The state Senate took a quick, but measured step back Tuesday from a proposal to ban coverage under the state's Children's Health Insurance Program for all sex change services.

The prohibition was amended into a bill extending the CHIP program, designed to make health care accessible to all children, last week.

In a statement posted on his Website after that initial committee vote, amendment sponsor Sen. Don White, R-Indiana County, said in part "It is completely inappropriate to use state funds to pay for sex change operations for children. I believe that is a position that is strongly endorsed by a vast majority of Pennsylvanians."

On Tuesday, however, after growing pushback from Senate Democrats and further consideration of the issue, the Senate's Republican majority pulled back.

On a 32-18 vote, the caucus passed a second amendment to the bill that would permit CHIP to be used to cover counseling services, drugs like so-called "puberty blockers and other costly treatments that can help kids with gender identity issues.

But the irreversible physical step of sex reassignment surgery would still be barred for what many experts still consider a psychological condition.

The idea, according to sources familiar with the discussion, was that authorizing counseling was an important way to help families with children who are experiencing "gender dysphoria."

Counseling can help kids who are dealing with those issues, and the potential side effects like depression.

Some of the hormone treatments, which are not permanent, can essentially buy time for kids to discover if they are truly transgender before becoming full-bodied men or women.

No one spoke for the amendment, nominally sponsored by White, on the Senate floor.

But after the vote Drew Crompton, chief of staff to Senate President Pro Tempore Joe Scarnati, R-Jefferson County, said the move "was a result of a very healthy full conversation in caucus.

"We have different views on this and the Republican members decided it was a good resolution."

The amendment passed with support from 29 Republican and three Democrats.

But opponents were not satisfied.

"This amendment would put back many of the services that were taken out, wrongfully so. and it's good to put the services back," said Sen. Sharif Street, a Democrat from Philadelphia.

"... But we send a message (to trans-people) that you are less than other people, and that is wrong," Street said, comparing the measure to past American social justice missteps like "separate but equal" policies of the early 20th Century.

It may not be the last word on the issue.

The Senate still has to take final action on the CHIP extension bill, which would also require a reconsideration debate in the House.

And it's not at all clear that Gov. Tom Wolf would accept the compromise language.

Wolf's Department of Human Services began extending coverage for sex change treatments last summer, in response, officials said, to federal regulations springing from the Affordable Care Act.

The Trump Administration, at this point, is not enforcing that rule.

To date, DHS says, medical suggest no more than 34 CHIP enrollees have used health services related to gender identity disorder.

Wolf's Press Secretary J.J. Abbott said Wolf "strongly opposed" the original amendment, and condemned Republicans in Washington and Harrisburg for "playing politics with children and their families."

The administration had not yet addressed Tuesday's change.