Nurse leaders must do their best to help maintain patient privacy and be prepared to pivot as regulatory requirements change.
As nurse leaders, it's important to guide the workforce to do their best to safeguard patient rights and privacy.
On June 2, the FBI released a call to action via its official X account stating that they wish for individuals to report tips of any "hospitals, clinics, or practitioners" performing surgical procedures on children "under the guise of gender-affirming care."
This calls into question the issue of patient rights to privacy, and it presents an ethical problem for nurses who want to care for their patients to the best of their ability. CNOs need to understand the current policies regarding the release of patient information to best equip their nurses to care for transgender and gender nonconforming patients.
Current policy
Under the Biden administration, HHS' Office of Civil Rights (OCR) implemented the 2022 HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy (2022 OCR Notice and Guidance), which stated that medical interventions for transgender minors may improve physical and mental health outcomes.
The notice specifically stated that healthcare providers and entities could not disclose protected health information (PHI) about gender-affirming care without patient authorization. This provided transgender patients with protections under HIPAA. The only exception was in circumstances where providers were explicitly required by the law to do so.
However, on Feb. 20, 2025, that guidance was rescinded, in response to Executive Order 14187, "Protecting Children from Chemical and Surgical Mutilation," which was put forth by the Trump administration. HHS stated that their basis for recission was that the 2022 OCR Notice and Guidance lacked legal basis under federal privacy laws, including HIPAA Privacy, Security, and Breach Notification Rules.
What comes next
So, what does this mean for health systems, and, more specifically, for nurse leaders?
As of right now, EO 14187 has been put on hold as two different legal challenges to the EO make their way through the courts. According to analysis from law firm Husch Blackwell, this means that currently providers and health systems do not have to choose between complying with the 2022 OCR Notice and Guidance and EO 14187, pending the outcome of those legal challenges.
For CNOs and other clinical leaders, it's important to remain in compliance with current legal requirements and to be proactive by creating internal policies that can evolve with regulatory updates. CNOs should instruct their nurses to remain in compliance with HIPAA requirements and work to safeguard PHI for transgender patients.
G Hatfield is the CNO editor for HealthLeaders.
KEY TAKEAWAYS
Currently, providers and health systems do not have to choose between complying with the 2022 OCR Notice and Guidance and EO 14187, pending the outcome of legal challenges.
CNOs and other healthcare executives must remain in compliance with current legal requirements and to be proactive by creating internal policies that can evolve with regulatory updates.
CNOs should instruct their nurses to remain in compliance with HIPAA requirements and work to safeguard protected health information for transgender patients.