Its co-founder, Dr. Scott Rodgers, has described the “Trustworthy, Evidence-Based, Affirming, and Multidisciplinary” clinic's mission in passionate terms: “The clinic, its presence and its openness, sends a powerful message that we are here for you.”

But last fall, UMMC leadership made a drastic decision. TEAM Clinic would no longer provide gender-affirming medical care — meaning puberty blockers and hormone therapy — to trans minors. The move in mid-October 2022 came months before lawmakers banned gender-affirming care for trans youth, and was implemented as quietly as possible. Parents received phone calls instead of letters and were supposed to be told only that “unforeseen clinical circumstances” necessitated the change.

The news swiftly spread through Mississippi's small LGBTQ+ community, but the reasons for it haven't been reported — until now.

Emails obtained through a public records request show UMMC's decision to stop providing gender-affirming care to trans youth was a reaction to lawmakers who were seemingly angered that the public hospital was helping trans kids transition at all.

In late August, a legislative committee had begun formally probing for information, like how much state funding supported gender transition at the clinic, part of UMMC's Center for Gender and Sexual Minority Health.

“While our one pager clearly outlines what the Center is and does and much of it is not objectionable, it seems that the overarching issue of concern is our providing hormone therapy and reassignment is most alarming to Members, coupled with their feeling caught off guard that we do this at all,” Kristy Simms wrote in a Sept. 12 email to Dr. LouAnn Woodward, the vice chancellor, and other executive leadership.

Simms, UMMC's point person with elected officials at the state and federal level, had a proposal.

“It's looking more and more like we have two options: Pause or shutter some/all of the work of the Center or be told to do so by the legislature in January.”

UMMC's decision echoes those made by hospitals in other conservative states. In Texas, a well-known gender clinic closed after receiving an information request from Gov. Greg Abbott. A similar clinic at Vanderbilt University Medical Center in Tennessee paused gender-affirming care for minors last October following pressure from Republican lawmakers.

UMMC said it had no comment for this story. The emails do not show UMMC officials taking into account the impact that suddenly rescinding care would have on trans youth, but it is unclear what leadership discussed in person.

Among the handful of trans teenagers affected was 17-year-old Raymond Walker, who received puberty blockers and a testosterone prescription through the clinic. That care — which Walker had waited months to get starting in 2020 — was the only thing that relieved the intense gender dysphoria that came with female puberty. It was also a comforting environment. His mother, Katie Rives, recalled that the pediatric endocrinologist “treated Ray like everybody should treat Ray but not everybody does.”

Then one day in early November, Walker learned he could no longer go to TEAM Clinic when Rives picked him up from school. His dad had received a call that the clinic was no longer offering hormone therapy — but wasn't told why. It was just a few days before Walker's appointment and he was running out of testosterone.

“Because it was such a welcoming environment, I couldn't believe that they had just dropped patients like that,” Walker said. “I was just completely blindsided.” 

Walker said he felt like UMMC abandoned trans kids.

“I don't know how they could have a clean conscience about this,” he said. “They stripped away health care from children. It was an important resource that they just took away.”

In fact, it was thriving. The pioneering clinic, founded in 2015, was booked the first Friday of every month. The staff — a roster of psychiatrists, psychologists, social workers, physicians and plastic surgeons — often saw more than 50 patients in a day, some of whom had traveled across state lines to be there.

But this time, lawmakers' inquiries came amid a nationwide panic over gender-affirming care. Across the country, conservative politicians were likening gender-affirming care, the medically recommended treatment for gender dysphoria, to child abuse. By early September, emails show that UMMC had already received “about a dozen inquiries” from lawmakers.

Simms responded by creating a one-pager. She asked leadership if she should send lawmakers a press release that “‘humanizes' the mission of the clinic and shows that it is doing much more than gender reassignment and hormone therapy.”

“When we transmit this to legislators, we will be sure to reiterate that state funds support our education mission ONLY,” she wrote on Sept. 9.

Three days later, Simms had an urgent update. She had received even more calls.

“We have been contacted by chairmen we rely on, friendly legislators and leadership staff,” she wrote on Sept. 12. “Today I got a call from Sam Mims who was very frustrated and indicated that he had been talking with the Speaker about this and he is not happy. I would characterize the conversation as hostile and slightly threatening.”

It's unclear what Mims, chair of the House Public Health and Human Services Committee, said because he did not return inquiries from Mississippi Today. But things moved quickly after that. Simms suggested leadership discuss the future of TEAM Clinic, and Woodward emailed Brian Rutledge, her chief of staff, to coordinate. Rutledge then suggested Rodgers, the clinic's co-founder, be included, noting he “will likely have some feelings.”

Among leadership, Rodgers was in a unique position. A tenured professor, his scholarly work has looked at the mental health of LGBTQ+ youth. That research inspired him to help start TEAM Clinic. It has also enabled him to rise through UMMC's ranks, where last year he became associate vice chancellor for academic affairs.

