Tennessee to track transgender patients, put trans women in male prisons

Tennessee Gov. Bill Lee has signed several bills legislating Tennessee’s LGBTQ community — and more on the way to his desk.

Having already banned gender-affirming care for transgender youth — paving the way for other states to do so — Tennessee Republicans focused on tracking and limiting the care of transgender adults. At the same time, they expanded coverage for those de-transitioning.

The measures would also give parents more control over their child’s gender expression, preventing doctors from asking about a minor’s gender identity without their parent’s consent and clarifying that raising a child as their gender assigned at birth does not qualify as child abuse. Another would allow people unhappy with their gender-affirming care to sue their providers.

Lawmakers revisited legislation from previous years, cementing that TennCare would not cover trans health care like hormone therapy or gender-affirming surgeries for state employees. Meanwhile, HB0754 / SB0676 would expand coverage for people de-transitioning, and require clinics to report who is accessing gender-affirming care.

The bill’s sponsor, Rep. Jeremy Faison, R-Cosby, said that the data would be de-identified, meaning reports would not include names, social security numbers or geographical information.

“Collecting data gives us the ability to study trends, outcomes and effectiveness of treatment without knowing who the patient is,” Faison said on the House floor.

Transgender advocates worry that detailed information will still exist in some form because of how it’s reported to the state’s health department. Chaplain Dahron Anneliese Johnson with the Tennessee Equality Project said it’s hard for trans people to trust the legislature, given that state lawmakers have passed a record-breaking number of bills rolling back protections for transgender Tennesseans in the past few years.

“We’re making lists of folks. We’ve got history lessons, hopefully, that we’ve all learned about what happens when lists of folks start being made,” Johnson said.

The state has already demonstrated interest in obtaining data from those seeking gender-affirming care. In 2023, the Tennessee Attorney General’s Office was able to obtain detailed medical records of transgender patients from Vanderbilt University Medical Center.

LGBTQ advocates have asked Lee to veto the bill when it reaches his desk, but Lee has signed onto similar legislation in the past. In his over seven years in office, Lee has only vetoed a bill once.

Another measure headed to Lee’s desk would require schools, prisons and shelters to only recognize a person’s sex at birth in gendered spaces. HB 0571 / SB 0468 would place transgender women in male prisons and require trans boys to use the girl’s locker room. The law, called “The Riley Gaines Women’s Safety and Protection Act”, was named after the former swimmer and conservative activist who became a proponent of keeping trans women out of women’s sports after she tied for fifth with a trans swimmer.

Marianna Bacallao WPLN News

District 7 Metro Councilmember Emily Benedict urges Gov. Bill Lee to veto a slew of LGBTQ measures on the steps of the Nashville courthouse.

The Nashville Metro Council’s LGBTQ Caucus has also urged the governor to veto a measure that would redefine sex as sex assigned at birth for state and local governments. Councilmember Emily Benedict said the change runs counter to federal discrimination law and could open up cities to lawsuits.

“Infringing upon the rights of cities is exactly what small government should not be doing. Small government should be focused on its citizens,” Benedict said.

Lawmakers considered other LGBTQ proposals that never made it across the finish line, like a measure to ban pride flags during Pride Month in June. Tennessee Republicans were successful in naming June “Nuclear Family Month,” which LGBTQ advocates say erases the identities of many Tennessee families.