By Eduardo Morales, Ph.D.–
A letter recently signed by 19 Republican state attorney generals expresses opposition to the Department of Health and Human Services’ proposed rule, HIPAA Privacy Rule To Support Reproductive Health Care Privacy. The letter specifically targets medical records concerning not only abortion but also transgender healthcare. Read the full letter at: https://tinyurl.com/ve5pzamr.
Following the release of the letter in June, Vanderbilt University Medical Center (VUMC) confirmed that it provided transgender patients’ medical records to the Tennessee attorney general as part of an investigation into medical billing. “The Tennessee Attorney General has legal authority in an investigation to require that VUMC provide complete copies of patient medical records that are relevant to its investigation,” John Howser, VUMC’s Chief Communications Officer, said.
The Centers for Disease Control and Prevention (CDC), however, holds that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires protection of sensitive patient health information, such that it is not disclosed without the patient’s consent or knowledge. The U.S. Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA.
A major goal of the Privacy Rule is to make sure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high-quality healthcare, and to protect the public’s health and well-being. The Privacy Rule permits important uses of information while at least attempting to protect the privacy of people who seek care and healing.
Chris Sanders, Executive Director of the Tennessee Equality Project, an LGBTQ advocacy organization, said three different parents of transgender children called him in a panic after they were told by Vanderbilt that their child’s medical records were released to the attorney general as “part of an investigation.” According to CNN: “19 states have laws restricting gender-affirming care, some with the possibility of a felony charge. While some states have enacted laws that can punish healthcare professionals who provide gender-affirming treatment to minors with prison time, others have built in limited exceptions for minors to continue medication-based or nonsurgical forms of care.”
Transgender medical treatment for minors is one of the key issues being debated during the present lead up to the 2024 presidential primary election, with each side digging into their position. Blue states have been enacting protections for access to care, but the following states have placed bans on gender-affirming care: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, and West Virginia. Alabama’s law has since been blocked by a federal judge as it faces a challenge in court. Due to these bans and other problems, the Human Rights Campaign has declared “a national state of emergency for LGBTQ+ people” in the U.S.
Florida Governor Ron DeSantis in May even signed a law that, in the words of the organization TruthOut, “allows trans children to be taken by the state, giving courts the power of ‘temporary emergency jurisdiction’ to modify out-of-state custody agreements in certain circumstances. The bill classifies gender-affirming care as ‘serious physical harm,’ allowing a dissenting parent to request a warrant to receive physical custody of a trans child if they are undergoing or ‘threatened,’ as the bill says, with gender-affirming care.”
This, in essence, allows the state under the aforementioned circumstances to kidnap children in Florida. According to The New Republic, “The new law will allow the state to take custody of a child if they have been ‘subjected to or [are] threatened with being subjected to’ gender-affirming care, which includes puberty blockers and hormone replacement therapy. Florida courts could modify custody agreements from a different state if the minor is likely to receive gender-affirming care in that second state [and] refers to gender-affirming care … as a form of physical harm.”
But, as legal expert Chris Geidner wrote for Rolling Stone: “This isn’t about disagreeing on issues. We aren’t all expected to think the same things or make the same decisions about how to live our lives or how to raise our children. This is about his using the law to take away fundamental choices that we all should be free to make for ourselves. And in the latest attacks, DeSantis and his ilk are staking out an even more extremist position—criminalizing certain choices, turning fundamental freedoms into potential prison sentences.”
The privacy of all of our medical records is at stake as well, considering the letter released by the 19 Republican state attorney generals. At least at the state level here in California there is the California Confidentiality of Medical Information Act. Yet it allows for disclosure of medical information by providers under multiple possibilities. Know your rights by reading about those situations here: https://tinyurl.com/259kxt9j
Eduardo Morales, Ph.D. is a Professor Emeritus, retired Distinguished Professor, and current adjunct professor at Alliant International University. He is also a licensed psychologist and a founder and current Executive Director of AGUILAS, an award-winning program for Latinx LGBTQ+. Of Puerto Rican decent, he has received numerous distinguished awards and citations, including being named a Fellow of 12 divisions of the American Psychological Association.
Nuestra Voz
Published on July 27, 2023
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