Fueled by a Twitter report, Republican lawmakers are planning to pass legislation in 2023 to stop Vanderbilt University Medical Center from performing pediatric transgender surgeries.
Meanwhile, Gov. Bill Lee requested an investigation, and Attorney General Jonathan Skrmetti's office said he will use the "full scope" of his authority to make sure state law is being followed.
House Speaker Cameron Sexton, R-Crossville, said in a statement he is looking into "conflicting reports" on the matter but noted it is "inappropriate for any minor to have any gender reassignment surgery or puberty blockers given to them."
"Your biological sex at birth is your identity. There will be legislation filed this session by many members to protect Tennesseans from this barbaric practice," Sexton said.
Outrage surfaced among some legislators after conservative blogger Matt Walsh posted video and reports Tuesday showing Vanderbilt officials discussing gender-affirming surgeries.
Walsh, a political commentator, blogger and podcaster for the conservative Daily Wire, engaged in similar social media accusations against Boston Children's Hospital last month. What followed there were threats of violence against staff and doctors, including a bomb threat that forced the evacuation of the hospital.
A statement released by Vanderbilt University Medical Center on Wednesday noted that the acclaimed teaching hospital is "now the subject of social media posts and a video that misrepresent facts about the care the Medical Center provides to transgender patients."
"VUMC began its Transgender Health Clinic because transgender individuals are a high-risk population for mental and physical health issues and have been consistently underserved by the U.S. healthy system."
The statement noted the hospital provides care to all adolescents "in compliance with state law and in line with professional proactive standards and guidance established by medical speciality societies," including requiring parental consent to treat minors for issues related to transgender care.
On Wednesday, the websites for the Vanderbilt Clinic for Transgender Health and associated pages regarding transgender care were down. The hospital did not respond to follow-up questions about the sites or whether there were security concerns at the hospital.
Walsh on Wednesday posted a series of videos on Twitter he said were taken in 2018 and 2020, including one featuring Vanderbilt physician Dr. Shayne Taylor calling gender transition surgery a "big money maker." Some procedures, which are covered by the Affordable Care Act, could bring in up to $40,000 and others could cost $100,000, Taylor said in the video.
Taylor does not refer to children in the video clip Walsh posted, which did not appear to contain her full remarks.
Another video Walsh posted includes a Vanderbilt plastic surgeon discussing guidelines doctors must follow before performing "top surgeries," or double mastectomies, on transgender patients. The requirements include a letter documenting persistent gender dysphoria from a licensed mental health provider and ensuring patients are capable of making fully informed decisions on their own, the physician said. Patients who are 16 or 17 years of age who have been on testosterone and have parental consent may also qualify, the doctor said.
But Walsh inaccurately characterized the remarks to suggest that after children are "drugged and sterilized," Vanderbilt surgeons "will happily perform double mastectomies on adolescent girls."
Walsh also posted an undated video of Dr. Ellen Clayton, a Vanderbilt professor of law, pediatrics and health policy, noting that "conscientious objections" to gender affirming surgery is "problematic."
"You are doing something to another person and you are not paying for the cost of your belief," she said. "I think that's a real issue," she said. She noted that Vanderbilt would likely accommodate religious objections, but "it would not be without consequences."
It's not clear from the edited clip posted whether she was referring to consequences for patients or for staff.
In its statement, Vanderbilt University Medical Center noted its policies "allow employees to decline to participate in care they find morally objectionable and do not permit discrimination against employees who choose to do so. This includes employees whose personal or religious beliefs do not support gender-affirming care for transgender persons."
In addition, Walsh singled out Vanderbilt's "Trans Buddies" program, for providing "trans activists" to accompany patients to appointments.
The program, a Medical Center statement noted, has received national acclaim for providing peer volunteers to support people seeking "highly personal care in an unfamiliar environment, and who may have been refused medical services in the past or avoided seeking them out of fear of being met with hostility."
