Seattle Children’s Hospital is suing the Texas Attorney General’s Office after it demanded—and was refused—medical documentation of trans patients from Texas who got care in Seattle.

Texas Attorney General Ken Paxton believed his state’s consumer protection laws and state ban on youth transition care gave him the authority to slap Seattle Children’s with a civil investigative demand for providing care that is legal in Washington.

Seattle Children’s responded with their suit on December 7 which, when translated from legalese, said: Sorry Ken, you don’t have the authority.

What is Texas Looking For?

According to documents in Seattle Children’s petition, the Texas Attorney General’s Consumer Protection Division was investigating potential violations under the state’s Deceptive Trade Practices Act over misrepresenting gender-affirming care in some way, a strategy Paxton’s employed in past lawsuits.

In late November, Paxton’s office requested Children’s hand over medical documentation including the number of identities and personal information of patients from Texas, their diagnoses, prescriptions, lab test results, and visit records dating back to January 2022. The office also asked for Seattle Children’s standard protocol for treating children who live in Texas, and how it “weaned” children off of hormones, something they are not required to do in Washington. The demand included a notice that anyone who concealed or falsified information could face a $5,000 fine or a year in county jail.

In its defense, Seattle Children’s whipped out a newly passed state law of its own. House Bill 1469 protects people who come to Washington for protected medical services—including abortion or gender-affirming care—from states that have banned or criminalized those practices. The hospital wrote in its petition that, legally, it could not hand over the documents without violating at least three laws: HB 1469, HIPAA, and Washington’s healthcare privacy laws. 

The hospital also argued that because they don’t own Texas land, have offices in Texas, or provide telehealth services in Texas, Texas has no jurisdiction over their practices. The hospital has a limited number of employees in Texas, but none deal with gender-affirming care. It also said the investigation may violate the dormant Commerce Clause in chilling interstate commerce.

“Seattle Children’s took legal action to protect private patient information related to gender-affirming care services at our organization sought by the Texas Attorney General,” a Seattle Children’s spokesperson wrote in an email to The Stranger. “Seattle Children’s complies with the law for all health care services provided. Due to active litigation, we cannot comment further at this time.”

The hospital asked the court to overrule, modify the request, or grant an extension for their reply.

Texas Loves Investigating This Stuff

For years, Gov. Greg Abbott and Attorney General Paxton have thrown down the gauntlet in the conservative culture war against trans rights.

In 2021, Paxton began an investigation into the mainstream medical practice of puberty blockers, citing the same Texas Deceptive Trade Practices Act. (This year, Missouri AG Andrew Bailey would use the same strategy of employing consumer protection laws in an attempt to limit trans care.)

The next year, Abbott directed the Texas Department of Children and Family Services to investigate the families of trans children. Paxton argued they were child abusers under current Texas law. A lawsuit from the ACLU and Lambda Legal resulted in a temporary federal injunction.

This year, the Texas state legislature introduced 66 anti-trans bills. The youth care ban SB 14 went into effect in September despite a legal challenge from the ACLU of Texas. The law bans the use of puberty blockers and hormone replacement therapy for trans children and threatens to revoke doctors’ licenses for offering either.

The laws, and atmosphere created by those laws, has become oppressive enough for adults and families to flee the state for safe harbors. We profiled two of those adults in our Forced Out series this fall. Trans punk Isobel moved to Portland, while the musical theater-loving Bumblebee relocated to Philadelphia.