Fight for transgender medical care at heart of Houston medical records leak

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to date on the most essential Texas news.

As the Texas legislature considered banning the use of puberty blockers and hormone treatments for trans children last year, a Houston doctor violated the records system at Texas Children’s Hospital in Houston — the nation’s largest pediatric hospital.

Dr. Eithan Haim, a former hospital employee, collected personal information from minor patients not under his care and illegally disclosed it to a conservative activist, court documents show.

The activist published them, sparking outrage among conservatives. Attorney General Ken Paxton opened an investigation. Parliament voted to ban them within days.

More than a year later, federal prosecutors charged Haim with violating patient confidentiality laws.

Those actions and the subsequent indictment have thrust him into the center of one of the most emotional and controversial issues in Texas politics. Prosecutors accuse him of providing the public with misleading information to harm the reputation of his former hospital and “advance his own personal interests.” The Texas Republican Party supports him.

Transgender rights advocates say the case illustrates how misleading conservative rhetoric is making life worse for Texas families with transgender children. They see the recent legislation targeting gay and transgender people as part of a broader effort in Texas and many states dominated by conservative politicians to stigmatize and punish gay people in ways that are profoundly disrupting the lives of tens of thousands of families.

Meanwhile, Haim is being hailed as a martyr by conservatives in Texas and elsewhere who say he is the victim of political persecution. On the podcast circuit and elsewhere, they are calling transition-related care for children abuse and portraying the doctors and parents who provide it as abusers.

Members of Congress have written to support him. His supporters have raised nearly $1 million for his defense. He is represented in court by Ryan Patrick, a former top U.S. attorney during the Trump administration who is the son of Lt. Gov. Dan Patrick.

Haim has pleaded not guilty. He said his actions were intended to expose the hospital’s transgender care program.

“I have said from day one that I did nothing wrong,” Haim said in court last week, according to the Houston Chronicle. “We are going to fight tooth and nail to defend whistleblowers everywhere.”

Haim was released on $10,000 bail and now faces up to 10 years in federal prison and a maximum fine of $250,000. On his fundraising website, Haim said he did not break the law because the documents were redacted and “no personally identifiable patient medical information was disclosed.”

Transition care covers a wide range of treatments. It can include social measures such as adopting new pronouns or changing clothing styles. It can also involve medical interventions such as puberty blockers, hormone therapy and surgery, although the latter is less common in children. These treatments are aimed at gender dysphoria, the distress that occurs when a person’s gender identity does not match the sex they were assigned at birth. The American Medical Association has defended this care, saying that such treatments are essential to the well-being of transgender youth.

Concerns about transition-related health care for children began to gather momentum in Texas in February 2022, when Governor Greg Abbott directed the Texas Department of Family and Protective Services to investigate cases of transition-related care for transgender children as child abuse.

In response, Texas Children’s Hospital announced it would suspend prescribing hormone therapy to transgender children. The hospital said the decision was made to “protect our healthcare professionals and affected families from potential legal repercussions.”

Months later, a state Supreme Court ruling said that while DFPS was authorized to conduct such investigations, the governor’s directive was not a legally binding instruction and it was not required to do so.

Haim said the hospital continued these practices in secret. In the charges against him, prosecutors noted that Haim had received training on medical privacy rules and had attended “numerous trainings related to the anonymous reporting of any instances of misconduct, ethics violations or child abuse.” But, they said, Haim did not report his concerns to any supervisor, anonymous hotline or child protective services.

Instead, he turned over redacted versions of the medical records to conservative activist Christopher F. Rufo, who published a story in May 2023 reporting that the hospital continued to administer puberty blockers and intersex hormones to minors and linking to the documents. In the report, Rufo names the doctors and details the types of procedures they performed. The leaked documents are no longer available through this article. The hospital did not respond to a request for comment, but has said in the past that the care it provides meets legal requirements.

At the time of the leak, such treatments were not yet illegal in Texas.

There is no situation in which a doctor should publicly disclose a patient’s medical information without their consent, said Johnathan Gooch, a spokesman for the LGBT rights group Equality Texas. This disclosure puts families at risk, Gooch said.

“In an age where people are having fun finding where a random pin is on Google Maps, people are very good at doing research on the internet,” Gooch said. “Doxxing has become very popular in radical circles, so it’s clear that the health and well-being of these families and their children is at risk, especially when this exposure is taking place in a hyperpolarized environment.”

But Haim and his supporters say he showed courage in speaking out against the misconduct.

In a letter to the prosecutor, US Senator Ted Cruz, Republican of Texas, denounced what he called “selective prosecutions and the instrumentalization of the Department of Justice against political opponents.”

U.S. Rep. Chip Roy, R-Austin, sent a letter to U.S. Attorney General Merrick Garland also suggesting the misuse of law enforcement to ideologically target critics and requesting information for the House Judiciary Committee. U.S. Rep. Dan Crenshaw, R-Houston, backed Hiam at a news conference last Wednesday where he said Haim did nothing wrong.

Two Republican lawmakers, Rep. Brian Harrison of Midlothian and Sen. Mayes Middleton of Galveston, wrote to the state Health and Human Services Commission criticizing the alleged use of Medicaid funds to pay for the treatments. In their letter, they praise Haim and say the hospital has abused children.

Harrison told the Texas Tribune that the support for Haim is indicative of how Texas is “trying to protect children.” Fueled by similar statements about “protecting children,” anti-LGBTQ+ legislation has received considerable attention in the Texas legislature in recent years — a sentiment that has inspired actions like Haim’s.

After his indictment, Haim was hailed by several far-right websites and forums. Rufo described him as a “whistleblower.”

“If Haim prevails, other courageous doctors and health care professionals will follow his lead and speak out,” Rufo wrote in a City Journal article.

Prosecutors, however, have questioned Haim’s motives. The indictment alleges that Haim committed “malicious harm” toward the hospital and its patients. The hospital suffered “financial losses, medical delays … and threats and harm to its valued patients and physicians.”

Opponents of the state’s crackdown on translation-related care are also concerned about politicians’ support for Haim.

For Equality Texas’ Gooch, the rhetoric and actions of state officials are troubling. He says there is a “direct connection” between the words of Texas politicians and the experiences of transgender people in the state.

“We’ve seen many families move to continue to provide health care for their young people,” Gooch said. “And those who have had to stay in Texas, if they couldn’t afford to leave, have been forced to spend enormous amounts of money to travel across state lines to get regular checkups.”

Disclosure: Equality Texas and Texas Children’s Hospital are financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a full list of supporters here.

Breaking News: Former U.S. Representative Liz CheneyR-Wyoming; U.S. Senator John FettermanDemocrat from Pennsylvania; and the governor of Oklahoma. Kevin Stitt will take the stage at the Texas Tribune Festival, September 5-7, in downtown Austin. Buy your tickets today!