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What to know about gender-affirming care in Mississippi 

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What to know about gender-affirming care in Mississippi 

Mississippi lawmakers are considering a bill that would ban gender-affirming care for trans kids this , sparking fear among LGBTQ+ Mississippians and their families and allies.

House Bill 11125, also known as the “Regulate Experimental Adolescent Procedures” (REAP) Act, would prevent Mississippi's roughly 2,400 trans kids and their families from getting hormone therapy or puberty blockers in the state. Lawmakers, contradicting the recommendations of every major medical association in the U.S., have likened gender-affirming care to child abuse and say the bill will protect children.

Trans Mississippians and their allies have said the bill is part of a coordinated attack on their rights. The bill comes two years after lawmakers banned trans athletes from competing on teams that align with their gender identity.

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As the bill moves through the legislative process, Mississippi Today compiled answers to some commonly asked questions about HB 1125 and gender-affirming care.

What is gender-affirming care?

Gender-affirming care 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. It seeks to reduce gender dysphoria, the distress trans people can experience when their physical features do not match their gender identity. The Transgender Care Navigation Program at the University of California, San Francisco, says gender-affirming care can range from “coming out” to friends and family, using different pronouns and changing one's hairstyle, clothing to going on puberty blockers, hormone therapy or surgery.

Puberty blockers are a type of medication that prevents sex organs from producing estrogen or testosterone. They are reversible and have been used for decades for precocious puberty, the of secondary sex characteristics at a young age, in cisgender kids. Hormone therapy – the prescription of estrogen or testosterone – typically starts at 16-years-old for trans kids.

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For trans kids, who must have parental consent, the goal of gender-affirming care is often to give them time to determine if they want to go through puberty corresponding to the sex they were assigned at birth or if they want to transition, said Lee Pace, a nurse practitioner and co-owner of Spectrum: The Other Clinic, the only transgender medical clinic in Mississippi.

Gender-affirming care is recommended by every major medical association in the United States. It is also evidenced-based and, contrary to the title of HB 1125, not considered “experimental” by the medical community.

In a blog post on the American Medical Association's website, the president, Jack Resneck, wrote that, “studies have consistently demonstrated that providing gender-affirming care that is both age-appropriate and evidence-based to improved mental health outcomes. Conversely, denying such care is linked to a greater incidence of anxiety, depression and self-harm.”

Nationally, trans youth attempt suicide at a rate more than four times their cisgender peers due to social stigma and discrimination. Research has repeatedly shown that gender-affirming care significantly boosts the chances that trans kids will 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.

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Are trans youth undergoing gender-confirmation surgery in Mississippi?

No. On the House floor, Rep. Nick Bain, R-Corinth, could not name a single instance of a trans kid undergoing gender-confirmation surgery in Mississippi.

There is no medical clinic in Mississippi that offers gender-confirmation surgery to trans kids, according to Pace and other advocates for the state's trans community. In general, surgery is not recommended for trans kids by medical organizations that support other forms of gender-affirming care for youth.

No clinic in Mississippi provides what's commonly called “bottom surgery” to trans people of any age, though adults can access chest surgery in the state.

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A handful of trans kids in Mississippi are receiving gender-affirming care. At Spectrum, Pace estimated that in the last two years, he has seen 30 trans kids for care and less than half have had parental consent to go on puberty blockers. The number of trans kids across the country who are on puberty blockers is similarly small. According to an investigation in Reuters based on insurance claims, just 1,390 trans kids ages 6-17 in the United States were prescribed puberty blockers in 2021.

How would HB 1125 be enforced?

HB 1125 is enforced by a civil, not criminal, process in which anyone who “aids or abets” gender-affirming care for a trans child could be sued for monetary damages for up to 30 years. In addition, doctors who continue to gender-affirming care after the bill passes could lose their license.

The State Board of Medical Licensure, which would enforce the bill's provision revoking providers' licenses, didn't respond 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, “we have no comment for now.”

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McKenna Raney-Gray, staff attorney for the American Civil Liberties Union of Mississippi's LGBTQ Justice Project, said on a call last month that the bill is designed to make it so doctors in Mississippi have no incentive to provide gender-affirming care.

How would this legislation affect access to gender-affirming care in Mississippi?