Lt. Gov. Randy McNally, R-Oak Ridge, and Sen. Ferrell Haile, R-Gallatin, who sponsored legislation in 2021 to restrict transgender drug therapy and surgery for prepubescent children, said they expect a bill dealing with transgender medical care to be sponsored in 2023 when the 113th General Assembly convenes.
Haile said his two concerns are making sure Vanderbilt Hospital is following state law and then to ensure the hospital didn't find loopholes.
He said a "medical consideration" must be considered with any follow-up legislation, but he declined to speak further about the matter.
McNally said Wednesday he believes "sexual reassignment" surgery should be delayed until a person is past puberty, even if parents give consent, because of the long-term impact on the patient.
"I think in many cases, the individual, the child, later in life has difficulty with what's happened, and I think it's better to wait and make sure that's what they need to do, if the parents and child are considering having something like that done," McNally said.
Lee issued a statement saying he wants a probe of the hospital to make sure it is operating legally.
"The 'pediatric transgender clinic' at Vanderbilt University Medical Center raises serious moral, ethical and legal concerns. We should not allow permanent, life-altering decisions that hurt children or policies that suppress religious liberties, all for the purpose of financial gain. We have to protect Tennessee children, and this warrants a thorough investigation," Lee said.
And Skrmetti issued his own statement, which said he was "aware of allegations of illegal conduct at the Clinic for Transgender Health. General Skrmetti will use the full scope of his authority to ensure compliance with Tennessee laws."
Chris Sanders, executive director of the LGBTQ advocacy group Tennessee Equality Project, was critical of the Twitter report's source.
"Matt Walsh has this history of going after trans people. He's really got a focus and obsession on this. So what has caught everybody off guard is this sudden firestorm that's arisen over gender-affirming care that's been offered," Sanders said Wednesday.
Rather than protecting children, the rhetoric by Republican lawmakers on Wednesday is putting their safety and well-being in danger, said Jace Wilder, a master's student and research fellow at Vanderbilt University.
"That the attack on Vanderbilt is encouraged by the Lee Administration is disgraceful," he said.
"They are using trans kids as political pawns. They're saying this is going to protect kids, but this is going to further perpetuate violence," Wilder added.
House Republican leaders filled Twitter with outrage, promising to dismantle the Vanderbilt program.
Majority Leader William Lamberth of Portland said he is "deeply troubled" by the social media report.
"@GovBillLee is right to call for an investigation and we will support that investigation 100%. This type of child mutilation should be illegal and soon will be in TN," Lamberth said on Twitter.
House Republican Caucus Chairman Jeremy Faison of Cosby also commented on Twitter.
"Giving hormone replacement treatments to minors is unconscionable but threatening doctors with 'consequences' who have religious objections is against everything this country stands for," he wrote.
He added that he would lead the "fight" next session to stop the procedures.
Their stance conflicts, however, with a statement by the American Medical Association.
In a letter to the National Governors Association, Dr. James L. Madara, CEO and executive vice president of the association, wrote that the group and its member governors oppose state legislation that would prohibit medically necessary "gender transition-related care to minor patients" because it represents a "dangerous governmental intrusion" into medical practice and could harm the health of transgender children nationwide.
State lawmakers have already passed legislation restricting gender-affirming hormones for children prior to puberty. Sanders pointed out this type of medicine was not being practiced when Haile sponsored his legislation.
A separate bill to ban hormone therapy and gender affirming surgery for all minors failed in the legislature earlier this year.
State Rep. John Ray Clemmons, a Nashville Democrat, criticized the political outrage over Vanderbilt hospital's practices.
"Rather than using taxpayers' money to investigate an internationally renowned and respected health care facility," Clemmons said, he would support investigations into Gov. Lee's use of no-bid contracts, failure to use federal welfare funds, shortcomings of the Department of Children's Services, the departures of Lee's cabinet members and alleged bribery by state officials during the 2019 House vote on vouchers.
Read more at TennesseeLookout.com.