A panel of education researchers, clinicians and attorneys warned Thursday that Maine’s school-based health centers may be facilitating gender-related services for minors without parental consent, and blamed state laws that grant broad medical autonomy to adolescents with what they described as limited oversight.
The forum, hosted by former state Rep. Heidi Sampson and the Maine Education Initiative, drew parents, school board members and elected officials. Republican gubernatorial candidates Jim Libby and David Jones were among those in attendance.
Presenters included child psychologist Dr. Tom Moyer, Maine Policy Institute research fellow Jonah Davids and Children’s Health Defense general counsel Kim Mack Rosenberg, each outlining what they said are under-recognized vulnerabilities in how schools’ partner with medical providers.
Sampson opened the event by citing Maine’s decades-long academic decline and criticizing the Department of Education’s “Back to Basics” initiative as “branding, not genuine reform.” She said past comments from the commissioner suggested academics would “take a backseat” to other priorities and added that the goal must be “transparency and accountability” to restore trust in public schools.
“I think there’s something like 26 or 29 of these school-based health centers in our state already, and the goal is to have them everywhere,” Sampson said. “The blueprint has been laid, and we need to wake up, smell the coffee and fight back.”
She also said many school board members are “deliberately misled” about their authority, adding, “I’m like Paul Harvey and I’m going to tell them the rest of the story.”
Moyer: Adolescents Are Vulnerable, Especially Those with Autism or Anxiety
Dr. Tom Moyer told attendees that adolescent identity formation is deeply influenced by mental health challenges, peer pressure and developmental disabilities.
“Children on the autism spectrum are more prone to being confused about their gender because of rigid thinking and black-and-white interpretations,” he said.
Moyer said teens coping with anxiety, trauma or depression may focus on gender change as a perceived solution to deeper issues.
“Sometimes children who are significantly depressed or anxious grasp at the wrong solution,” he said. “They come up with the idea that they’re in the wrong body when the real issue is untreated mental-health pain.”
He added that informed-consent standards become especially troubling for students with developmental disabilities.
“For special-needs students, informed consent is even more questionable,” he said. “Can they truly understand what’s being offered?”
Davids: State Law Allows Real Pathways to Medical Transition
Researcher Jonah Davids outlined how Maine law interacts with school-based health centers to create what he described as a “pipeline” from school counseling to medical transition.
He said media narratives claiming gender-related services cannot occur in school clinics are misleading.
“The response was mostly to say, ‘None of this could ever happen,'” Davids said. “However, the truth is more complicated than that.”
Under Maine law:
- Students 14 and older may independently consent to mental-health counseling, sexual-health services and substance-use treatment.
- Students 16 and 17 may receive gender-affirming hormones or puberty blockers without parental consent under certain conditions.
Davids said general consent forms signed at the start of the school year often do not explain which services are considered confidential.
“Under the law, they are able to,” he said. “And parents often never know the services their child received.”
He highlighted MaineHealth one of the largest operators of school-based clinics for openly advertising gender-identity counseling, puberty blockers, hormone therapy and surgical referrals.
“They’re very open about it,” Davids said. “They provide gender-affirming treatments and never say no as long as a child states they believe they’re the opposite gender.”
He urged policymakers to require transparency.
“A very good next step would be requiring these centers to reveal what is actually happening so there’s no more confusion,” he said.
Rosenberg: Districts Could Face Major Legal and Financial Liability
Attorney Kim Mack Rosenberg warned that school districts may face significant liability tied to HIPAA privacy rules, FERPA regulations and federal Medicaid billing.
“If there aren’t adequate safeguards to protect health information, schools could face HIPAA penalties,” she said.
She added that shared electronic records or informal communications between clinic and school staff could expose districts to lawsuits.
“If it can be reasonably assumed that the school and the center are not independent,” Rosenberg said, “the district may be held liable.”
Rosenberg also warned that improper Medicaid billing could trigger severe consequences under the federal False Claims Act.
“The damages are tripled, and each claim can carry penalties of up to roughly $27,000,” she said. “That adds up to millions very quickly.”
She noted two major federal cases with implications for Maine: Mahmoud v. Taylor, decided earlier this year and Childs v. Salazar, which is still pending.
In Mahmoud, “the Supreme Court, in a 6-3 decision, sided with parents,” Rosenberg said, ruling that districts cannot compel students to participate in LGBTQ-themed instruction that violates family religious beliefs.
In Childs, “the Court is examining whether states can prohibit therapists from discussing alternatives to gender-affirming care,” she said.
Parents and School Board Members Press for Answers
During a Q&A session, parents questioned panelists about Title IX conflicts, pre-screened public-comment rules, special-education vulnerabilities and whether school board members could face personal liability.
Rosenberg said districts are typically the named defendants, though exposure remains significant.
Sampson urged districts to assert stronger oversight.
“These clinics should not be operating without full board oversight,” she said.
Growing Debate Over Parental Rights in School-Based Healthcare
The forum underscored a growing statewide debate over school-based clinics, parental notification and the extent of medical decision-making rights for minors.
As the meeting ended, Sampson delivered a warning:
“We abdicated responsibility for our schools, and now we’re reaping the whirlwind.”
She urged parents and school officials to reengage and “move the needle back in the right direction.”
