In an unsettling series of events, Missouri Attorney General Andrew Bailey’s extensive use of private medical records has significantly disrupted the healthcare landscape for LGBTQ Missourians, particularly impacting transgender individuals and their families. The state investigation, which initially targeted the Washington University Transgender Center in St. Louis, has broadened to include therapists and social workers across the state, stirring widespread concern over patient privacy and the future of gender-affirming care.
A Troubling Investigation
The saga began last year when Bailey initiated an investigation based on an affidavit from Jamie Reed, a whistleblower at Washington University. The affidavit accused the Transgender Center of not following best practices in providing care. Using this as a foundation, Bailey has expanded his scrutiny to other providers, including Planned Parenthood, with an apparent goal to “eradicate” gender-affirming care providers from Missouri.
Documents made public through various lawsuits reveal that Bailey has obtained unredacted and loosely redacted records of transgender minors, including a list of patients treated at the Transgender Center at St. Louis Children’s Hospital. Furthermore, Bailey is seeking unrestricted access to the university’s digital medical records system, raising alarm over the confidentiality of sensitive patient information.
Impact on Healthcare Providers and Patients
Katy Erker-Lynch, executive director for the Missouri LGBTQ advocacy organization PROMO, voiced her fears about the investigation driving healthcare providers out of the state, particularly affecting rural Missourians. “The attorney general has created a hostile environment for medical providers where they are afraid to stay and practice medicine,” she said.
Therapists and counselors, who were unexpectedly drawn into the investigation, face significant stress and uncertainty. Kelly Storck, a licensed clinical social worker specializing in LGBTQ-positive therapy, was interviewed last year and expressed grave concerns about unredacted medical records of minors being in the hands of a state official known for opposing gender-affirming care. Storck hired a lawyer before meeting with the investigator and was alarmed to find that the investigator had a stack of her unredacted recommendation letters for gender-affirming care.
Storck recounted that senior investigator Nick McBroom seemed unsure of the process and questioned why she had a lawyer. After a brief interview, McBroom asked her to write up her process, which she declined through her attorney. Her case was subsequently closed, but the experience left her distrustful and concerned about who had accessed her documents.
Families in Fear
The investigation has also had a significant impact on parents of transgender children. Becky Hormuth and her 17-year-old son Levi, who was a patient at the Transgender Center, have been living in a state of anxiety over the scope of Bailey’s investigation. They learned that Levi’s psychologist’s records were being scrutinized and heard about other providers facing similar probes.
Levi described the attorney general’s actions as “complete government overreach.” His mother, Hormuth, prepared to move out of state to escape Bailey’s invasive tactics. “It is very invasive, what he’s doing,” she said. “The state has already basically disrupted our lives. They’ve disrupted our families, our children’s lives with the legislation that has passed. Then for him to continue going on is even more invasive and damaging.”
The Hormuths, like many others, have had to navigate disrupted healthcare access due to the investigation. When lawmakers passed a ban on gender-affirming care for minors, including a provision for broad medical malpractice claims, the Transgender Center stopped providing Levi’s medication. Hormuth had to stretch her son’s medication and eventually sought care out-of-state to avoid further interference from Bailey.
The Fight for Patient Privacy
The legal battle over patient records is ongoing. Washington University and the attorney general’s office are embroiled in litigation over the records used in the investigation. Documents show that the university turned over three sets of documents, including a spreadsheet titled “Transgender Patient data,” which contained detailed patient information.
Reed, the whistleblower, stated that any documents she provided to the attorney general were redacted. However, the records investigators had during interviews, including those of Storck’s patients, contained unredacted names, causing further distress among healthcare providers and families.
Planned Parenthood and other healthcare organizations have filed lawsuits to block the attorney general’s civil investigative demands, which they argue seek sweeping and unauthorized access to patient records. Judges have ruled in favor of the attorney general’s office in several cases, but these decisions have been appealed.
The Human Toll
The impact of these investigations on transgender patients and their families is profound. Storck highlighted the compounded anxieties about access to gender-affirming care following the legislative ban. “I really was so afraid that some of my clients were going to be in absolute emergent situations and really struggle to get access to healthcare,” she said. The disruption has turned previously straightforward medical visits into day-long or multi-day events.
Levi and his mother, along with countless others, continue to navigate the turbulent healthcare landscape, seeking safe and reliable care amidst the attorney general’s relentless pursuit. The legal and emotional battles waged by these families underscore the urgent need for protecting patient privacy and ensuring access to gender-affirming care.
The Bottom Line
The attorney general’s aggressive investigation into gender-affirming care providers in Missouri has cast a shadow over the state’s healthcare system, putting LGBTQ Missourians at risk. The use of private medical records and the targeting of therapists and counselors have not only interrupted essential healthcare services but also instilled fear and uncertainty among families. As legal battles continue, the resilience and determination of the transgender community and their allies remain crucial in the fight for privacy, dignity, and access to necessary care.
