Mississippi Medicaid Comes Out Against ‘Gender-Affirming Care' for Children

Protesters hold placards during a rally against gender-affirming care at the War Memorial Plaza in Nashville, Tenn., on Oct. 21, 2022. Seth Herald/AFP via Getty Images

As the Mississippi Senate considers a bill that would ban the use of pharmaceuticals and sex reassignment surgery for minors who think they are experiencing gender dysphoria, the state’s leading health coverage company has taken a firm stance against the procedures.

The Mississippi Division of Medicaid said it agreed with a report from the Florida Agency for Health Care Administration (pdf) concluding that there is a lack of conclusive evidence to support medical intervention for gender dysphoria in children and adolescents.

“Mississippi Medicaid concurs with Florida Medicaid’s determination that available medical literature provides insufficient evidence that sex reassignment through medical intervention is a safe and effective treatment for gender dysphoria,” said Drew Snyder, executive director of Mississippi Medicaid, in a Feb. 15 statement (pdf).

Snyder added that Mississippi Medicaid agrees that the evidence that is available demonstrates that the treatments cause “irreversible physical changes and side effects that can affect long-term health.”

In June 2022, Florida Medicaid issued the report stating that the medical literature supporting gender reassignment for children and adolescents was inadequate, while the studies that claim medical intervention benefits their mental health and prevent suicide “are either low or very low quality and rely on unreliable methods such as surveys and retrospective analysis, both of which are cross-sectional and highly biased.”

Florida’s report (pdf) relied on five clinical and technical expert assessments that recommended against the use of medical interventions to treat what was classified as a mental health disorder.

Among potential sources for gender confusion listed in the report are biological, autism, and other psychiatric disorders.

“In addition to biological factors and correlations with ASD, researchers are exploring psychological and social factors to assess their role in gender dysphoria etiology,” the report states. “This literature examines a range of potential causative agents, including child abuse, trauma, and peer group influences.”

‘Booming Business of Gender Clinics’

In a previous interview with The Epoch Times, Patrick Lappert, an Alabama plastic surgeon, explained that many recent cases of gender dysphoria are based on the self-diagnosis of the child, who is reportedly experiencing anxiety, depression, and thoughts of suicide.

Because children don’t have high executive functioning, they aren’t allowed to do things like vote and buy alcohol, he said, yet they’re permitted in this case to be their own diagnostician in medical treatment that is irreversible.

Through cognitive therapy, children historically have had a 92 percent success rate of overcoming gender dysphoria, he said.

But guiding children out of gender dysphoria with therapy doesn’t fit the new standard of gender-affirming care, which has led to what Lappert called “the booming business of gender clinics.”

Just 10 years ago, there were only five gender clinics in the United States. Now, he said, there are up to 57.

Republican Sen. Marsha Blackburn speaks during a rally against gender-affirming care at the War Memorial Plaza in Nashville, Tenn., on Oct. 21, 2022. Seth Herald/AFP via Getty Images

A Questionable Study

A study published in January in the New England Journal of Medicine stated that as a result of taking cross-sex hormones, “appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased” for minors and young adults with gender dysphoria.

The study included 315 people, aged 12 to 20 years old, who considered themselves to be transgender or “nonbinary.”

The most common adverse event in the study was suicidal ideation, which occurred in 11 participants, and two participants took their own lives.

However, according to the medical watchdog organization Do No Harm (DNH), the study “raises several questions that weaken its overall conclusions that this form of therapy is truly beneficial to these subjects.”

“First, the absence of any control group raises the possibility that ongoing psychological counseling and therapy may explain the slight improvement in some parameters of the study,” said DNH founder and chairman Dr. Stanley Goldfarb in a response to the study (pdf). “Second, the fact that the subjects were seen in these clinics for some prolonged period of time prior to entry into this study may produce spurious results due to the well-known phenomenon in surveys called ‘demand characteristics.’ In this way, if the survey is conducted under the auspices of the study authors, the results may be influenced by a ‘cheering on’ effect.”

According to Goldfarb, the researchers at the four clinics in the study are known for radical activism, with a pre-invested interest in supporting medical transition for children.

“Given this obvious bias, there is a high likelihood that study participants were steered toward responses that align with the activism promoted by these clinics,” Goldfarb said.

Among its major flaws, the study’s results suggest that the only improvements were in “appearance congruence.”

“Improvement in positive affect, life satisfaction, depression, and anxiety only improved by the smallest margins,” Goldfarb said.

Researchers observed minimal improvements in mental health among participants who took hormones late in puberty, the study reports.

For those who took hormones early in puberty, researchers were left with “static measures.”

Researchers explain that these observations are in alignment with other studies promoting positive psychological functioning resulting from early access to so-called “gender-affirming” care, Goldfarb said.

“In other words, they assert that the lack of improvement among this subsample constitutes evidence in support of their radical worldview,” Goldfarb said.

It’s a “fatally flawed” study that leans into the unscientific and warrants skepticism, Goldfarb said.

“Rather than follow their lead, policymakers should emulate European countries that increasingly prohibit access to these experimental treatments for minors, largely due to acknowledgment that the evidence base fails to establish that these treatments are beneficial on balance,” Goldfarb said.

Fairfax County mother Stacy Langton (L) protests the school district's pro-transgender policies and "gender-affirming care" outside a Fairfax County School Board meeting in Falls Church, Va., on Nov. 3, 2022. Terri Wu/The Epoch Times

Europe’s ‘Sharp Departure’

According to another report (pdf) by DNH, Europe has largely rejected gender-affirming care for children.

Several countries such as the United Kingdom, Sweden, and Finland have deserted the model out of concern that these treatments and procedures have been overprescribed.

“In a sharp departure from the gender affirmation model employed in the United States, these countries now discourage automatic deference to a child’s self-declarations on the grounds that the risks outweigh the benefits, while also calling for months-long psychotherapy sessions to address co-occurring mental health problems,” Goldfarb said.

The different approaches between Europe and the United States reveal a disturbing trend in the country’s eagerness to provide irreversible and harmful medical intervention, according to the DNH report.

“Given the growing body of evidence and the European consensus, which is grounded in medical science and common sense, the United States should reconsider the gender-affirming care model to protect the youngest and most vulnerable patients,” DNH said.