Committee finds GOP attorneys general committed “abusive” practices to obtain trans patient data

Republican attorneys general in Indiana, Missouri, Tennessee, and Texas have been using “abusive legal demands” to collect transgender patients’ medical records in pursuit of “ideological and political goals,” according to a 10-page report recently released by the staff of the U.S. Senate Finance Committee’s Democratic majority.

The report accuses the attorneys general of using misleading legal pretexts to make civil investigative demands of gender-affirming healthcare providers. The investigations have contributed to hostile anti-LGBTQ+ social and political climates and have also worsened queer people’s mental health, leading to “suicidal ideation, severe depression, and intense anxiety,” the report added.

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Tennessee Attorney General Jonathan Skrmetti’s investigation alleged clinicians’ misuse of Medicaid funds as a “money-making scheme.” Indiana Attorney General Todd Rokita and Missouri Attorney General Andrew Bailey both alleged that gender-affirming clinics had violated consumer protection laws. Texas Attorney General Ken Paxton demanded records from clinics in his state, Georgia, and Washington state without ever explaining why.

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All four states mentioned above have passed bans on gender-affirming care for minors.

“In their sweeping anti-LGBTQIA+ campaigns, Attorney General offices demand a host of invasive items such as unredacted physical and mental health records, photographs of children’s bodies, correspondence to hospitals’ general email addresses for LGBTQIA+ patients, and lists of people referred for transgender health care,” the report stated.

While Tennessee’s Vanderbilt University Medical Center (VUMC) handed over its records — compelling its patients and their families to sue the hospital for privacy violations — hospitals in Missouri and Washington refused to comply with investigative requests, respectively citing federal patient privacy laws and suing to protect patient records.

The 1996 Health Insurance Portability and Accountability Act (HIPAA) allows healthcare providers to share patient information without their consent with law enforcement personnel. But it also requires that administrative requests, like the ones mentioned above, are tailored to be “relevant and material” to an investigation, “specific and limited in scope,” and acceptance of anonymized information that can’t reasonably be used to identify patients or retaliate against them.

The report states that hospitals should use HIPAA and other legal avenues to protect their patients. In some states, attorneys general lack the power to obtain private patient records because such power lies with more appropriate state agencies that oversee healthcare.

“Attorneys General are weaponizing their oversight authorities for their own political gain, at the expense of LGBTQIA+ people and their families,” the report stated. “Further, by implicating the Medicaid program, a cornerstone public insurance program for low-income Americans, these efforts undermine the integrity of public health care.”

Senate Finance Committee Chair Ron Wyden (D-OR) said of the report, “A handful of red-state attorneys general are misusing their authority to terrorize transgender teens in their states, violating patients’ privacy, and causing real harm to vulnerable kids and adults in the process. It’s shameful that law-enforcement officials are choosing to persecute teens trying to live their lives, just to score points with far-right activists.”

“Giving up on patient privacy, particularly after the repeal of Roe v. Wade, opened the door to criminalizing women’s private reproductive health choices and is an utter betrayal of a medical provider’s responsibility,” Wyden added.

At least 23 states have banned gender-affirming care for trans minors, while 14 states and Washington, D.C. all have “shield” laws protecting such care and refusing to work with any out-of-state investigations into the receipt of such care. A recent report found that negative healthcare experiences harm LGBTQ+ patients’ mental health and make queer people less likely to seek health care.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgement-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.