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Morrisey Argues Against Gender Affirming Care Through Medicaid

West Virginia Attorney General Patrick Morrisey does not think the state’s Medicaid plan should cover gender-affirming surgery.

On Thursday, West Virginia Attorney General Patrick Morrisey said his office argued a case before the Fourth U.S. Circuit Court of Appeals involving the state’s decision not to cover gender-affirming surgeries under its Medicaid plan.

That case is an appeal from an order last year from a federal district court. It said the state’s choice not to cover gender-affirming care under Medicaid violates the U.S. Constitution’s Equal Protection Clause.

The original class-action lawsuit was filed in the U.S. District Court for the Southern District of West Virginia on behalf of three Medicaid recipients. Christopher Fain, a Medicaid participant; and Zachary Martell and Brian McNemar, a dependent and state employee, respectively.

Usually, three-judge panels decide cases on appeal, but the Fourth Circuit set the argument before the entire court in this case and a related case out of North Carolina.

For now, gender-affirming care is covered under the state’s Medicaid program.

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‘A House In The Clouds’ Documentary Highlights Life Of LGBTQ Artist In West Virginia

Douglas Imbrogno and Bobby Messer’s Film “A House In The Clouds: The Artistic Life of Robert Singleton” is a documentary about the life of Robert Singleton — a gay man who grew up in Appalachia and survived loss, discrimination, and trauma to ultimately become an award winning artitst. Imbrogno said it’s not a story of a superhuman, but a story of a life well lived, despite hardships.

Douglas Imbrogno and Bobby Messer’s Film “A House In The Clouds: The Artistic Life of Robert Singleton” is a documentary about the life of Robert Singleton — a gay man who grew up in Appalachia and survived loss, discrimination, and trauma to ultimately become an award-winning artist. Imbrogno said it’s not a story of a superhuman, but a story of a life well lived, despite hardships.

“This creative soul has been, has been battered, and had many losses in his life has found his way to equilibrium. And I describe him as a jovial soul,” Imbrogno said.

Imbrogno says it’s important that these kinds of West Virginia stories are told, because often there is a lot of bad news coming out of the state.

“I think that’s quite an inspirational thing to share, because so much of the news is filled with bad actors and human beings behaving badly. Here’s an example of how life can be well lived,” he said.

Imbrogno and Messer said the film also comments on the attempts to brand trans youth as damaged souls with parallels in the film to what many trans people face today. Imbrogno says he wants to take viewers to the beauty Singleton reflects in his painting and his home in the mountains of West Virginia.

“I want them to feel the mountains. I want them to be up in the clouds with Robert’s artwork, to see his development as an artist from landscapes to abstraction to these spiritual ethereal paintings that he’s doing these days,” said Imbrogno.

The film premieres at 7 p.m. on Sunday at the Juliet Art Museum inside The Clay Center in Charleston. Tickets are available at the Clay Center box office. There are two showings in October in Thomas, West Virginia. Streaming is not yet available for the film.

Students Protest Anti-Abortion Display At WVU

Students at West Virginia University (WVU) in Morgantown are protesting an anti-abortion display on campus.

The anti-abortion group Center for Bio-Ethical Reform staged a demonstration Wednesday and Thursday in WVU’s free speech zone in front of the Mountainlair student union.

The organization displayed images that purported to show aborted fetuses alongside victims of lynching and the Holocaust, comparing abortion to genocide.

Jacinta Robin is a media liaison for Center for Bio-Ethical Reform events. She said the organization brought the display — titled the “Genocide Awareness Project” (GAP) — to WVU because the university’s “plethora of students with diverse ideas” made it a good place for public discourse.

“We seek public universities for the reason of there being a public discourse on their campus in some capacity, that we should be allowed to use as a taxpayer in this country,” Robin said. “But we still abide by the university’s protocol every time.”

She said the organization aims to sway public opinion and that their images represent the organization’s beliefs.

“Many people believe that abortion is the process of eliminating blood and tissue,” Robin said. “We’re reversing that narrative that abortion decapitates and dismembers a tiny human child.”

Returning student Adrienne Dering called the information on the signs ”factually incorrect.”

“This is an institution of education, and people deserve to be educated,” Dering said.

“Abortion doesn’t look like D&Cs [dilation and curettage] anymore,” she continued. “Ninety-seven percent of abortions in this country are in the first trimester, and the vast majority of them are medical abortions where women have a safe, medically monitored miscarriage in the comfort of their own home and the blood clot is the size of an olive.”

