Fight over trans medical care is at the core of leaked Houston health records case

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As the Texas Legislature considered banning the use of puberty blockers and hormone treatment for trans kids last year, a Houston doctor breached the record system of Texas Children’s Hospital in Houston — the largest pediatric hospital in the country.

Dr. Eithan Haim, a former employee of the hospital, retrieved the personal information of underage patients who were not under his care, and illegally leaked them to a conservative activist, court documents allege.

The activist published them, and conservative outrage followed. Attorney General Ken Paxton opened an investigation. The Legislature passed the ban within days.

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

Those actions and the indictment that followed have thrust him into the center of one of the most emotional and divisive issues in Texas politics. Prosecutors are accusing him of feeding the public misleading information to damage his old hospital’s reputation and “promote his own personal agenda.” The Texas GOP is backing him.

Advocates for trans rights say the case is an example of how often misleading conservative rhetoric has only made it more dangerous for Texas families with trans children. They cast the recent legislation targeting gay and trans people as part of a broader effort in Texas and across many states dominated by conservative politicians to stigmatize and punish queer people in ways that profoundly upend the lives of tens of thousands of families.

Meanwhile, Haim is being hailed as a martyr by conservatives in Texas and beyond who assert he is a victim of political persecution. On the conversative podcast circuit and elsewhere, they call transition-related care for kids child abuse and describe the doctors and parents that provide it as abusers.

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

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

“I maintained from day one that I have done nothing wrong,” Haim said last week outside the courthouse, The Houston Chronicle reported. “We’re going to fight this tooth and nail to stand up for whistleblowers everywhere.”

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

Transition-related care covers a wide range of treatments. It can include such social steps as adopting new pronouns or changing one's style of dress. It can also mean medical interventions such as puberty blockers, hormone therapy and surgeries, though those are rarer for children. These treatments are for gender dysphoria, the distress that arises when a person’s gender identity does not align with their birth-assigned sex. The American Medical Association has defended such care, arguing that such treatments are essential for the well-being of transgender youth.

Concerns about transition-related health care for kids started to gain steam in Texas in February 2022, when Gov. Greg Abbott directed the Texas Department of Family and Protective Services to investigate instances of transition-related care for transgender children as child abuse.

In response, Texas Children's Hospital announced that it would pause the prescription of hormone therapies for transgender kids. The hospital said the decision was made to “safeguard our health care professionals and impacted families from potential legal ramifications.”

Months later, a state supreme court ruling stated that while DFPS was allowed to conduct such investigations, the governor's directive was not a legally binding instruction and they did not have to.

Haim said that the hospital continued these practices in secret. In the charges against him, prosecutors noted that Haim received training on health privacy regulations and attended “numerous trainings related to anonymous reporting of any instances of misconduct, ethic violations or child abuse.” But, they said, Haim did not report concerns to any supervisors, anonymous hotlines or Child Protective Services.

Instead, he turned over redacted versions of the medical records to conservative activist Christopher F. Rufo, who published an article in May 2023 reporting that the hospital continued administering puberty blockers and cross-sex hormones to minors and linking to the documents. In the report, Rufo names physicians and details the types of procedures they were conducting. The leaked documents are no longer available though that 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 had not yet been made illegal in Texas.

There is no situation in which a doctor should publicly disclose any patient's medical information without consent, said Johnathan Gooch, a spokesperson for an LGBT-rights group, Equality Texas. This release of information puts families at risk, Gooch said.

“In an age where people make a game of figuring out where a random pin is on Google Maps, people are very good at searching the internet,” Gooch said. “Doxxing people has become very popular in radical circles. So it definitely puts the health and well being of these families and their children at risk to be exposed, especially when that exposure is in a hyperpolarized environment.”

But Haim and his supporters argue that he took a brave stand to expose misconduct.

In a letter to the prosecutor, U.S. Sen. Ted Cruz, R-Texas, denounced what he called "selective prosecution and the weaponization 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 similarly suggesting misuse of law enforcement to ideologically target detractors and requesting information for the House Judiciary Committee. U.S. Rep. Dan Crenshaw, R-Houston, supported Hiam in a news conference last Wednesday where he said that Haim did nothing wrong.

And two Republican state lawmakers, Rep. Brian Harrison of Midlothian and Sen. Mayes Middleton of Galveston, have written to the state Health and Human Services Commission criticizing the alleged use of Medicaid funds to cover these treatments. In their letter, they laud Haim and say that the hospital committed child abuse.

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

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

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

However, prosecutors have questioned Haim’s motives. The indictment argues, Haim committed “malicious harm” to the hospital and its patients. The hospital faced “financial loss, medical delays … as well as threats and harm to its patients and esteemed physicians.”

And opponents of the state’s crackdown on translation-related care are concerned about the politicians backing Haim.

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

“We've seen many families moving away in order to keep providing health care to their young people,” Gooch said. “And then those who had to stay in Texas, if they didn't have the means to leave, have been forced to spend massive amounts of money to travel across state lines in order to get regular checkups.“

Disclosure: Equality Texas and Texas Children's Hospital have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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