Medical Institute for Sexual Health

This content was last updated Oct. 4, 2023, 7:59 a.m. UTC

The Medical Institute for Sexual Health (MISH) is an abstinence education group in Dallas, Texas. Founded by Joe S. McIlhaney, Jr. in the early 1990s, MISH has maintained a primary focus on advocating for abstinence-only education in lieu of more modern approaches to education on sexual health and reproduction. Much more recently, MISH has begun advocating against gender-affirming care for transgender minors.


MISH was founded in 1992 by Joe S. McIlhaney, Jr., in Dallas, Texas. McIlhaney was an obstetrician/gynecologist who founded the organization after reportedly finding “many women needed infertility and cancer treatments resulting from sexually transmitted diseases (STDs) they had acquired years earlier,” while running his private practice. The organization’s stated goal is to provide sexual health information, but their focus on abstinence-only education has been criticized publicly as far back as 2006, and received criticism from medical professionals in 1997.


MISH is a 501(c)(3) nonprofit organization with several decades of reportable revenue in amounts that require the submission of a full Form 990. The group’s total revenue has varied widely from year to year, with a high of $2.7 million in 2005, and a low of $214,006 in 2016.

Salaries paid out by MISH also vary from year to year, with the most consistent payments going to McIlhaney, who received a minimum salary of $100,000 in both 2020 and 2021. Other recipients are Science Director Michael Mitakidis, who received $136,248 in 2021 and $146,667 in 2020, and CEO Lori Kuykendall, who received $139,333 in 2021 and $58,000 in 2020.

For the fiscal year ending in 2022, the majority of the group’s listed funding was gained through grants and contributions totaling $1,143,412, with a minor contributing factor of program service revenue totaling $22,423. With a total revenue of $1,166,392 weighed against their total expenses of $676,329, MISH ended 2022 with an excess of $490,063 and total assets equaling $625,936. The organization does not list its donors by name on their returns.

MISH did not pay any of their six top listed employees in 2022, but did list a $137,500 payment to Prolific LLC and $146,667 to Joseph David Advertising LLC as independent contractors. Additional expenses include $79,685 in miscellaneous salaries, $245,663 in advertising and promotion, and $149,810 in conferences, conventions, and meetings. 

History of Anti-LGBTQ+ Activism

MISH’s position statement on treatment options for transgender minors cites Transgender Research: Five Things Every Parent and Policy-Maker Should Know, a paper published by The Institute for Research & Evaluation. The paper, which contains various examples of poorly-sourced data to oppose gender-affirming care for minors, claims “Scientific evidence has not shown that cross-sex medical treatments are beneficial to children or adolescents,” and “research claiming to show positive effects from cross-sex hormones or surgery is methodologically flawed and not scientifically reliable.” The American Psychological Association advocates for making gender-affirming care accessible and minors who are denied treatment are at a much higher risk for depression and suicidal ideolation.

The organization also cites Irreversible Damage: the Transgender Craze Seducing Our Daughters by Abigail Shrier, an anti-trans activist and author who supports the idea of the social contagion model and rapid onset gender dysphoria for which experts in the field have said no evidence exists.

Beyond their stated goals, the group’s advocacy work has directly led to schools removing discussion of boundaries and consent from Texas’ health education standards in 2022.

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