Tennessee House Passes Bill Requiring Public Reporting of Transgender Data, Sparking Outrage

The Tennessee House has passed HB 754, a sweeping bill that would require the state to collect and publish detailed data on transgender patients and providers, raising alarm among advocates who warn it could expose and endanger a vulnerable community.

In a move that has ignited protests, legal concerns, and national scrutiny, the Tennessee House of Representatives has passed House Bill 754, legislation that would require the state to collect and publicly release detailed medical data on transgender patients receiving gender-affirming care.

The bill, approved March 26 in a 70–21 vote, now awaits consideration in the Senate. If enacted, it would mandate that gender clinics across Tennessee submit extensive patient and provider information to the state Department of Health, which would then publish an annual report accessible to the public.

As lawmakers advanced the measure inside the Capitol, demonstrators filled the rotunda, chanting and holding signs that read “Hands off our medical records!” and “Health data is a human right!” One protester was physically removed by state troopers after refusing to leave the House gallery.

The moment captured a growing tension between lawmakers advancing the bill as a matter of oversight and detransition care access, and advocates who say the legislation represents a dangerous expansion of state surveillance over private medical decisions.

Rep. Jeremy Faison, R-Cosby, the bill’s sponsor, has repeatedly described HB 754 as a “simple bill” designed to ensure that individuals who seek to detransition have access to care and insurance coverage.

On the House floor, Faison said the legislation responds to individuals who experience what he called “buyer’s remorse” after undergoing gender-affirming procedures. He cited conversations with detransitioners who, he argued, face barriers navigating the health care system.

The bill would require insurance companies that cover gender transition procedures to also cover detransition-related care. It would also require gender clinics that receive state funding to offer detransition services.

During committee hearings, detransitioner JD Breedlove testified that the measure could help address gaps in care, particularly in medical coding and treatment pathways.

But critics argue that framing obscures the bill’s broader reach and impact.

Advocates point to federal survey data indicating that detransition is rare, with fewer than 1% of transgender individuals reporting that transition was not right for them. Many who discontinue or reverse treatment do so because of external pressures, including stigma and discrimination, rather than regret.

What HB 754 actually does

Beyond insurance requirements, HB 754 introduces a sweeping reporting system that would require every gender-affirming care provider in Tennessee to submit detailed patient data to the state.

Under the bill, the Tennessee Department of Health would compile and publish an annual report that includes:

• Patient age and sex assigned at birth
• County and state of residence
• Diagnoses, including gender dysphoria and other mental or behavioral health conditions
• Dates of care and referrals
• Types of procedures performed or prescribed, identified by billing codes
• Medications prescribed, including dosage, frequency, and method of administration
• Names, contact information, and specialties of health care providers

While the bill does not require patient names or direct identifiers to be published, advocates warn that the specificity of the data could make individuals identifiable, particularly in rural areas with small populations.

The legislation also imposes strict penalties for noncompliance. Physicians who fail to report required data could have their licenses suspended for at least six months, while clinics could face fines of up to $150,000.

The first public report would be due by December.

Critics say the scope and detail of the required disclosures are unprecedented.

“This bill seeks to grab data from insurers, from providers, about patients throughout this state,” said Dahron Johnson, Nashville co-chair of the Tennessee Equality Project. “Information that any other patient in any other community would be horrified to know was being put in reports and sent to desks in both the House and Senate.”

Although supporters of HB 754 argue that the data would be “de-identified” and compliant with federal health privacy laws, opponents say the combination of demographic, geographic and clinical information could allow individuals to be identified with relative ease.

“It would not be difficult to identify patients with all of this information,” said Adam Shoop, a Davidson County parent of a transgender adult child, during earlier testimony. “Particularly in smaller communities where there are a limited number of providers.”

Advocates also warn that publishing provider information could expose doctors and clinics to harassment or threats, further shrinking access to care in a state where gender-affirming services are already limited.

Typically, such detailed medical data remains confidential between a patient, their health care provider, and insurers. Opponents argue that HB 754 departs from long-standing norms of medical privacy by creating a publicly accessible registry of care.

Johnson emphasized the broader implications: “Making highly specific registries of patients, what type of medications they’re on, what type of care they’re receiving, any of us would be horrified to know that that information was going out of our doctor’s office.”

Efforts to amend the bill have so far failed.

Rep. Justin Jones, D-Nashville, introduced an amendment that would have prevented the public release of patient data, but it was voted down by House Republicans ahead of the final vote.

During floor debate, Jones warned that the bill could set a precedent for broader intrusions into personal health information.

“If we allow the government to put in public the health information of people we don’t like this time because they’re transgender, what if it’s people who don’t get vaccines next time?” Jones said. “What stops that precedent?”

Debate on the bill was ultimately cut short after Rep. Jason Zachary, R-Knoxville, moved to limit discussion following remarks from only two Democratic lawmakers.

Two Republicans,  Reps. Bud Hulsey of Kingsport and Monty Fritts of Kingston voted present rather than for or against the bill.

HB 754 arrives amid ongoing scrutiny of how Tennessee officials have handled transgender health data.

In 2023, the state attorney general sought medical records from Vanderbilt University Medical Center as part of an investigation into alleged billing practices. While those records were turned over, they were not made public.

Advocates say HB 754 represents a significant escalation, moving from behind-the-scenes data collection to public disclosure.

They argue that the bill could have a chilling effect, discouraging both patients and providers from engaging in gender-affirming care out of fear of exposure or retaliation.

By requiring clinics and insurers to absorb additional costs tied to detransition care, critics also warn the law could make providing gender-affirming services financially untenable, leading some providers to withdraw care altogether.

HB 754 now heads to the Tennessee Senate, where its fate remains uncertain.

If passed, the legislation would position Tennessee among the first states to create a publicly accessible database of gender-affirming care data, a move that could face legal challenges over privacy and discrimination concerns.

For advocates and patients, the stakes are immediate.

“This is about whether people can access care without fear,” Johnson said. “And whether their most personal information remains their own.”

As the bill advances, those questions remain at the center of a debate that continues to ripple far beyond the walls of the Tennessee Capitol.