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Tennessee is among a number of states trying to limit health care access for transgender people. There are only a few clinics that offer gender-affirming care in the state. And this week, patients at one of those clinics received a troubling email. Marianna Bacallao of member station WPLN in Nashville reports.
MARIANNA BACALLAO, BYLINE: At first, Jack (ph) ignored an email from the clinic where they receive care. But then they heard that the attorney general was asking for the names and medical records of transgender patients, specifically from their clinic.
JACK: Oh, that's what this is.
BACALLAO: NPR is not using Jack's full name out of a concern they could be targeted. The email notified them that the clinic had already passed on their information to the government.
JACK: This isn't, like, you know, a reminder to get a shot or telling me that I've got an appointment coming up. This is, like, hey, by the way, we shared your information. Have fun with that.
BACALLAO: Jack's clinic is a part of Vanderbilt University Medical Center. It's been a frequent target of criticism from Republican lawmakers for offering gender-affirming care.
JACK: I mean, I'm definitely feeling scared. This is not even close to the first time that I feel like my life as a trans person is being targeted in this state, by a long shot.
BACALLAO: Lawmakers in Tennessee have passed many laws to limit freedoms for trans people in the last few years. It's still legal to provide gender-affirming care here. However, it's not legal for some insurance plans to pay for it, specifically for state employees. Republican Attorney General Jonathan Skrmetti is investigating Vanderbilt's clinic, accusing them of finding ways to bill insurance for this care anyway.
JACK: Put yourselves in our shoes. You're a marginalized group. You've seen piece of legislation after piece of legislation that is targeting you and people like you. And then all of a sudden, the attorney general has the most intimate details of your medical history. Even if that's the end of it, that is still terrifying.
BACALLAO: In a statement, the attorney general's office said they keep patient's records in, quote, "the strictest confidence." The investigation, the statement says, is focused on providers, not patients. Some have asked the clinic, why didn't they resist turning over the information? Brice Timmons is a civil rights lawyer who litigated health care claims.
BRICE TIMMONS: It is a tough spot for a hospital to be in to face a facially legitimate investigation on one side and to have to worry about patient confidentiality on the other.
BACALLAO: Health privacy laws like HIPAA make a lot of exceptions for law enforcement. Patients and their providers don't have much recourse, says Timmons. He worries there's no guarantee this information will be safe.
TIMMONS: I don't think there's anything that we've seen from this administration and the Tennessee attorney general's office to indicate that they wouldn't be willing to use the information that they obtained through this administrative investigation in other processes.
BACALLAO: Health privacy laws, says Timmons, rely on the government acting in good faith to protect their citizens. Transgender patients in Tennessee say they don't feel protected. For NPR News, I'm Marianna Bacallao in Nashville.
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