Doctors In This Red State Now Have To Give The Government Detailed Information About Their Trans Patients

Tennessee Gov. Bill Lee (R) signed a bill into law Thursday that vastly expands the state’s power to gather information about transgender patients and their healthcare providers.

Clinics that receive state funding will now be required to provide aggregated data about transgender patients and their doctors to the state, and the information will be made publicly available.

Health care providers will be tasked with detailing the age and sex of patients receiving any type of gender-affirming care, as well as the type of procedure, names of drugs, dosages, frequencies, methods by which drugs are administered, and any diagnoses of mental health or neurological conditions. Clinics will also have to disclose the name, contact information and medical speciality of any health care provider who offers gender-affirming care.

Any state-funded clinic that offers gender-affirming care will also have to provide similar information about patients who detransition, meaning they once sought gender transition and now want to stop or reverse some aspects of it.

LGBTQ+ and privacy advocates have called the law a massive invasion of privacy. Although individual patients or clinics will not be directly identified in reports to the state legislature, experts worry that patients and providers will remain at risk since transgender people, and the doctors who treat them, make up such a small fraction of the overall population.

The law is the first of its kind in the U.S. Its text draws heavily from model legislation crafted by an influential conservative nonprofit, Do No Harm, which has helped pass laws restricting access to gender-affirming care around the country.

The new law’s passage signals a growing effort among the conservative anti-trans movement to force healthcare providers to produce data on patients receiving gender-affirming care, building on the Trump administration and state officials’ attempts to investigate children’s hospitals and clinics that treat transgender youth. At the same time, Republicans have implemented several policies to support and uphold the small minority of people who detransition, part of a larger shift to discredit the legitimacy of transgender identity altogether.

In Tennessee, access to gender-affirming care for youth and adults is already a challenge. Last year, the Supreme Court upheld Tennessee’s own ban on gender-affirming care for minors, ruling in a 6-3 decision that the law did not violate the equal protection clause of the Constitution. Twenty-seven states have enacted laws banning access to treatments such as puberty-blockers and hormone replacement therapy for transgender youth.

If Tennessee providers refuse to comply with this law’s new requirements, they would be subject to investigation by state Attorney General Jonathan Skrmetti.

In 2022, Skrmetti launched an investigation into Vanderbilt University Medical Center after a right-wing media figure targeted the hospital’s transgender health clinic in a series of social media posts, and the hospital released patient medical records as part of the investigation.

Under HIPAA, healthcare providers and insurers are allowed but not required to disclose patient data ― and generally, providers take a cautious approach.

“Transgender and intersex Tennesseans, especially from less populated areas, will face the risk of having their health information revealed simply because of their gender identity and proximity to their healthcare provider,” Miriam Nemeth, the executive director of the ACLU of Tennessee, wrote in a letter to Lee before he signed the bill into law.

The effect, Nemeth wrote, will essentially be another roadblock for all transgender Tennesseans seeking gender-affirming care, as many providers will likely close out of fear of government targeting. She notes that this level of “excessive governmental interference” into the healthcare of transgender patients sets a dangerous precedent, especially since it applies only to those undergoing gender-affirming care and not to any other medical condition.

Republicans, however, did scrap an additional requirement in an earlier version of the bill that would have required healthcare providers to note the county of residence of the person receiving gender-affirming care. State Rep. Jeremey Faison and state Sen. Brent Taylor, Republicans who sponsored the law, eventually removed this requirement after meeting with protesters who raised fears about their individual HIPAA rights.

Faison and Taylor said the bill is necessary to provide the public with transparency about the number of people who choose to detransition.

“What about the poor folks that took up this transition nonsense, and they transitioned to a sex or a gender that they thought would solve their problem, and they just want to be left alone? They want to be able to go back to their birth gender,” Taylor said at the recent Senate meeting. “The party that is always for universal healthcare and for choice… they’re for choice, but only one way.”

Since 2020, state legislatures have enacted dozens of laws restricting transgender people’s access to healthcare, sports and bathrooms, as well as their ability to update identity documents, and the ability of federally funded schools and universities to acknowledge LGBTQ+ themes in classrooms.

In the past few months, Republican-led state legislatures have enacted policies that have further encroached on the lives of transgender youth and adults. Idaho passed a law criminalizing trans people from using bathrooms, even in private businesses, that align with their gender identity. Kansas invalidated 1,700 transgender people’s driver’s licenses overnight and without notice.