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‘They are justifiably scared’: Transgender patients sue medical center for handing over confidential records to state officials


FILE – Vanderbilt University Medical Center in Nashville, Tenn., is pictured on July 16, 2013 (AP Photo/Mark Humphrey, File). Inset: Tennessee Attorney General Jonathan Skrmetti (via Tennessee government website).

Two transgender patients filed a class action lawsuit against a hospital Monday alleging that the medical center participated in a targeted campaign against transgender patients by the state of Tennessee.

The plaintiffs say that Vanderbilt University Medical Center (VUMC) knew that Tennessee Attorney General Jonathan Skrmetti purported to investigate medical billing fraud while intending all along to single out transgender patients for harassment — and that the health system took active part in trampling its patients’ privacy rights.

The anonymous plaintiffs say VUMC violated state and federal privacy laws by sharing the medical records of over 100 patients with Skrmetti’s office in response to a “wildly overbroad” records request. Thereafter, the hospital notified those patients about the sharing of their data. As a result, the plaintiffs say they now face “significant threats of harassment, harm, and bodily injury from being transgender or perceived as transgender.”

Per the complaint:

Plaintiffs and the Proposed Class guard their health information and only wish to disclose it to trusted individuals that they know will not harass them. In Tennessee, transgender individuals and those perceived as transgender like the Plaintiffs and the Proposed Class face significant threats of harassment, harm, and bodily injury from being transgender or perceived as transgender. As discussed more fully below, a significant percentage of transgender individuals and those perceived as transgender experience high rates of discrimination, harassment, and violence. In the climate of hostility in Tennessee, transgender individuals and those perceived as transgender are leaving the state in order to feel safe and secure. They are justifiably scared.

Skrmetti’s office denied any hostility toward the transgender community and said the document request had been merely a routine part of a “run of the mill” fraud investigation.

Tennessee has enacted some of the country’s most restrictive laws affecting transgender people. From laws withholding funds from public schools that allow transgender children to participate in sports, to laws banning transgender people from using bathrooms that comport with their gender identities, to bans of gender-affirming care for transgender minors, the Tennessee legislature has placed itself at the forefront of a conservative agenda with respect to treatment of transgender people.

According to the complaint, it is not only the legislature that has exhibited outright hostility toward the transgender community, but Skrmetti himself as well. The court filing noted Skrmetti’s praise of a bill “that would define sex as an ‘immutable’ characteristic” and his creation of a $2.5 million “strategic litigation unit” comprising 10 attorneys meant to focus on “proactive litigation” around such policies.

The plaintiffs argue that VUMC “was aware of the anti-transgender agenda” of multiple state officials and that it turned over documents requested by Skrmetti’s office — including the records of patients who were not even part of VUMC’s Transgender Health Clinic itself — without putting up any sort of fight.

VUMC spokesperson John Howser said in a statement that the organization received multiple Civil Investigative Demands from the Tennessee attorney general that requested information “for an investigation into VUMC’s billing practices for people enrolled in state sponsored insurance plans who received gender-affirming health care at VUMC.”

Howser characterized the request as “common,” and said that health systems regularly receive requests for patient records related to billing investigations and audits without the prior consent of the patients involved. Howser also said that it is common for health systems to comply with such requests as VUMC did.

“The State has told VUMC multiple times that the investigation is not focused on any patient and that the State will maintain records obtained in strict confidence,” Howser insisted.

Howser said that the health system’s lawyers are “in on-going discussions” with Skrmetti’s office about what else will be provided for the investigation.

Howser also addressed Vanderbilt’s decision to notify the patients about their health data having been shared. He said that the decision to notify patients directly was made in an effort to prevent patients from learning secondhand by media coverage of the ongoing lawsuit by the ACLU challenging Tennessee’s transgender healthcare ban for minors.

In the statement, Howser assured patients as follows:

VUMC places paramount importance on securing patient privacy and confidentiality, as permitted by state and federal laws. By providing this information, we hope to reassure our patients and our employees that the decision to release patient records for any purpose is never taken lightly, even in situations such as this where VUMC was legally compelled to produce the patient records.

The plaintiffs say that the patients affected by VUMC’s actions are state workers, their adult children and spouses, those individuals on TennCare (the state’s Medicaid plan), and others who were not event patients at the transgender clinic — none of whose identities were redacted in the relevant documents.

The plaintiffs say they have had to withdraw from their regular activities and have experienced emotional damage as a result of Vanderbilt’s wrongdoing.

You can read the full complaint here.

Law&Crime reached out to the plaintiffs’ lawyers for comment, but did not immediately receive a response.

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Editor’s Note: This piece was updated from its original version to include comment from counsel.

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Elura is a columnist and trial analyst for Law & Crime. Elura is also a former civil prosecutor for NYC's Administration for Children's Services, the CEO of Lawyer Up, and the author of How To Talk To Your Lawyer and the Legalese-to-English series. Follow Elura on Twitter @elurananos