The Tennessee House and Senate have now both passed a bill that, among other anti-LGBTQ+ harms, will help them to create a registry of trans people, including what gender-affirming care they have sought, and when they received it. While the bill’s sponsors claim the information will not include identifiable information, experts have suggested it would feasibly allow government agents to identify members of the state’s relatively small trans population

“This is a bill that gathers data on trans and gender diverse patients throughout the state, as well as providers,” said Chaplain Dahron Johnson, the co-chair of the Tennessee Equality Project’s Nashville chapter, ahead of the Senate’s passage of the bill. “It asks for details around prescriptions, around what’s discussed in medical visits, around how long somebody has been in treatment or has been having gender care discussions with their providers.” 

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The bill was primarily sponsored by Tennessee Representative Jeremy Faison (R) as H.B. 754. It passed the House on March 26; yesterday it passed in the Senate as SB 676. While the bill now has to go back to the House for a concurrence vote on minor amendments added in the Senate, that is effectively a formality, and there is no sign that Gov. Bill Lee (R) will not sign it into law as soon as it reaches his desk.

Primarily, the bill masquerades behind concern for those (extreme few) who regret a medical transition and detransition.

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“What about the poor folks that took up this transition nonsense and they transitioned to a sex or a gender that they thought would solve their problem, and they just want to be left alone?” said the bill’s champion in the Senate, Sen. Brent Taylor (R).

This takes the form of forcing clinics that accept state funds for gender-affirming care to eat the cost of any “detransition procedures” and mandating insurance companies that cover gender-affirming care to also cover those “detransition procedures.” The bill also acknowledges that this will increase insurance premiums for trans people, and seems to be inspired by similar bills from Texas and Utah.

However, that aspect of the bill hides the even more toxic elements of the bill. The bill as passed also puts a prohibition on any localities within Tennessee from enacting a conversion therapy ban. With the Supreme Court’s recent ruling against conversion therapy bans, that measure is an additional blow that’s causing concern.

“It is unfair for us to legislate in a way that allows or bans the banning of behavior or treatment that could be harmful to someone,” said Sen. Raumesh Akbari (D). “There is ample evidence on the dangers of conversion therapy. There are dangers in forcing these young people to go into these programs.”

The bill also calls for a “right to public transparency” around gender-affirming care with the idea that they might find a higher rate of detransition than has been reported in countless studies. That transparency will take the form of providers having to report a wealth of data about their trans and non-binary patients to the Tennessee Department of Health, sparking fears for trans people’s privacy and safety.

That information is set to include the date of any “gender transition procedure” being prescribed or referred for, the patient’s age, sex, and type of procedure, what drugs were prescribed and how, a list of any diagnoses for “neurological, behavioral, or mental health conditions.” While the bill says that reports must not include “individually identifiable health information,” with the relatively small size of the trans population, privacy experts have suggested that individuals might still be identifiable from this information.

While Texas’ attorney general has created a list of trans people with names and their requests to update the gender marker on their licenses, this list will include personal details about medical procedures that can be tied to individual people living in the state. It is often time to worry when the government makes lists of the marginalized.

The data will also be published to a public government website, in accordance with the bill. While earlier versions of the bill said the data would not be aggregated (making it possible to identify people), a later summary seems to have corrected that language to suggest it will be aggregated. However, the latest version of the bill simply says the data will be reported, without mentioning aggregation. This confusion has prompted concerns about this data not only being held by the government, but potentially becoming a public registry of trans people in Tennessee.

The bill also goes as far as to ensure that medical providers can’t reasonably avoid reporting the information of their trans patients. Not fully reporting the required data can result in a provider’s license being suspended for six months or longer, their employers facing up to $150,000 in fines, and all medical providers involved being subjected to an investigation by the attorney general.

One final amendment in the Senate removed the requirement that providers include the state county in which their patient resided. Protestors outside the Senate pushed the fact that some counties had such small populations that identities would be far too easily calculated, and the amendment was a direct result. That didn’t stop Tennessee state troopers from forcibly removing a protester for shouting from the House gallery after the bill was passed.

In expressing his apparent concern for people regretting their transitions and defending his bill, Faison compared trans identities to lobotomies, saying, “I believe that we as a society are going to look back on this time that really burst out in 2014 and think, ‘Dear God, what were we thinking? This was as dumb as frontal lobotomies.”

Tennessee has passed a huge number of anti-trans bill in recent years. Additionally, in 2023 the state’s attorney general was able to force Vanderbilt University Medical Center to hand over the complete medical records for trans patients.

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