A proposed law in Tennessee could result in transgender residents’ private medical information being made available to the public, potentially exposing them to harassment.

Earlier this week, Republicans in the Tennessee House of Representatives voted to advance House Bill 754, according to independent journalist Aleksandra Vaca.

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The bill, similar to one passed in Texas last year and another awaiting Utah governor Spencer Cox’s signature, ostensibly requires trans people seeking insurance coverage for gender-affirming care to also purchase coverage for detransition care. As Vaca notes, the burdensome requirement is likely to drive up healthcare costs for trans people in Tennessee.

Unlike the Texas and Utah laws, however, H.B. 754 also mandates that healthcare providers “report statistics regarding all gender transition procedures” to the Tennessee Department of Health and for that data to be made available in a “comprehensive annual statistical report” on the department’s website.

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Gender-affirming care providers would have to report the date on which patients received a “transition procedure,” their age and “biological sex,” their state and county of residence, their doctor’s name and contact information, information on neurological, behavioral, or mental health conditions with which they’ve been diagnosed, and information about the specific prescription or procedure they received.

Such requirements likely violate patients’ privacy rights under the Health Insurance Portability and Accountability Act (HIPAA). As Vaca notes, the 1996 law explicitly bans providers from disclosing healthcare information “that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.”

According to the Department of Health and Human Services, under HIPAA, “individually identifiable health information” includes a patient’s county of residence and the exact dates they were admitted and discharged. But as Vaca notes, HIPAA also includes exceptions when disclosing protected health information is required by state law.  

Under H.B. 754, providers who do not report trans people’s private medical information could have their medical licenses suspended for a minimum of six months, and their employers could be fined up to $150,000.

Vaca warns that bad actors could potentially identify trans people by the information required in the publicly available “comprehensive annual statistical report.” Should H.B. 754 pass, Vaca warns, “every trans Tennessean will suddenly find themselves at risk of being singled out and targeted—both by the state and by members of the public wishing to harass and even potentially harm them.”

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