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When Attorney General Jonathan Skrmetti’s office informed Vanderbilt University Medical Center that it was under investigation, it reportedly produced something ominous — a list of 106 transgender patients who had received care from the hospital.

Skrmetti wanted all of the patients’ records. And VUMC gave the documents to the state.

Two of the patients on the list filed a class-action suit against the hospital in chancery court on Monday, alleging that “VUMC knew about the State’s active targeting of the transgender community” but still gave their medical information to the Attorney General in violation of the hospital’s privacy policies and the federal Health Insurance Portability and Accountability Act, or HIPAA. The plaintiffs, listed only as Patient 1 and Patient 2, are represented by Herzfeld, Suetholtz, Gastel, Leniski & Wall and Abby Rubenfeld.

“The attachment contained 106 entries of individual patients without explanation as to the source of the names on the list,” the complaint stated. “The list included individuals who are: (1) on the state employees’ health plan and their family members, and (2) people who receive their health care through TennCare. Some of the VUMC patients whose records were disclosed were not even patients of the VUMC Transgender Health Clinic.

“Nevertheless, it appears that instead of pushing back, VUMC simply complied with the AG’s demand and turned over all requested records. Those records included the personally identifying information of its patients and some of the most intimate details of their private lives. VUMC did not inform its affected patients that it had done this.”

The patient records were turned over as part of two civil investigative demands made by Skrmetti. After receiving the patient data, the office then began investigating Vanderbilt’s Dr. Melissa Cyperski and sent a third CID seeking “all communications between Dr. Melissa Ciperski and anyone working at Centerstone regarding or related to a potential gender dysphoria diagnosis of a person receiving mental health treatment at Centerstone during the relevant time period.” 

Under HIPAA, a medical provider may turn over protected health information only if “de-identified information could not reasonably be used.” The suit alleges that Vanderbilt turned over some of the most sensitive information possible, including pictures of genitalia, gender identity unknown to others, private communication with clinicians, sexual history, identity of intimate partners and more. 

The complaint states many of the individuals on the list are either state employees or adult children or spouses of those employees. 

Nationwide, transgender people have become a target of Republicans. The GOP supermajority in Tennessee’s state legislature was no different during this year’s session, with 26 bills targeting the rights of LGBTQ Tennesseans. According to the Human Rights Campaign, Tennessee has enacted more anti-LGBTQ legislation than any other state since 2015.

Things ratcheted up a notch in September, when Gov. Bill Lee called for an investigation of the Vanderbilt Pediatric Transgender Clinic. This came following a Twitter thread by Matt Walsh, a far-right commentator at The Daily Wire, where he alleged that Vanderbilt University Medical Center was doing gender-affirming surgeries for financial gain. Skrmetti’s request was sent shortly after Walsh’s posting.

From there, things quickly escalated. 

At an anti-transgender rally held by Walsh in October, U.S. Sen. Marsha Blackburn, state House Majority Leader William Lamberth (R-Portland), Senate Majority Leader Jack Johnson (R-Franklin) and a number of other conservative leaders spoke to a downtown Nashville crowd that included members of the far-right group the Proud Boys. During the rally, state lawmakers said they would be filing anti-trans legislation in the upcoming session. 

Prior to the 2023 legislative session beginning, Johnson and Lamberth had already filed Senate and House Bill 1, a bill to effectively ban gender-affirming care for minors. This set the tone for the season, which saw several pieces of anti-LGBTQ legislation. One bill attempted to restrict drag performances, but a federal judge blocked it in May. One failed bill attempted to stop medical providers who accept TennCare from providing gender-affirming care. Yet another bill that passed requires students in K-12 private schools to participate in sports based on their biological sex

Throughout the debate over SB1/HB1, the American Civil Liberties Union threatened a lawsuit if the state went through with the legislation. The organization filed suit in April, following the passage of HB1/SB1 across Lee’s desk. One week later, the U.S. Department of Justice asked the U.S. District Court for Middle Tennessee to block the law, which was to go into effect on July 1. 

On June 28, a federal judge partially blocked the ban on gender-affirming care. Trump-appointed Judge Eli Richardson ruled to allow the ban on surgical procedures to go into effect, but blocked the ban on puberty blockers and hormone therapies. VUMC had already preemptively shut down its transgender clinic as of June 1 in anticipation of the ban going into effect. Throughout all of this, Tennessee Attorney General Jonathan Skrmetti vocally opposed the blocking of anti-trans legislation. On July 8, the 6th Circuit Court of Appeals lifted the block, fully banning gender affirming care for minors.  

Steve is a three-decade veteran of newspapers, working around the country at places like the Washington Post and Chicago Tribune before returning home to Nashville in 2011 to edit The City Paper and Nashville...