The bill will go into effect immediately. Spectrum is likely the one provider in the state offering gender-affirming care to trans kids, Pace said, and he will stop treating the handful of 16 and 17-year-old trans teenagers in his care the moment the bill passes. His wife and co-owner of the clinic, Stacie Pace, said they will likely post signs on the clinic's front door saying they no longer accept trans children.

It is unclear if the bill will prevent doctors in Mississippi from referring families and trans kids to out-of-state providers.

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Still, the small number of families seeking gender-affirming medical care involving puberty blockers or hormone treatment will have to go out of state if the bill passes, though some people worry this also would not be allowed under the bill's “aids and abets” clause.

During a Senate Judiciary B committee hearing last month, Sen. Joey Fillingane, R-Sumrall, said he did not think the bill would prevent families from going out of state for care.

“We only control the within the boundaries of the state of Mississippi,” he said. “Now if use it to go to New York or wherever they want to go – L.A. – and do this, that would be controlled by the laws in that state.”

Who supports HB 1125, and why?

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The bill is authored by Rep. Gene Newman, R-Pearl. He has not responded to a request for comment from Mississippi Today. It is backed by a coalition of powerful Republican lawmakers in Mississippi, including Gov. Tate Reeves and House Speaker Philip Gunn, and endorsed by conservative and religious organizations like the Alliance Defending Freedom.

These lawmakers and groups have cast the measure as a way to protect children in Mississippi, sometimes likening gender-affirming care to child abuse. At a rally last month, Gunn said he did not think children in Mississippi should be allowed the choice to transition with puberty blockers or hormones.

“We have decided as a society that children are not always capable of making decisions based on age, lack of maturity and lack of understanding,” he said. “Is there any more consequential decision than changing one's sex?”

Reeves echoed Gunn during his State of the State address.

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“The fact is that we set age restrictions on driving a car and on getting a tattoo,” Reeves said. “We don't let 11- year- olds enter an R-rated movie alone, yet some would have us believe that we should push permanent, body-altering surgeries on them at such a young age.”

What do trans Mississippians, their supportive families and providers of gender-affirming care think of the bill?

Trans Mississippians call the bill an attack on their rights. Jensen Luke Matar, director of the nonprofit Trans Program, said on a call last month that lawmakers are using trans Mississippians as political bait.

“It's just chess,” said Matar, a trans man. “They're playing chess, and they're using the most vulnerable population as their pawns.”

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Supportive parents are devastated by the measure and afraid of what will happen if their trans kids can no longer receive gender-affirming care, Pace said. Many parents are still to figure out how to tell their kids that Mississippi is considering this bill, according to parents who spoke with Mississippi Today on the condition of anonymity. Some are considering the possibility of moving away to states like California and Colorado that have laws protecting gender-affirming care.

Providers of gender-affirming care in Mississippi say the bill will contribute to increased mental illness among LGBTQ+ Mississippians and are worried it will lead to higher suicide rates if it passes.

“The number one thing, if this bill goes into effect? A lot of dead kids,” Stacie Pace told Mississippi Today. “This law goes into effect, it is, in my opinion, the direct cause of youth suicide.”

What forms of gender-affirming care for trans minors would still be permitted under HB 1125?

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Raney-Gray of the ACLU said the bill will not ban social transitioning, such as using new pronouns or wearing different clothes, for trans youth in Mississippi.

It remains unclear how the bill could affect access to gender-affirming care that is provided through a counselor or if that would fall under the measure's “aids and abets” clause. Counselors across the state who have worked with trans people told Mississippi Today that if they accept a trans child as a client, they would seek legal guidance.

READ MORE: ‘Kids will kill themselves': Providers of gender affirming care say anti-trans bill will be a direct cause of suicide

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

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Mississippi Today

On this day in 1850

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May 3, 1850

Shadrach Minkins, right, worked at the Cornhill Coffee House and Tavern, believed to have been located in the highlighted area. Credit: Courtesy of National Park Service

Shadrach Minkins, already separated from his , escaped from the Norfolk, Virginia, home, where he was enslaved. He made his way to Boston, where he did odd until he began working as a waiter at Taft's Cornhill Coffee House.

Months later, Congress passed the Fugitive Slave Act, which gave authorities the power to go into states and arrest Black Americans who had escaped .

