinic expenditures totaled $96,781 – roughly $25,000 annually). Support staff costs account for nearly 59% of that number.
UMMC is a beneficiary of state dollars but has indicated that those dollars are not used to fund education at the hospital, including in the TEAM Clinic.
Between FY 2020 and FY 2023 the clinic offered 221 patients gender transition services. At the time, 24% of those were minors. In addition, 99 patients received hormone therapy treatment which included testosterone and estrogen. There was $82,307 billed to the clinic for gender transition services.
New law prohibits gender transition care in minors
During the 2023 legislative session, lawmakers passed the REAP Act. The REAP Act prevents doctors in Mississippi from administering medications or surgery with the intent of aiding gender transition in someone under 18 years of age. The bill does not prohibit gender transition care for adults.
The new law considers the transition services for minors outside the medical standard of care required to maintain a medical license. A physician who provides gender transitioning care to a minor now risks having their medical license taken from him or her.
Drew Snyder, Executive Director of the Department of Medicaid, penned a letter to all managed healthcare companies outlining the state’s position on treatment for gender dysphoria.
Snyder stated that after further review, Medicaid concurred with the Florida Agency for Health Care Administration (Florida Medicaid). The decision found that medical literature does not indicate enough evidence to pursue sex reassignment as an effective treatment for gender dysphoria.
“Furthermore, Mississippi Medicaid agrees with AHCA’s view that available evidence demonstrates these treatments cause irreversible physical changes and side effects that can affect long-term health,” Snyder wrote at the time.
The PEER report indicated that because the clinic has not given care to any minors since 2022, UMMC does not believe the REAP Act will have any impact on their services. UMMC indicated that they plan to work with their attorneys to determine if clinical providers within regular care settings will be allowed to refer patients to providers outside of the state for such matters or if that is a violation of state law.