Andy McMillan (center) joins transgender friends and family at the Plaza's Mill Creek Park on Sunday, April 16, to protest restrictions on trans caregiving in Missouri.

Andy McMillan (center) joins transgender friends and family at the Plaza’s Mill Creek Park on Sunday, April 16, to protest restrictions on trans caregiving in Missouri.

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As Missouri lawmakers were considering the most anti-LGBTQ bills of any state, the state health department quietly scrubbed youth sexual health and LGBTQ resources from its website.

Lisa Cox, the spokesperson for the Missouri Department of Health and Senior Services, emailed the agency’s website team in late January directing the removal of links from the website’s adolescent and teen health information page. The page, which is housed within the “Healthy Families” section of the website, directs users to health care resources for teens, parents, educators and providers.

The removed resources, according to emails obtained by The Star, included links to sexual health providers in Missouri, LGBTQ youth groups and other groups that provide sexual health care information.

Roughly 15 minutes after Cox’s email, an information technologist with the Office of Administration emailed back saying that the resources had been removed. The links are no longer available on the website.

Other emails obtained by The Star appear to show DHSS staff discussing whether some resources on the agency’s website were too controversial in Missouri.

The emails, provided to the newspaper after a records request by American Oversight, a progressive government watchdog group, illustrate the lengths that the health department went to remove teen health care resources amid an onslaught of legislation aimed at the LGBTQ community.

One former employee with direct knowledge of the situation and who was employed at the time told The Star in an interview that the removal of the resources was part of a larger pattern of political pressure from outside and within the health agency. The former employee, who spoke on condition of anonymity to avoid retribution, said this pressure played a major factor in the employee’s decision to leave the agency this year.

“There was a lot of political pressure given the content of teen pregnancy prevention and just anything around LGBTQ health and wellness faced a lot of pressure to be censored,” the former employee said. “That was something that I faced repeatedly throughout my time at DHSS.”

When asked about the removed links, Cox told The Star in an email that DHSS staff located hundreds of external resource links during audits of the agency’s website as it prepares for a new site. She said some of the links were dead and others directed people to pages inappropriate for the public health department to house, causing DHSS to establish a standard of removing non-governmental links from the website.

“A couple of the links you referenced below were advocacy groups with a fundraising mechanism built into their homepage. Some included political content,” Cox said.

At least one other state health agency has made a similar move in the last year. In Virginia, the administration of Republican Gov. Glenn Youngkin in May quietly took down LGBTQ youth resources from a state website after a conservative media outlet questioned the links, the Washington Post reported last month. It was the third time the administration had removed information from the website, the newspaper reported.

At the time the behind-the-scenes discussions were happening in Missouri, lawmakers were in the first month of this year’s legislative session and considering nearly 30 bills targeting LGBTQ issues. Republican lawmakers later approved a ban on gender-affirming care for minors and legislation barring transgender student athletes from playing on teams that match their gender identity.

Heather Sawyer, the executive director of American Oversight, said that the department’s removal of resources illustrated a chilling effect caused by the anti-LGBTQ legislation and the state’s near-total ban on abortion, which went into effect last year after the U.S. Supreme Court struck down the federal right to an abortion.

“With attacks on reproductive freedom and LGBTQ rights on the rise, political concerns, including whether information about contraceptive methods and resources for transgender Missourians are too ‘controversial,’ are overriding the need to ensure that all Missourians have access to critical health care information,” Sawyer said.

A spokesperson for Missouri Attorney General Andrew Bailey, a Republican who has played a major role in the state’s anti-LGBTQ push, said the attorney general was not aware of the removed resources. A spokesperson for Republican Gov. Mike Parson declined comment, directing questions to DHSS.

‘Controversial’ resources

Cox’s initial email, sent Jan. 20, directed the agency’s website team to remove the following resources, which were available for teens, parents, educators and health care providers:

  • Power to Decide, a nonprofit that provides information about contraceptive methods and sexual health.

  • Missouri Family Health Council, a network of low-cost sexual health providers in Missouri.

  • Amaze, a Washington, D.C.-based group that provides animated sexual education videos.

  • Sex, Etc., a website that provides sexual health information for teens, including stories written by teen staff writers.

  • Gender Spectrum, a California-based nonprofit that provides information about gender diversity.

  • Trans Student Educational Resources, a national group that provides resources to transgender youth.

  • GLESN, a group that provides resources to educators to create gender-affirming learning environments for LGBTQ youth.

“They’ve been removed. Thanks,” the information technologist with the Office of Administration emailed back minutes later.

Cox, in a statement to The Star, said that each bureau within the agency’s Division of Community and Public Health was at the time conducting a similar audit of links being shared on their pages. She said one of the links discovered during the audit, for example, directed users to a foreign gambling site.

Three days later, on Jan. 23, emails between Cox, Lori Brenneke, the director of the agency’s Division of Community and Public Health and Steve Cramer, a deputy director at DHSS, show that the staff members were still reviewing whether the resource links had been removed. Cramer, in an email to Cox, wrote that “when sharing with Lori, we think it might be helpful to have a larger discussion because a number of the resources listed could be seen as controversial.”

Cox, in a follow-up to Cramer, wrote that after speaking with Brenneke, she was “looking to only allow external links from governmental pages. I’m sure we will get some pushback. Let me know if you want to talk that through further.”

Cramer responded that this would be good practice and asked whether Cox was referring to state or federal governmental pages.

“I ask because there could be times when the information on a federal level site that may be controversial in MO,” he wrote in the email.

Cox, in response, requests that Cramer and Brenneke take a look at the website before non-governmental links are removed in order to ensure that required trainings will not be disrupted, stating that “It’s not as simple as I thought it might be.”

The emails appear to show additional links that were to be removed from the website, but the attachments were not included in the records obtained by The Star.

‘Political decision’

Some Missouri lawmakers, in statements to The Star, criticized the decision to remove the resources, painting it as politically motivated amid the broader legislative push to regulate reproductive and LGBTQ issues.

“Missourians need access to medically accurate information to make healthy decisions. DHSS scrubbed these links not because the information was deemed inaccurate — but because they thought it might offend certain elected officials who want to impose their beliefs on others,” state Sen. Lauren Arthur, a Kansas City Democrat, said in a statement.

Arthur said families across the state “will suffer, once again, because of a political decision in Jefferson City.”

State Rep. Brian Seitz, a Branson Republican, said in an interview that he would have to research the issue further. However, he said, the agency may have just been cleaning up its website so people can get verifiable information.

“I think it is important to do a self-audit and if that’s what we’re doing, then I think that is appropriate,” he said. “We want to provide correct information. Not hearsay and/or opinion but actual information if it’s coming from the state health department.”

Cox, the DHSS spokesperson, said that she directs changes to the agency’s website daily and looks forward to “significant improvements” to the site next year.

“While it’s not a hard rule, in most cases, we plan to include state and federal resources on our website as appropriate,” she said.

After her initial statement, Cox did not respond to two follow-up requests, including questions asking whether the links were removed in response to pending legislation or the overall climate surrounding sexual education in Missouri.

A reporter for The Kansas City Star covering Missouri government and politics, Cassen Bayless is a native of St. Louis, Missouri. He graduated from the University of Missouri with an emphasis in investigative reporting. He previously covered projects and investigations in coastal South Carolina. In 2020, she was awarded South Carolina’s top honor for outspoken journalism.

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