A slave catcher named John Caphart arrived in Boston, with papers for Minkins. While serving breakfast at the coffee house, federal authorities Minkins.

Several local lawyers, Robert Morris, volunteered to represent him. Three days later, a group of abolitionists, led by African-American abolitionist Lewis Hayden, broke into the Boston courthouse and rescued a surprised Minkins.

“The rescuers headed north along Court Street, 200 or more like the tail of a comet,” author Gary Collison wrote. They guided him across the Charles to the Cambridge home of the Rev. Joseph C. Lovejoy, whose brother, Elijah, had been lynched by a pro-slavery mob in Illinois in 1837.

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Another Black leader, John J. Smith, helped Minkins get a wagon with horses, and from Cambridge, Hayden, Smith and Minkins traveled to Concord, where Minkins stayed with the Bigelow family, which guided him to the Underground Railroad, making his way to Montreal, spending the rest of his in Canada as a free man.

Abolitionists cheered his escape, and President Millard Fillmore fumed. Morris, Hayden and others were charged, but sympathetic juries acquitted them. Meanwhile in Montreal, Minkins met fellow fugitives, married, had four and continued to work as a waiter before operating his own restaurants.

He ended his career running a barbershop before dying in 1875. A play performed in Boston in 2016 told the dramatic story of his escape.

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

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Medgar Evers will receive Presidential Medal of Freedom

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At her husband's funeral in 1963, Myrlie Evers heard NAACP Executive Director Roy Wilkins declare, “Medgar Evers believed in his country. It remains to be seen if his country believes in him.”

Later , his country will declare its belief in him when the of the slain Mississippi NAACP leader receives the Presidential Medal of Freedom, the highest civilian honor.

But Medgar Evers was more than a civilian. He fought the Nazis in World War II, only to return home and fight racism, this time in the form of Jim Crow, which barred Black Mississippians from the ballot box.

On his 21st birthday, he and other Black of the war went to vote at the courthouse in Decatur, where they were met by white men with guns.

Afterward, he vowed he would never be defeated again and that he would keep fighting by joining others dedicated to the cause of the civil rights movement.

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“The movement for equality was always on his mind, and whites' denial of his right to vote in his hometown served as one cog of many in the overall wheel of injustice, a wheel of which he was bound and determined to break,” said Michael Vinson Williams, author of “Medgar Evers: Mississippi Martyr.”

Myrlie Beasley met Medgar Evers on the first day of her freshman year at Alcorn A&M College in fall 1950. As she leaned against a light pole, she said he told her to be careful, “you might get shocked.”

And shocked she was when she fell in love and married him a year later. He was one of those military veterans that her family had warned her about. And he was involved in the movement that her family had avoided.

She joined him in the fight, and they moved to Mississippi's only all-Black town, Mound Bayou, where he helped Dr. T.R.M. Howard a boycott. They distributed thousands of fluorescent bumper stickers that read, “Don't Buy Gas Where You Can't Use the Restroom.”

In January 1954, the University of Mississippi School of Law turned Medgar Evers away because of the color of his skin. NAACP officials considered taking his case to court, but they were so impressed with him they hired him instead as the first field secretary for the Mississippi NAACP.

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Myrlie Evers worked as his secretary. She said he insisted they call each other “Mr. Evers” and “Mrs. Evers” in the office.

He spent much of his time on the road, putting 40,000 miles a year on his car, recruiting new members, reviving branches and inspiring young people to participate in the movement, Joyce Ladner, who invited him to speak to the NAACP Youth Council in Hattiesburg.

“He had a quiet courage,” she recalled. “I was always amazed that he drove up and down Mississippi's two-lane highways alone at night. He was a marked man, but he kept on going.”

Joan Mulholland is seen holding a photo of her booking shot taken when sge and othger Freedom Riders were in Mississippi un 1961. Credit: Courtesy of the Mulholland family

In 1961, Joan Trumpaeur Mulholland was one of more than 400 Freedom Riders, half of them white, who challenged segregation laws in the South. She and other Riders were arrested and sent to serve their time at the State Penitentiary at Parchman.

When she and other Riders needed a lawyer, Medgar Evers “was the one who took care of it,” she said.