Dering said she was also protesting because the information being presented, which included comparisons of gender transitioning to genital mutilation, was potentially harmful.

“The information on that hurts people, and we need to protest against anything that is divisive and hurtful to people of all gender assignments and to human beings,” she said.

Counter-protestors started their action as early as 7 a.m. Thursday, which included handing out contraceptives as well as information about safe sex and reproductive health resources.

Students like freshman Leah Coleman blocked the view of the display with oversized signs painted on tarps and bed sheets reading “Protect Trans Folks” and “Abortion is Healthcare.”

“By putting it in front of the Mountainlair, it’s making it look like, ‘Oh, this is WVU’s message. This is what WVU supports,’” Coleman said. “But obviously, this is not what the student body supports, or we wouldn’t be here.”

A similar display and counterprotest took place at Marshall University earlier this week.

Many of the students at the counterprotest said they have written to the university expressing their concern and confusion at the Center for Bio-Ethical Reform’s presence on campus. Some have asked for the group’s removal.

The organization is considering returning Friday. Students plan to continue their protest if they do.

W.Va. Governor Signs Ban On Gender-Affirming Care

West Virginia Republican Gov. Jim Justice on Wednesday signed a bill banning gender-affirming care for minors, joining at least 10 other states that have enacted laws restricting or outlawing medically supported treatments for transgender youth.

The bill outlaws those under 18 from being prescribed hormone therapy and fully reversible puberty blockers. It also bans minors from receiving gender-affirming surgery, something physicians say doesn’t even happen in West Virginia.

Unlike measures passed in other states, however, West Virginia’s law contains a unique exemption: It permits doctors to prescribe medical therapy if a teenager is considered at risk for self-harm or suicide.

Under the law, which will take effect in January 2024, a patient can be prescribed puberty blockers and hormone therapy after receiving parental consent and a diagnosis of severe gender dysphoria from two clinicians, including a mental health provider or an adolescent medicine specialist.

Both practitioners must be trained to diagnose and treat young people with severe gender dysphoria and provide written testimony that medical interventions are necessary to prevent or limit possible or actual self-harm.

The provisions were added at the urging of Senate Majority Leader Tom Takubo, who is a physician.

“These kids struggle. They have incredible difficulties,” the Republican said on the Senate floor earlier this month. Takubo cited more than a dozen peer-reviewed studies showing a decrease in rates of suicide ideation and attempts among youth with severe gender dysphoria who had access to medication therapy.

Gender dysphoria is defined by medical professionals as severe psychological distress experienced by those whose gender identity differs from their sex assigned at birth.

The bill also prohibits minors from being prescribed hormone therapy before the age of puberty, something West Virginia physicians say doesn’t happen anyway.

The medication dosage for any adolescent must be the lowest possible necessary to “treat the psychiatric condition and not for purposes of gender alteration,” according to the bill.

The West Virginia law comes as Republican lawmakers across the U.S. have pursued several hundred proposals this year to push back on LGBTQ+ rights, particularly rights for transgender residents, including banning transgender girls from girls sports, keeping transgender people from using restrooms in line with their gender identities and allowing or requiring schools to deadname trans students.

Lawmakers in West Virginia and other states moving to enact bans on transgender health care for youth and young adults often characterize gender-affirming treatments as medically unproven, potentially dangerous in the long term and a symptom of “woke” culture.

Every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association, supports gender-affirming care for youths.

A 2017 study by UCLA Law’s The Williams Institute estimated West Virginia had the highest per capita rate of transgender youth in the country.

The rate of suicide ideation, or having suicidal thoughts or ideas, for transgender youth in West Virginia is three times higher than the rate for all youth in the state, according to West Virginia Youth Risk Behavior Survey data.

Natalie Frazier, who oversees gender-affirming care for Planned Parenthood in North Carolina, South Carolina, Virginia and West Virginia, said the bill Justice signed Wednesday was “better than it could have been.”

“But it’s still unnecessary — just an unnecessary barrier to care that is going to end up harming people,” she said, adding that not every child’s family will have the resources to travel to two different clinicians for a gender dysphoria diagnosis.

Frazier, who is also a certified nurse midwife, said the diagnosis of severe gender dysphoria with risk of suicide “could probably apply to just about any kid getting access to gender-affirming care.”

“That’s why people are are so invested in providing the care because there is a disproportionate risk,” she said. “That’s something that any of these kids could be at risk for and nobody’s going into this care lightly.”

West Virginia’s ban also includes exemptions for people who are born intersex and for people taking treatments for infection, injury, disease or disorder that has been “caused by or exacerbated by the performance of gender transition procedures.”

