Metro Weekly

Tennessee Bill Could Create Transgender Registry

Proposal tracks gender-affirming care data statewide, raising concerns about privacy and surveillance.

Tennessee State Capitol – Photo: Ichabod, via Wikimedia.

Republican lawmakers in Tennessee are pushing a bill that critics warn could effectively create a registry of transgender residents, raising fears it could be used to surveil or harass them.

House Bill 754, sponsored by State Rep. Jeremy Faison (R-Cosby) and Sen. Brent Taylor (R-Memphis), would require all gender clinics in Tennessee to report monthly health data on patients who have received transition-related care to the Department of Health. The department would then publish aggregated annual reports.

The data would not include a patient’s name but would include age, sex assigned at birth, county of residence, prescribed medications, and the dates of any prescriptions or surgery referrals. It would also include the name of the recommending health care provider and any neurological, behavioral, or mental health diagnoses.

Clinics that fail to report the data could face fines of up to $150,000.

The bill also requires insurers that cover gender-affirming care to pay for detransition-related procedures — a mandate that could drive up costs for those seeking such coverage.

Insurers would also have to report the number of detransition claims, along with patients’ age, sex, and state and county of residence.

Supporters say the public has a right to know how often providers recommend gender-affirming treatments and argue the data would help the government track outcomes and assess the effectiveness of such care.

“If we’re honest with each other, the last 10 to 15 years, [gender-affirming care] has become in vogue,” Faison told Nashville-based ABC affiliate WKRN. “I think it’s important for us when something impacts our people as much as transition surgeries have impacted our people, it’s important that we know what’s going on and see the numbers and see the trends.”

Faison also argues the bill does not violate HIPAA because it would not reveal “individually identifiable health information,” such as names, addresses, contact details, Social Security numbers, or biometric identifiers.

Critics argue the required data could function as a de facto registry, making it possible to identify individuals, especially in smaller communities.

They also note that federal guidance requires removing geographic details smaller than a state to meet HIPAA de-identification standards — meaning the bill would fall short.

“Even when you’re dealing with supposedly generalized or anonymized data, and you’re dealing with small populations, it’s going to be easy to pick out that one provider,” Dahron Annelies Johnson, a trans rights advocate and co-chair of the Tennessee Equality Project, told WKRN. “It’s going to be easier to pick out these three or four specific patients because you’re not talking about a lot of folks to begin with. That’s absolutely concerning.”

Johnson also argued that the list could put people in physical danger if they are able to be identified from the published health data.

“If you’ve got a list of folks who are regularly targeted, who regularly have a finger pointed at them, and you know there’s a list floating out there, I hate to say that there are bad actors in the world, but somebody is going to want to get a hold of that list for something other than altruistic purposes, and that’s not just worrisome, that’s outright dangerous,” she said.

The bill passed the House on a 70-21 vote March 26 and is now under consideration in the Tennessee Senate.

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