LGBTQ Legal Issues

Texas AG seeks transgender records in Georgia as part of his wider probe

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Texas Attorney General Ken Paxton

Texas Attorney General Ken Paxton speaks in Washington, D.C., on Jan. 6, 2021. (Photo by Jacquelyn Martin/The Associated Press)

Texas Attorney General Ken Paxton has requested medical records from a Georgia telehealth clinic that provides gender-affirming care, a newly discovered move that shows the Republican official is looking in multiple states for information about transgender youths.

Paxton requested transgender youths’ medical records from QueerMed—which is based in Decatur, Ga.—late last year, the health provider’s founder Izzy Lowell told The Washington Post on Sunday.

“This request from the Texas Attorney general is a clear attempt to intimidate providers of gender-affirming care and parents and families that seek that care outside of Texas and other states with bans,” Lowell said in a statement.

Lowell, a family physician, said the clinic stopped providing services to minors in Texas after that state banned gender-affirming care for minors in September. Paxton’s Nov. 17 request, however, was for information about patients dating back to Jan. 1, 2022.

“Let me be clear: QueerMed will never, ever turn over HIPAA-protected patient information,” Lowell’s statement said. “We are not breaking any laws and we will continue to legally provide care in states that have not made the callous decision to put politics ahead of patient health.”

HIPAA, or the Health Insurance Portability and Accountability Act, is a federal law that regulates how health information is used and exchanged among hospitals and doctors’ offices. Lowell did not specify what questions Paxton asked of her clinic.

Texas’s law restricting gender-affirming care for youths does not bar families from seeking care elsewhere.

Georgia is at least the second state where Paxton has sought the medical records of Texas youths, showing that his office is ramping up efforts to curb access to gender-affirming care. Seattle Children’s Hospital received a similar letter in November. In response, the hospital requested a Texas judge to nullify, or at least rein in, Paxton’s demands, saying Paxton does not have jurisdiction over the hospital.

In its legal filing, the hospital also argued that the information Paxton requested was for private medical records and health information covered under HIPAA and Washington state privacy laws, and that Paxton’s queries, purported as an investigation by his consumer protection division, were “sham requests.”

Paxton had asked the Seattle hospital to confirm all medications prescribed by the hospital to Texas children, the number of Texas children treated by the hospital for gender dysphoria, the number of “gender reassignment” surgeries performed, diagnoses for every medication provided by the hospital to Texas children, and the names of labs in Texas that performed tests for the hospital before prescribing medications.

Lowell, of QueerMed, said Paxton’s request for her business’s records was similar to the one Paxton made of the Seattle hospital. It was not clear how many clinics across the country Paxton had requested records from, though Lowell said she had seen letters sent to colleagues in other states.

Paxton’s office did not reply to The Post’s request for comment and a copy of the request sent to QueerMed on Saturday and Sunday.

In November, The Post filed a public records request for all requests filed for medical records of Texas youths who received gender-affirming care out of state. The office responded Jan. 11 by sharing the request to the Seattle hospital. It did not share the QueerMed request.

The Post appealed to the Travis County district attorney after the attorney general refused to supply the QueerMed request.

Paxton has led similar initiatives in Texas. His office investigated clinics in Austin, Dallas and Houston for providing gender-affirming care last year, leading the clinics to close or stop providing services, The Post reported at the time. Paxton’s office also requested records from the Texas Department of Public Safety for those who had changed their sex on their driver’s licenses.

Other state attorneys general have requested similar records, but they have focused their requests on hospitals within their own states. Vanderbilt University Medical Center in Nashville is facing patient lawsuits and a civil rights investigation by the U.S. Department of Health and Human Services after the hospital confirmed in June that it had turned over the medical records of transgender patients as part of a probe by the Tennessee attorney general’s office.

This year, several Republican-led legislatures have put forward bills restricting medical care for transgender youths—and in some cases, adults. At least 22 states have banned gender-affirming care for children, most having done so in the past year, according to the AP.

Those supporting the bans say they have concerns about the treatments and want to protect children.

The American Medical Association, the American Psychological Association, the Endocrine Society and other major medical organizations oppose restrictions on gender-affirming care. The American Academy of Pediatrics has described such care as “medically necessary and appropriate” for some minors.

QueerMed received the Nov. 17 letter on Dec. 7, a delay Lowell attributed to a fire that burned down the care facility’s Decatur office last year. The fire was set intentionally, the Decatur Fire Department said. The perpetrators are still unknown, and the city is collaborating with federal and state agencies to investigate.

In her statement about Paxton’s investigation, Lowell said she is “deeply saddened by the pain and suffering this is causing all transgender and nonbinary patients and families across the South.”

Lowell founded the clinic in 2017 because at the time transgender and nonbinary people in Georgia didn’t have good access to health care, she said.

Patients were having to travel great distances for care, she said, so most of the clinic’s patients were using its telehealth services.

“I thought naively that I will provide this care for four to five years and then as access to such care will improve, I will move on to something else,” she said. “I couldn’t have been more wrong.”

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