Surgeries can be performed if a child is at risk for “imminent danger of death or impairment of a major bodily function.”

At least 11 states have now enacted laws restricting or banning gender-affirming care for minors: Alabama, Arkansas, Arizona, Georgia, Iowa, Kentucky, Mississippi, Tennessee, Utah, South Dakota and West Virginia. Federal judges have blocked enforcement of laws in Alabama and Arkansas, and nearly two dozen states are considering bills this year to restrict or ban care.

Justice Signs Several Bills Into Law At Deadline

In a flurry to get completed bills signed before a constitutionally imposed Wednesday deadline, Gov. Jim Justice put pen to paper on many, and let others simply become law.

In a flurry to get completed bills signed before a constitutionally imposed Wednesday deadline, Gov. Jim Justice put pen to paper on many, and let others simply become law. The governor has 15 days to either sign a bill or veto it after the end of the session. The governor also can allow a bill to become law without his signature.

Justice signed House Bill 2007, restricting medical options available to youths going through gender dysphoria. The law bans gender-affirming care, including medications, to anyone under the age of 18 in most circumstances. Under the bill, some young people with severe gender dysphoria may be able to access hormone therapy if the diagnosis is confirmed by two doctors, including a mental health care provider, and if the minor has parental consent. The bill will go into effect on January 1, 2024.

Planned Parenthood South Atlantic provides gender-affirming hormone therapy in West Virginia. Representatives say gender affirming care improves health outcomes for patients who are transgender or nonbinary.

“I cannot count the number of patients that we have seen who had seriously contemplated or even attempted suicide in the past who now tell us they are so much happier after starting gender-affirming hormone therapy,” Planned Parenthood South Atlantic clinician Carrie Lett said. “Although some young people may still be able to get the care they need, this law still amounts to the government putting politics over people’s lives and interfering with medical best practices.”

Justice said he struggled with House Bill 2820, allowing Hope Scholarship recipients to participate on public school teams unless the sport is already offered at their school.

An amendment to the bill allows student-athletes to transfer schools at least one time and keep their athletic eligibility. He let the bill become law without his signature.

“I fully support the ability of our HOPE scholarship recipients, students in microschools or learning pods, homeschooled students, or our private school students to participate in extracurricular activities at their school or at their local public school,” Justice said. “However, allowing student athletes to transfer to any school whatsoever with no purpose other than jumping to a better athletic team will do nothing but make a few teams better at the expense of all the others.”

Justice signed House Bill 3018, the so-called “child marriage bill.” The new law removes the possibility that anyone younger than 16 could marry. Those aged 16 and 17 would have to obtain parental consent and they couldn’t marry someone more than four years older than them.

Among other bills signed; House Bill 3135, raises the salaries of the Governor and Constitutional officers beginning in 2025, House Bill 2310, changing West Virginia vehicle inspections to every two years, Senate Bill 613, creating certificate of need exemptions for hospitals and physician groups and House Bill 2436 creating an acuity-based patient classification system meant to help address nursing staff needs.

Three hundred and thirty-three bills passed during the 2023 60-day legislative session that ended March 11.

Lawmakers Approve Gender-Affirming Health Care Ban, With Exception

House Bill 2007 was the last bill taken up on the floor of the Senate Friday night, and was amended to provide an option to healthcare providers and families.

The House of Delegates passed an amended version of House Bill 2007 Saturday that restricts gender-affirming medical care for transgender youth, but carves out an exception for some treatment.

Late Saturday, the Senate voted 30-2 to give the bill its final approval.

HB 2007 bans gender-confirmation surgeries for minors, which experts have said are rare or nonexistent in West Virginia and other states. The House last month passed a version with no exceptions for hormone therapies and puberty blockers.

However, the Senate amended the bill Friday night to create a narrow path for minors to receive such treatment, with the endorsement of doctors and parents.

On Saturday, the House approved the amended bill on a vote of 88-10.

Del. Ric Griffith, D-Wayne, spoke in favor of the amendment and the bill.

“And like I said, you know, I think about this, and the votes we take on this will show up next November. But I keep thinking which is more important. These children, or how we’re perceived by our voters, and the lives of these children, are critical for us to protect and this is a very narrow allowance for there to be an exception when the medical profession believes it’s in the best interests of preventing a suicide for these young people, so I urge adoption of the amendment.”

The amendment followed testimony from doctors, parents, counselors and religious leaders who spoke against the bill, followed by a protest Thursday at the Capitol by LGBTQ rights groups.

