Transgender Minors Unable to Stop Lawmakers’ UNC Records Request

Transgender minors, their parents, and a doctor challenging North Carolina’s gender-affirming care ban for youths can’t block lawmakers’ request for mental-health records of nonparty adolescents treated by the plaintiff doctor, a federal court said.

The minors and parents lacked standing to request an order preventing the University of North Carolina Health System’s release of the documents, and the doctor didn’t show that the records were protected from discovery, the US District Court for the Middle District of North Carolina said. UNC wasn’t a party to the action, nor were the patients whose records were sought.

The US Supreme Court heard oral arguments Dec. 4 in another case presenting one of the same issues: whether a state’s gender-affirming care ban for minors violates their 14th Amendment equal protection rights. The provision violates the parents’ due process right to direct their childrens’ medical care, the Affordable Care Act, and the Medicaid Act, the North Carolina plaintiffs also said. About two dozen states have similar laws.

The plaintiffs sued state officials in October 2023. The lawmakers soon joined the case to defend the law, and pretrial discovery began in January 2024. In July, the plaintiffs objected to the lawmakers’ subpoena to UNC requesting medical records for minors treated by the doctor.

Magistrate Judge L. Patrick Auld denied the motion Dec. 16, rejecting the doctor’s argument that the psychotherapist-patient privilege protected the records from disclosure.

The US Supreme Court recognized this privilege as a matter of federal common law, but Smith couldn’t assert it because he wasn’t a licensed psychotherapist, Auld said. The privilege couldn’t be extended to other licensed professionals, even if they dealt with mental-health issues, he said.

The doctor’s standing, moreover, was limited to his personal right or privilege in medical records he created, the court said. That narrowed his objection even further, as Smith testified that he didn’t create every medical record held by UNC that was responsive to the lawmakers’ request, it said.

Federal discovery rules allow parties to move for protective orders to protect information that would be annoying, embarrassing, oppressive, or whose disclosure would cause undue burden or expense, the court said. Some courts have said that includes information that likely would harm a business relationship, it said.

The doctor, however, asserted inter-personal interests, such as his relationships with his patients and the trust he’s built with their families, likely to be harmed by the disclosure, the court said. These interests weren’t equal to business interests, it said.

In any event, the doctor didn’t provide any evidence that the disclosure would lead him to lose his patients’ trust, the court said. Additionally, he didn’t explain how the requests would cause him annoyance, embarrassment, oppression, undue burden, or expense, it said.

Lambda Legal Defense & Education Fund Inc., National Health Law Program, McDermott Will & Emery LLP, and HWG LLP represent the plaintiffs. Cooper & Kirk PLLC and Dowling PLLC represent the lawmakers.

The case is Voe v. Mansfield, M.D.N.C., No. 23-cv-864, 12/16/24.