Fill a Prescription for Hormone Therapy? Your Pharmacist Could Release Your Records to the Police
A Washington Post report on pharmacies sharing patient records without a warrant has grave implications for the trans community who are seeing attempts to ban our treatments.
by Evan Urquhart
The word transgender doesn’t appear anywhere in a story published this morning by the Washington Post exposing the practices of major pharmacy chains who routinely share patients’ medical records with law enforcement without legal review, and without requiring a warrant. Instead, the Post’s story focuses on the risks to people who seek an abortion, whose records could be used to provide evidence of pregnancy. However, the clear implication of the Post’s reporting is that the trans community is under as much risk, and perhaps even more risk, in states that ban hormonal treatments trans people will need to take throughout their lifetimes.
The Post reports that three of the largest U. S. pharmacies quickly hand over personal medical information requested to law enforcement, without requiring a warrant and without review by legal counsel. The pharmacies’ practices were discovered by three Democratic lawmakers concerned about the risks of criminal prosecution for people seeking abortions in the wake of the Supreme Court’s Dobbs decision overturning Roe v Wade over a year ago.
The Post points out that individual pharmacies in these chains generally pull information from a shared database, meaning that records of care obtained out-of-state could be among that shared to law enforcement. For a woman who travels to a state where abortion is legal the risks are obvious, and covered in the Post’s story. However there is another area of medicine that has been just as heavily politicized, and that’s transgender healthcare. The story doesn’t mention that hormone therapy for transgender people has also been criminalized in some states where providers that treat transgender youth could face criminal charges.
At this moment, though some states have already sought to extend bans on transgender healthcare to young adults, criminal penalties for transgender patients or their parents have never been enacted. However, if lawmakers succeed in banning all transition-related treatments (which many anti-trans activists and some lawmakers support) the risk of pharmacies exposing private medical data would be even greater for the trans community than it is pregnant people. That’s because, unlike pregnancy, hormone therapy transgender people take to feminize or masculinize their bodies is a lifelong necessity.
Further escalating the stakes for transgender men, testosterone is currently a schedule III controlled substance. This means that legal testosterone prescriptions are already subject to restrictions and heavy monitoring, and criminal penalties already exist for those who take testosterone without a prescription.
To reiterate, there is no current risk of criminal penalties for people who transition. However, it’s completely plausible that medical records from today, a time when hormone therapy is legal for adults, could provide evidence in future case, after bans on care are enacted. If those bans happen, trans people forced to seek treatment in neighboring states where it is legal could be at a greatly increased risk from pharmacies that treat patient privacy cavalierly. Efforts by Democratic lawmakers to protect patients’ private medical information that are primarily concerned with pregnant people may be wind up being vital to the transgender community, so it is important to watch these discussions closely make sure protections aren’t tailored in a narrow way that includes people terminating their pregnancies but not members of the trans community filling their necessary, lifelong prescriptions.