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He became a model for her and others in character and courage, talking often to Tougaloo College students, she recalled. “He wasn't intimidated.”

In 1962, Evers installed Leslie McLemore as president of the Rust College chapter of the Mississippi NAACP. “Medgar Evers was really a brilliant man,” he said. “He had an incisive mind and personality that drew people to him. In another era, he could have been a U.S. senator from Mississippi or maybe even President.”

Evers investigated countless cases of intimidation and violence against Black Americans, including the 1955 murder of Emmett Till. Evers often dressed as a sharecropper in those investigations.

No matter where he went, threats of violence followed. He bought an Oldsmobile 88 with a V-8 engine so powerful it would leave most cars behind. On some dark nights across the Mississippi Delta, he floored it to escape those hell-bent on harming him.

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His name appeared on Ku Klux Klan “death lists,” and his home telephone rang at all hours with threats to him and his family.

When his daughter, Reena, answered the phone one time, she heard a man saying he planned to torture and kill her father.

In spite of these threats, he stayed. He told Ebony magazine, “The state is beautiful, it is home, I love it here. A man's state is like his house. If it has defects, he tries to remedy them. That's what my job is here.”

On May 20, 1963, Evers talked on television about the mistreatment of Black Mississippians. “If I die, it will be a good cause,” he told The New York Times. “I'm fighting for America just as much as the soldiers in Vietnam.”

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Weeks later, President Kennedy delivered his first and only civil rights speech, telling the millions watching on television, “If an American, because his skin is dark, cannot eat lunch in a restaurant open to the public, if he cannot send his children to the best public school available, if he cannot vote for the public officials who will represent him, if, in short, he cannot enjoy the full and free life which all of us want, then who among us would be content to have the color of his skin changed and stand in his place?”

Evers smiled. He and other Black had urged Kennedy to push Congress for a civil rights bill, and now that seemed certain to happen.

Hours later, returning home from a late civil rights meeting, Evers was shot in the back in the driveway of his home.

Myrlie Evers and their three children dashed outside, saw the blood and screamed. “Daddy!” Reena yelled. “Please get up, Daddy.”

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He never did.

“He had the courage to hold an impossible job at a crucial turning point in American history,” said Taylor Branch, the Pulitzer Prize-winning author of a trilogy on the civil rights movement.

For the first time, members of the mainstream press didn't call such a killing “a lynching,” he said. “They called it an assassination.”

In his book, “Parting the Waters,” he wrote, “White people who had never heard of Medgar Evers spoke his name over and over, as though the words themselves had the ring of legend. It seemed fitting that the casket was placed on a slow train through the South, bound for Washington so that the body could lie in state.”

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After the casket arrived, Medgar Evers was buried with full military honors at Arlington National Cemetery.

“The tragedy of his martyrdom is eloquent testimony to the courage and dedication of a leader who — in his lifetime — deserved the respect and of the powerful people who later publicly identified with this man and his cause,” said John Dittmer, author of “Local People: The Struggle for Civil Rights in Mississippi.” “Though long overdue, this award is a fitting tribute to Medgar Evers and his family.”

A year after Evers' assassination, Congress passed the Civil Rights Act on his birthday, and President Lyndon B. Johnson signed the bill into law hours later.

“Medgar Wiley Evers boldly stood against injustice, against oppression, against this country's determination to keep Black people as second-class citizens,” Williams said, “and he was murdered because of his commitment to truth, justice and the struggle for civil and human rights.”

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Before leaving office as governor in 1984, William Winter hosted Myrlie Evers and her family at the mansion, where he remarked that Medgar Evers did more than just free Black Mississippians, he freed white Mississippians as well from the bonds of racial segregation, oppression and hate, he said. “We were all prisoners of that system.”

It took three decades before Evers' killer was finally brought to justice in 1994, and that verdict helped to inspire the reopenings of other cases. There have been 24 convictions in civil rights cold cases.

Myrlie Evers' courage to press for justice in her husband's case started all of this, said Leslie McLemore, who helped found the Fannie Lou Hamer National Institute on Citizenship and Democracy. “It would not have happened without her persistence.”

When she learned last about the Presidential Medal of Freedom honoring her late husband, she exclaimed to her daughter, Reena Evers-Everette, “Oh, my God!”

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Then Myrlie Evers grew silent.

