AUSTIN — An electronic health bill requiring medical records to note a patient’s biological sex and any “sexual development disorder” passed the Texas House on Friday.
Many LGBTQ advocates told lawmakers they feared the measure would identify transgender Texans, potentially outing them to medical professionals who might be hostile to them because of their identity. Republicans pushing the bill, however, described it as an effort to give doctors access to important medical information so they can give patients the best care.
The Senate, which passed its version of the legislation in April, must decide whether to accept the House’s proposal, which passed in that chamber 86-49.
The state would have to ensure certain electronic health records from covered entities — such as health care insurers, researchers, facilities and providers — include a space to designate a patient’s biological sex as male or female and information on any sexual development disorder.
The agencies ensuring such information include the Texas Health and Human Services Commission, Texas Medical Board and Texas Department of Insurance.
The measure is necessary “so that medical professionals have access to the essential information they need to treat their patients and protect these records so that access is limited only to relevant parties,” Rep. Greg Bonnen, R-Friendswood, said during a Thursday debate, noting that it would require such digital records to be stored on servers in the United States.
Parents would get “complete and unrestricted access” to their minor children’s health records “immediately upon request” unless access is restricted by law or a court order, according to the bill.
The proposal does not prohibit records from including a person’s gender identity, but the biological sex could only be amended to correct a clerical error or if the patient is intersex.
“It seems the only disclosure that this is adding is for biological sex,” Rep. Jessica González, D-Dallas, said. “It includes definitions of what that means within your bill. Why is it only that information that you’re adding?”
Bonnen, who is a practicing neurosurgeon, said doctors can’t document a patient’s biological sex because of how the record is structured.
“That is relevant medical information,” he said.
Democrats unsuccessfully proposed seven amendments they said would improve the bill.
One would have required express permission to release private health information. Another would have mandated that patients be notified if their biological sex is changed in their health record. Others would have removed the investigative authority, disciplinary action and civil penalties. Bonnen opposed each.
The proposal was amended Thursday to allow a health care professional to use artificial intelligence for diagnostic purposes, such as recommendations on a diagnosis or course of treatment based on a patient’s medical record.
However, parameters would be in place. For example, they could only use AI to plan treatment if the practitioner is acting within the scope of their license or certification. Its specific use must not be restricted or prohibited by any state or federal law, and the practitioner must review all AI-created records.
Any credible allegation that a provision of the bill was violated — such as a failure to protect the confidentiality and availability of private health information — would be investigated by state health officials. Doctors and others with access to the records could face suspension or lose their licenses in repeat cases.
The bill would ban covered entities from collecting, storing and sharing information about a person’s credit score or voter registration in electronic health records.
The state attorney general could sue over violations with damages ranging from $5,000 to $250,000.
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