C.P. Hoffman Discusses “Gender Affirming Care, Medical Privacy, and Trans Rights” in 2023 Dean’s Lecture on Race & Discrimination

C.P. Hoffman, Legal Director at FreeState Justice, discussed threats to “Gender Affirming Care, Medical Privacy, and Trans Rights” in their talk at Vanderbilt Law School on Oct. 24.

Hoffman’s lecture was a 2023 Dean’s Lecture on Race and Discrimination and was co-sponsored by the Vanderbilt LGBTQ+ Policy Lab, LGBTQI Life, the Divinity School Carpenter Program in Religion, Gender, and Sexuality, the Vanderbilt Office of the Provost, and OutLaw.

Hoffman, a non-binary activist who earned their J.D. at the University of Illinois and LL.M. at McGill University in Montreal, Canada, discussed recent laws passed in several states, including Tennessee and Texas, intended to restrict access to transgender care for children and adults or eliminate access to care altogether. Here are key takeaways from their presentation:

• Transition-related care is medically necessary. Hoffman emphasized that the medical necessity of treatment for gender dysphoria is based on a “vast consensus” among healthcare professionals. More than 20 American medical professional societies, including the American College of Physicians, the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Medical Association, and the American College of Physicians, recognize the medical necessity of treatment for gender dysphoria.
• Benefits of transition-related care include increased levels of body satisfaction and decreases in suicide, anxiety, and depression among transgender individuals. “Treatment helps individuals have better outcomes in their lives,” Hoffman said.
• Patients’ needs for transition and gender-affirming care vary widely. “Transition is not one-size-fits-all—it looks different for everyone,” Hoffman said.
• Transgender care is under “legislative attack.” Twenty-two states have passed laws limiting or banning transition-related care for minors, and five states treat providing transition care to minors as a felony. Nine states prohibit any Medicaid coverage for transition care and three more prohibit coverage for minors. States have also passed laws criminalizing transition treatment. “Many states have Aiding and Abetting Provisions that place healthcare providers, clinic staff, and parents at risk of criminal investigation,” Hoffman stated.
• The maps of states restricting women’s reproductive rights and states restricting access to transgender care are very similar. “States that have heavy restrictions on access to abortion also tend to have heavy restrictions on transgender care,” Hoffman said, citing Guttmacher Institute maps showing states with recently passed laws restricting abortion access and those that have passed laws restricting access to gender-affirming care.
• The ability to travel to another state is not a solution for transition care. “Transition treatment requires regular visits to several providers,” Hoffman noted.
• Some states have adopted shield or sanctuary laws designed to protect individuals from other states seeking care where its delivery is legal. “None of these laws have been tested in court,” Hoffman said.
• HIPAA, an act designed to make insurance portable, only offers limited privacy protections. A law enforcement exception may require healthcare providers to disclose individuals’ healthcare information. “Usually, a court order or subpoena is required,” Hoffman said. As a result, they believe that “HIPAA is unlikely to save us from bad investigations.”

Hoffman emphasized that FreeState Justice and other LGBTQ advocacy organizations are working to ensure that everyone is free “to live authentically with safety and dignity” by providing legal services to individuals and working for law and policy changes.

Hoffman was introduced by Associate Dean for Academic Affairs Rebecca Allensworth. Provost and Vice Chancellor for Academic Affairs C. Cybele Raver discussed the work of a University task force to address recent Tennessee legislation affecting care for transgender and gender-non-conforming people.