Regardless of medical or parental opinion, HB 2007 has been hotly contested since the early days of the session and has sparked public hearings, rallies and lengthy floor discussions.

The bill originated with the purpose of banning gender affirming surgery for minors, something that medical experts testified in committee meetings is almost never done, and was later amended to include all forms of hormone therapy for minors as well.

House Bill 2007 was the last bill taken up on the floor of the Senate Friday night, and was amended to provide an option to healthcare providers and families. One complaint about the bill is that lawmakers didn’t listen to experts in the field when it was drafted, making some doctors on the relevant committees uncomfortable.

Senate Majority Leader Sen. Tom Takubo, R-Kanawha, who is a doctor, introduced an amendment to allow hormone treatment under certain circumstances when a person has a sense of unease because of a mismatch between their biological sex and their gender identity, a condition known as gender dysphoria.

“Patients with severe gender dysphoria, which is an extreme psychological illness, these kids struggle, they have incredible difficulties,” Takubo said. “What the section did was gave very strict guardrails so that the rest of the bill was left alone that talked about not being able to use the medicines just to create all these external changes, but instead it says that they can only be used in very specific situations.”

First, two distinct medical professionals, one specializing in mental health, must diagnose an individual with gender dysphoria. Second, the medical professionals must give a written opinion that hormonal therapy is medically necessary. Third, the patient’s parents or guardians, as well as the patient’s primary care provider, must all agree in writing that hormone treatment is the best course of action and finally, only the minimum level of hormones to treat the condition may be used.

Takubo went on to cite 17 peer-reviewed studies to dissuade concerns that hormonal therapy is not supported by the data. He began with a study in the New England Journal of Medicine, which he called, “almost one of the Bibles of medical studies.”

“What they did is they tested early treatment versus trying to wait because that’s the question, ‘What if we just wait till they’re adults to do this?’ When you wait, and the patient is already suffering from severe psychological psychosis, the incidence of depression was markedly higher,” Takubo said.

He went on to highlight the statistical significance of early treatment for gender dysphoria.

“The p value for the changes of what it did in severe depression, it had a p value of .001. If this was a surgery or cancer treatment, there would be no question,” Takubo said.

Sen. Mike Maroney, R-Marshall, also a doctor and the chair of the Senate Health and Human Resources Committee, stood in favor of the bill and extended Takubo’s comparison to cancer treatment.

“If it was a chemotherapy drug for lung cancer, you change the treatment the next day because it works better. But because it’s something we don’t quite understand, legislators can step in and tell experts across the nation and the world how to treat 30 patients that have a psychiatric condition,” Maroney said. “That is such a bad precedent to set.”

Several Senators, including Sen. Mark Maynard, R-Wayne, and Sen. Eric Tarr, R-Putnam, stood to oppose the amendment. Sen. Mike Azinger, R-Wood, provided the most animated opposition to the amendment. He said the nature of gender was “self-evident” and that giving children hormones to change their sex was “self-evidently” wrong. Azinger quoted a speech by Mississippi Gov. Tate Reeves about “a dangerous movement sweeping across America today.”

“It’s trying to convince our children that they are in the wrong body. This dangerous movement attempts to convince these children that they’re just a surgery away from happiness. It threatens our children’s innocence and it threatens their health,” Azinger read.

“It’s self-evident that you do not, you do not chop up a child just try to prove that you can change their sex. You do not interrupt the natural course of childhood, growing into a young person by blocking their puberty, the natural course of events,” Azinger concluded.

Woelfel stood in favor of the bill and the amendment, and pointed out the irony that Senators who just minutes before had spoken about protecting children from predators would now go against science proven to protect children’s healthcare.

“Moments ago by vote of 32 to 1 this body decided that 16 and 17 year old kids with their parents could make a major life altering decision to get married,” Woelfel said. “I just can’t fathom that some legislator would want to get in the middle of that doctor – patient, parent – child relationship.”

Woelfel also pointed out that similar bills in Alabama and Arkansas were found to be either partially or wholly unconstitutional.

The amendment passed 20 to 12, with two Senators absent.

Sen. Patricia Rucker, R-Jefferson, also proposed an amendment that would establish reporting requirements for the prescription of “gender altering medication.” The amendment was deemed to not be germane to the bill and was dismissed.

The Senate’s final vote to pass the amended bill was 30 to 2, with two Senators absent. Sen. Mike Caputo, D-Marion, and Sen. Robert Plymale, D-Wayne, were the two votes against the bill.