“I'm just utterly speechless,” she said, “and frozen with gratitude.”

Evers-Everette still misses the man she knows as “Daddy,” but she perseveres as the executive director for the Medgar and Myrlie Evers Institute, because his spirit inspires her.

“I feel him around me all the time,” she said. “I marvel at his courage, stamina, vision, and commitment for equality and justice for his people and all of humanity. I pray for his love and wisdom as I pursue this work, because I don't want him to have died in vain.”

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

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Legislative leaders: Medicaid expansion measure set to die Thursday night  

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mississippitoday.org – Taylor Vance and Bobby Harrison – 2024-05-02 19:07:04

An effort in the Mississippi to accept billions of dollars in federal money to expand coverage to the working poor – a policy which medical experts, clergy and business leaders advocated – was expected to die on a Thursday night deadline, according to House leaders.  

House Medicaid Chair Missy McGee, R-Hattiesburg, told reporters that she delivered a proposal to Senate negotiators on Thursday morning that would have voters to have the final say on a statewide referendum in November whether the should expand Medicaid. 

But the Forrest County lawmaker said she had not heard a response from the Senate at all on Thursday, leading her to believe expansion is certain to die by an 8 p.m. Thursday deadline. 

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“It's disappointing,” McGee said. “We worked really hard on it, and we fought to the bitter end.” 

The bill's death would mark an end to months of intense debate at the Capitol and scores of rallies urging legislators to adopt expansion under the federal Affordable Care Act. 

For a brief moment on Wednesday, it appeared both chambers at the Capitol might adopt a compromise, but expansion under that proposal contained stipulations the federal is not likely to approve and could have held expansion here in limbo for years.

House and Senate negotiators on Tuesday night agreed on a compromise that would have expanded Medicaid coverage to individuals who make roughly $20,000 but only if the federal government signed off on a work proposal for recipients – something the federal government was almost certain to reject. 

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But the deal fell apart after rumors circulated in the Capitol that the Senate did not have enough votes to support the plan and after a large portion of Democrats in the House objected to the work requirement. 

House Speaker Jason White, R-, said he would have had the votes Wednesday in the House to pass the compromise, even with the loss of a significant number of Democratic votes.

But the speaker opted to send the proposal back to negotiations after being told by Senate leaders that the Senate only had 28 votes – not enough to pass it by a needed three-fifths majority. 

White said his negotiators offered the referendum option as a compromise that he hoped more Senate Republicans could support. He said he knew it was a long shot that the Senate would accept the proposal, but he thought it was worth a try.

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“I am not casting blame,” White said when asked about what he said was the lack of votes in the Senate. “… But I had to act on that information.”

White said he was disappointed that Medicaid expansion did not pass this , but he said he is glad it was debated and discussed during the session.

“It was a good first step,” he said. “Whether we will look at it next year or the next, I don't know. We will have to reassess.”

White, in his first year as speaker, was the first Republican legislative leader to bring up legislation to enact Medicaid expansion. That original proposal passed by an overwhelming bipartisan vote in the House.

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When asked about whether the Senate had the votes to pass the compromise on Wednesday, a spokesperson for Lt. Gov. Delbert Hosemann said, “The Senate was working to secure the votes, but that effort stalled when House Democrats indicated they did not support the bill.”

Democratic leaders in a statement said they have been “crystal clear” about what they were willing to accept in a Medicaid expansion compromise, but whether House Republicans wanted to listen to is “beyond our control.”

“Unfortunately, neither House nor Senate leadership chose to act on the language we proposed,” the statement read. “Instead, we will without a plan to solve our state's increasingly dangerous healthcare crisis.”

If the expansion legislation dies as expected, lawmakers will have to wait until next year during the 2025 session to reconsider the policy that 40 other states have adopted. 

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Bishop Ronnie Crudup, Sr., the Mid-South Diocese of the Fellowship of International Church who has been advocating for expansion for months at the Capitol, told Mississippi he was still hoping the two chambers could reach a “dramatic” last minute compromise. 

“But we will continue to advocate for Medicaid expansion,” Cruddup said. “If something dramatic doesn't happen, we will be looking for other routes to make this happen.”

Lawmakers on Thursday said they expect to end the 2024 legislative session early Saturday.

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

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