Seattle Children’s Hospital Sues Texas AG Over Demand for Trans Youth Medical Records
The Texas Attorney General sent a civil investigative demand to Seattle Children’s Hospital seeking access to the medical records of trans patients. The hospital refused to provide the records and has filed a lawsuit that requests a Texas judge nullify the Attorney General’s demands.
The American Medical Association and the American Academy of Pediatrics believe that gender-affirming care is medically necessary and, in some cases, can be a lifesaving treatment for transgender youth; however, 20 states have imposed bans or placed restrictions on gender-affirming care for minors, and dozens of bills are being considered in other states. Earlier this year, Texas was added to that list when SB 14 was signed into law by Texas Governor Greg Abbott. The law prohibits the provision of gender transition care to Texas residents under 18 years of age.
In November 2023, Texas Attorney General Ken Paxton issued a civil investigative demand for the records of Texas residents who visited Seattle Children’s Hospital to receive gender-affirming care when under 18 years of age. In Washington, gender transition care can be legally provided to minors, including to individuals who travel to Washington from other U.S. states. AG Paxton sought access to information on diagnoses, lab test results, visit records, treatment for gender dysphoria, and other information about minor trans patients from Texas dating back to January 2022, along with the hospital’s standard protocol for treating patients with gender dysphoria who live in Texas. The hospital was given until December 7, 2023, to respond and provide the requested records.
The civil investigative demand was issued by the Texas Attorney General’s Consumer Protection Division as part of an investigation into alleged violations of the Texas Deceptive Trade Practices Act, specifically, the misrepresenting gender-affirming care. The demand for records was also accompanied by a threat of fines of $5,000 or a year in jail for anyone who concealed or falsified information. Seattle Children’s Hospital refused to provide the requested records and claimed that handing over the requested information would violate the Health Insurance Portability and Accountability Act (HIPAA), state healthcare privacy laws, and the recently passed House Bill (HB) 1469 – The Shield Law. The Shield Law protects individuals who travel to Washington to receive protected medical services such as abortion and gender-affirming care, which are banned or restricted in their home states.
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Seattle Children’s Hospital also explained in its lawsuit that it owns no land in Texas, does not provide telehealth services to Texas residents, and has no offices in Texas, and while the hospital does employ a small number of individuals in Texas, none of those employees deal with gender-affirming care, therefore the state has no jurisdiction over the hospital’s practices. The lawsuit claims that the Texas Attorney General’s demands are unconstitutional and are an attempt to chill potential travel from Texas to obtain legal healthcare in another state. The lawsuit requests a Texas Travis County Court Judge overrule AG Paxton’s civil investigative demand, or at least modify the request or grant an extension for reply.
Washington University (WU) has also taken legal action against a state attorney general over a civil investigative demand that sought access to the medical records of trans patients, in that case, the demand was issued by the Missouri Attorney General as part of an investigation into deceptive trade practices under Missouri law. The Missouri attorney general responded with its own lawsuit seeking an order from the court for WU to provide the records immediately, and to get clarification from the court as to whether providing the requested records violated HIPAA.