The emails don't include details about a meeting, so it's unclear what leadership discussed or how Rodgers' perspective was factored into the decision. But later that week, Woodward sent Rodgers an email, urging him to focus on “what we can do for UMMC that is feasible and good.”

“I know this is not fully possible – but to the degree that you can do so – please don't let the current challenges and issues get you down,” she wrote on Sept. 14. “There is nothing about the situation that is your fault. We likely will have to make some adjustments. And I can not predict what the legislature will do.”

Rodgers replied that night.

He asked Woodward about an idea she would “likely consider ‘high risk.'” He wrote that he had traveled the country giving successful talks on TEAM Clinic. Perhaps he could convince the Institutions of Higher Learning or lawmakers of the clinic's value.

“I am confident that I won't be able to win over everyone, but if my track record is any indicator, I will likely make some inroads into changing hearts and minds,” he wrote.

It was either that, Rodgers continued, or “sit back, hope this dies down, and begin dismantling TEAM clinic, which is likely the safer approach to take, but it sure doesn't feel right to me.”

Woodward didn't reply in writing, and it's not clear if she ever OK'd Rodgers' request. Rodgers didn't respond to a request for comment.

“I am not intimidated by the politicians and the Board, and I would treat them with great respect throughout, just as I treat each and every family that I've ever worked with,” he assured Woodward. “I also wouldn't make it political at all.”

“For example, the recent bru ha ha created about our TEAM clinic (clinic for LGBTQ) – not expected,” Woodward wrote in an Oct. 13 email to Tom Duff, the IHL board president. “The clinic has been in place in some form since 2015 and in its current form since 2017 – who knew it would be a hot topic in September of 2022?”

A plan to end TEAM Clinic's services for trans youth, created by the co-directors of UMMC's Center for Gender and Sexuality Minority Health, Alex Mills and Seth Kalin, was dated for the next day. It was printed and hand-delivered to leadership. Employees at the TEAM clinic had been told not to use email to communicate about the transition period.

According to a copy obtained by Mississippi Today, the goal was to move all trans youth patients away from the clinic by Nov. 4. Though the plan was specific to TEAM Clinic, it impacted services across UMMC. Minors who had gone to TEAM Clinic for counseling would be moved to another UMMC center. Those being seen for gender-affirming care were to be given a list of “LGBTQ+ friendly health services” — all outside of UMMC. The only “providers outside of Mississippi” were two websites: getplume.com and queermed.com. 

If parents wanted information about a UMMC-specific provider, the plan says they were supposed to be told to call TEAM clinic.

“We need to ensure a safe and adequate transfer of care and on emergent bases may need to have patients seen during the November TEAM clinic,” Mills and Kalin wrote. “These potential cases can be reviewed by UMMC leadership should they wish.”

It didn't always work out that way in practice — at least not for Walker, the teen whose testosterone prescription was running out. His dad left three calls for his pediatric endocrinologist, but ultimately, his parents found a new provider on their own. They ended up at Spectrum: The Other Clinic in Hattiesburg, an hour and a half drive from the Jackson metro area.

Stacie Pace, Spectrum's co-owner, received a flurry of calls from other scared parents. A passionate advocate for trans health care, she was furious to hear of UMMC's decision.

“It's pitiful to me that the leadership in an organization as large as UMMC — that has its own medical school, that produces its own research — is being forced to bend to political whims,” she told Mississippi Today. “This is insanity. This is a page from Hitler's book on how to erase people.”

The emails obtained by Mississippi Today do not show whether leadership appeared to consider the impact that ending gender-affirming care would have on trans youth patients, who have high rates of mental illness and suicidality.

That would have been crucial to consider, noted Arthur Caplan, a medical ethicist at New York University. He said that neither the plan, nor the way it was implemented in Walker's case, was sufficient, because patients need to be fully apprised of their options for care both in state and out.

“You can't say, ‘We're done, call this 1-800 number of this website, good luck.' That's not adequate,” he said. “You've gotta do much better than saying goodbye, here's a website.”

Per Mississippi State Board of Medical Licensure policies, physicians wanting to end a patient relationship should give written notice and agree to continue providing care for at least 30 days.

Kalin couldn't be reached. Mills, who spoke to Mississippi Today on his behalf and not UMMC's, said he was “demoralized” by the failure of health care leaders in Mississippi to stand up for trans kids.

He apologized for what happened.

“I don't know how to summarize it other than just saying I'm sorry to the community, to these families,” he said. “If there was something that I could do, or if I could just say the right thing to the right person in power to defend the right to health care and life, I wish I knew what it was. And I wish I could have said it before September.”

Walker said he could see how UMMC leadership may have felt like they were picking “the lesser of two evils,” that perhaps if they stopped treating trans kids at the clinic, lawmakers might not pass House Bill 1125.

But he still felt there was “a better way to do it.”

“They could have stayed and fought for their patients and maybe fought the lawmakers or say hey we swore an oath as medical providers, we can't just stop,” Walker said. “I want to know what they were thinking. They swore an oath as medical providers to do no harm. Every person who helped in making this decision has broken that oath.”

Read all the emails here and the transition plan here.

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

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