Seattle hospital sues Texas AG who sought records of trans minors

By Kim Bellware, Molly Hennessy-Fiske, Timothy Bella and Ben Brasch

On December 21, 2023

Texas Attorney General Ken Paxton (R) tried to compel a Seattle hospital to hand over information about gender-affirming treatment Texas youths may have received across state lines, according to court filings, signaling an escalation of his office’s attempts to crack down on Texans’ ability to access such health care.

The Seattle Children’s Hospital requested a Texas judge nullify, or at least rein in, Paxton’s demands, arguing that his office lacks the jurisdiction over the Washington state hospital. In filings this month, the hospital said Paxton’s queries — made under the guise of an investigation by the AG’s consumer protection division — were “sham requests.”

Paxton’s office did not respond to request for comment about the hospital’s filing Thursday.

A spokesperson for Seattle Children’s Hospital declined to comment on the specifics of its legal action. In a statement, the spokesperson said the hospital complies with the law for all heath-care services and “took legal action to protect private patient information related to gender-affirming care services at our organization sought by the Texas Attorney General.”

Conservative lawmakers have driven efforts in recent years to criminalize gender-affirming care with laws similar to ones that restrict abortion access by creating legal liability for health-care providers and the in-state portion of people’s travel for out-of-state care.

Paxton has been at the vanguard of such efforts. Last year, his office investigated clinics in Austin, Dallas and Houston for providing gender-affirming care, leading them to close or stop offering the services. 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.

Paxton’s legal battle with Seattle Children’s Hospital marks a rare instance of conservative officials reaching the state’s long arm beyond their own borders.

Officials and doctors with Seattle Children’s Hospital signed affidavits sayingthe hospital has virtually no ties to the state of Texas: The hospital is not incorporated in Texas, does not have bank accounts or property in the state, does not advertise youth gender-affirming care in Texas and does not have physicians or health staffers who provide care in Texas.

The hospital’s legal filing further argues the information the Texas attorney general requested was for private medical records and health information covered under HIPAA and Washington state privacy laws.

Among the requests by Paxton’s office were documents for how many Texas children the hospital treated for gender dysphoria, the number of “gender reassignment” surgeries performed and specific medications hospital employees had prescribed to children from Texas.

“The demands are an unconstitutional attempt to investigate and chill potential travel by Texas residents to obtain healthcare in another state,” attorneys for the hospital wrote.

For families like Lisa Stanton’s, the hostile climate fostered by Texas’s anti-LGBTQ+ policies became overwhelming. Last summer, Stanton and her family moved to Colorado from Texas because of the state’s treatment of transgender children. On Thursday, her phone was “blowing up” with messages about the Seattle lawsuit.

“My moms group, we were all discussing it,” said Stanton, who has a 12-year-old transgender daughter.

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 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.

“We would hope most hospitals would respond as Seattle is, but what happened at Vanderbilt was shocking,” said Stanton, who noted that the Vanderbilt hospital now faces a lawsuit for releasing patient records.

Stanton predicted some families in states such as Texas who hadn’t previously considered moving will flee the state as the fear and risks of staying grow so strong that they outweigh the loss of leaving home.

At that thought, Stanton started to cry.

“It is a loss. It’s hard to be away from your friends, your community, all the people you care about,” she said. But in Texas, they were not safe anymore. “When very bad people have your information, you have to get out.”

If the courts rule in Paxton’s favor, it could give “a powerful tool to any other hostile state” wishing to similarly burden providers of gender-affirming care anywhere in the country, said David B. Cruz, a constitutional law professor at the University of Southern California.

“It does seem like this action by the attorney general is trying to push the state of Texas’s efforts further to restrict gender-affirming care and reduce or limit the ability of medical professionals to treat these people who need it,” Cruz said.

Ian Pittman, an Austin-based attorney representing families with transgender children, including some who sued Paxton and the state for using Child Protective Services to investigate them, said Texas’s SB14 law, which restricts gender-affirming care for youths, does not bar families from seeking the care out of state. If courts grant Paxton access to transgender Texas youths’ out-of-state medical records, he said, that may not matter.

Pittman likened the attacks on the LGBTQ+ community by the Texas GOP to attacks on reproductive and voting rights in recent years.

“They think that by harassing families like this, and generally making the state inhospitable, that two things will happen: People who are impacted will be more likely to move out of the state, and people who are not impacted but whose ideology is aligned with this will be more likely to move to the state,” Pittman said. “… It’s all connected and an attempt to maintain power.”

Beyond contesting Paxton’s jurisdiction over the matter, Seattle Children’s Hospital argued in its filing that it is protected under the state’s recently enacted Shield Law.

The law, crafted in response to the Dobbs ruling that eliminated federal protections related to abortion access, protects providers of abortion and gender-affirming treatment and their patients. Under the law, Washington courts and law enforcement may not aid, enforce subpoenas and investigations by or make arrests at the request of outside states seeking to prosecute treatment that they ban but that is legal in Washington.

Washington state Sen. Drew Hansen (D), who sponsored the Shield Law, said the legislature crafted the measure specifically to protect people in Washington from “aggressive overreach from states like Texas.”

“They say, ‘Don’t mess with Texas.’ But also don’t mess with Washington state,” Hansen said. “We make our own laws here. Other states don’t get to harass people here because of legal choices they made.”

This piece was republished from The Washington Post.