Whistleblowers are often courageous people who expose unethical or illegal behavior. But what if the government targets a whistleblower for speaking out? And is it ever right to break the law to expose wrongdoing?
Those questions are relevant to the case of Dr. Ethan Haim, a surgeon in Texas who has been indicted on four felony counts of violating the federal Health Insurance Portability and Accountability Act (HIPAA).
Last year, Haim, at the time a surgical resident at Houston-based Texas Children's Hospital, gave conservative journalist Christopher Rufo records indicating that the hospital had secretly continued "transgender medical interventions" on minors despite a public pledge that it had stopped such treatments.
According to the now-unsealed indictment, the U.S. Attorney's Office in the Southern District of Texas has charged Haim with obtaining protected individual health information for patients who were not under his care and without authorization.
Haim and his supporters say he is being targeted not for violating HIPAA but for speaking out. If so, the government should not be using its power to silence and punish a whistleblower.
Dr. Ethan Haim: Surgeon, whistleblower, felon?
In March 2022, Texas Children's Hospital, the largest children's hospital in the nation, announced it would no longer prescribe gender-affirming hormone therapies, citing potential legal liability.
A month earlier, Gov. Greg Abbott and Attorney General Ken Paxton had announced that "'sex-change' procedures on children, and prescribing puberty-blockers to them, is 'child abuse'” under the Texas Family Code.
“The mission of Texas Children’s Hospital is to create a healthier future for all children, including transgender children, within the bounds of the law,” the hospital said in a statement. “This step was taken to safeguard our healthcare professionals and impacted families from potential legal ramifications.”
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But according to Haim, the hospital did not stop gender-affirming care for minors.
Haim recorded evidence of the hospital's ongoing care and passed it on to Rufo. Haim says he redacted any patient information that would violate HIPAA. On May 16, 2023, City Journal published Rufo's story that included Haim's anonymous account of what he witnessed at the hospital. The Texas Legislature then officially banned transgender medical interventions on minors.
“They were talking publicly about how they were concealing what they were doing," Haim recently told The Free Press. "You can’t take care of your patient without trust. For me as a doctor, to not do something about this was unconscionable.”
In a City Journal story published in January, Haim revealed his identity and detailed the gender-affirming care he had seen firsthand, including a surgeon who had implanted a hormone device for gender dysphoria in an 11-year-old girl. Haim said the frequency of procedures like that one had increased, and that "potentially hundreds more children" had received hormone interventions for gender dysphoria.
Last June, federal agents came to Haim's home, he said, handing him a letter revealing that he was a "potential target" of an investigation involving alleged violation of federal criminal law related to medical records.
The indictment unsealed Monday says, "In April 2023, Haim allegedly requested to re-activate his login access at TCH to access pediatric patients not under his care. The indictment alleges he obtained unauthorized access to personal information of pediatric patients under false pretenses and later disclosed it to a media contact."
Haim's concerns mirror growing caution in the medical community
Haim is not alone in his concerns about doctors participating in the treatment of minors struggling with gender dysphoria.
Recently, the National Health Service England said it will not prescribe puberty blockers as a “routine treatment” to children and other young people seeking gender transitions. The Cass Review, an independent, nearly 400-page report on transgender care suggested that providers slow down on drug treatments and found that the evidence supporting this kind of gender care is “remarkably weak.”
'Extreme caution':Cass Review raises red flags on gender-affirming care for trans kids
The American College of Pediatricians, a group of about 700 conservative medical providers, recently urged other medical professionals to cease intervening in the care of gender dysphoria on minors.
In recent years, Denmark, Finland, Norway and Sweden have worked on placing new limits on hormone treatments for youth experiencing gender dysphoria.
Given the concerns increasingly expressed by medical professionals, it's stunning that discussions about life-altering care of transgender children are still so politically volatile. My home state of Texas isn't alone in restricting such care; 24 other states have banned medical gender-affirming treatment of minors.
Is the government silencing Haim for political reasons or for violating HIPAA?
The indictment accuses Haim of illegally accessing patient records, and doing so under false pretenses. If that proves to be accurate, Haim needs to be held accountable.
However, Haim's objective − to blow the whistle on Texas Children's Hospital − raises the question of whether his alleged wrongdoing should be taken into account, because the hospital continued treatments on transgender minors when it said it would stop.
HIPAA violations should be taken seriously. But "up to 10 years in federal prison and a $250,000 maximum possible fine" for exposing the hospital's alleged wrongdoing seems excessive.
The care of transgender minors is fraught with complicated issues. Unlike adults, children, who are still legally minors and who in many cases have yet to reach puberty, cannot truly give informed consent and cannot know what they might want when they become adults.
It's vital that ongoing discussions take place among medical providers, youth, their families and policymakers.
What must be avoided are efforts to silence dissent.
Nicole Russell is an opinion columnist with USA TODAY.She lives in Texas with her four kids.Sign up for her newsletter, The Right Track, and get it delivered to your inbox.
