He Sued Oregon for Its Own Pediatric Gender-Treatment Data — State Democrats Then Tried to Make That Request Illegal.
Paul Terdal, a Portland-based health-policy advocate and a visiting fellow with Do No Harm, spent years pulling public claims data on Oregon’s taxpayer-funded pediatric gender-transition services. In August 2025, he sued the state to keep doing it.
His federal lawsuit alleges the Oregon Health Authority illegally withheld records specifically to suppress his research and “skew public debate” — a First Amendment claim, not just a records dispute. Months later, Oregon’s Legislature took up a bill that would have made his kind of request impossible going forward.
This is the story of what Terdal says his own numbers show, why the state says it stopped sharing them, and how Salem answered the fight over access — not by releasing more data, but by moving to close the door on requests like his for good.
- 7,585 patients — of all ages received taxpayer-funded gender-transition services in Oregon, per Terdal's 2019 pull of the state's APAC claims database
- 160 children — on puberty blockers, per data Terdal says he separately obtained and detailed in his September 2025 RealClearPolitics op-ed
- ~370 children — on cross-sex hormones, per the same Terdal data set
- 33 mastectomies, 2 uterus/ovary removals — among girls age 15 and older (mastectomies) and 17-year-olds (uterus/ovary removal), per Terdal's own figures — his accounting, not an audited state total
- August 2025 — when Terdal filed a federal First Amendment lawsuit against the Oregon Health Authority over withheld records
The data set at the center of this fight is Oregon’s APAC — All Payer All Claims — database, which aggregates insurance claims across Medicaid, Medicare, and private payers for nearly every Oregonian. Terdal had used it once before, pulling a statewide snapshot in 2019. When he asked the Oregon Health Authority (OHA) for an updated pull in February 2025, the agency denied his request the following month, citing a newly discovered HIPAA violation inside its own data-release system as the reason it could no longer share what it had shared once before.
Terdal’s lawsuit, filed in federal court in August 2025, calls that explanation a pretext. It doesn’t just ask a judge to order OHA to hand over records — it argues the state’s refusal amounts to viewpoint-based obstruction of a citizen trying to inform a public policy debate, in violation of the First Amendment. OHA has not conceded the point; the case remains pending.
Paul Terdal, a Do No Harm Visiting Fellow, argues the evidence base doesn't support many of the unproven pediatric gender-transition drugs and surgeries in wide use — a position he was pressing well before his 2025 lawsuit over Oregon's data.
The bones of what Terdal is fighting to update are already public, because he obtained them once. His 2019 APAC pull found 7,585 patients of all ages who received taxpayer-funded gender-transition-related services in Oregon. More granular data he says he separately obtained afterward — detailed in his September 2025 RealClearPolitics op-ed — breaks the pediatric slice down further: 160 children on puberty blockers, roughly 370 children on cross-sex hormones, 33 girls age 15 and older who underwent mastectomies, and two 17-year-olds who underwent uterus-and-ovary-removal procedures.
Terdal also makes a claim about cost that this piece treats as his own accounting, not a verified state total: he says actual spending on these services runs “more than 100 times” an initial $200,000 estimate the state had put forward. Oregon has not published a reconciled figure, and no dollar total in this story should be read as audited — only as Terdal’s own claim, sourced to his own writing.
In a separate, unrelated court filing — State of Washington v. Trump — Oregon’s own Department of Justice stated that “genital surgery is not performed on transgender minors” in the state. Terdal points to his own APAC-derived figures — the mastectomies among girls age 15 and older and the uterus-and-ovary-removal procedures among 17-year-olds — as, in his telling, contradicting that claim. Whether the two statements actually conflict turns partly on definition: “genital surgery” typically describes procedures like vaginoplasty or phalloplasty, not mastectomy or hysterectomy, so the state’s specific wording and Terdal’s specific procedures may not describe the same category of surgery. We present both statements as made and leave that tension to the reader.
Oregon is endangering minors by hiding the true scope of its pediatric gender-transition programs, argues Do No Harm's Paul Terdal — in 'Oregon Lies About Transgender Treatments for Kids.'
While Terdal’s lawsuit worked through federal court, Oregon’s Legislature took up a bill that touched the same underlying fight from the other direction — not access to past records, but whether future requests like his could be made at all. City Journal’s Kurt Miceli, a physician and Do No Harm’s chief medical officer, covered the bill in a March 2, 2026 piece: HB4088, chief-sponsored by State Rep. Lisa Fragala (D-Eugene) and Sen. Floyd Prozanski (D-Eugene), would block future public-records access to this category of OHA gender-treatment data going forward.
The bill passed the Oregon House in February 2026 and cleared the full Legislature in early March 2026. State Rep. Virgle Osborne (R-Roseburg) was among those who voted no.
BREAKING: Oregon House Democrats just passed HB4088...
Oregon Democrats just passed a bill that would block public records access to the state's pediatric gender-treatment data.
Paraphrased commentary · not a verbatim post
Paraphrased — the exact Truth Social post text was not independently pulled, but the account and the HB4088 passage it references are confirmed.
Oregon is pumping children full of hormones. The state pushes teens toward 'transgender-related diagnoses' and dangerous treatments, write Leor Sapir and Paul Terdal.
The fight over data access has an echo inside Oregon’s largest academic medical center. Willamette Week reported in January 2026 that Oregon Health & Science University (OHSU) had quietly paused gender-affirming surgery for patients under 19 back in February 2025 — nearly a year before the story broke. OHSU President Dr. Shereef Elnahal said clinicians “have elected to no longer do that for various reasons,” including “risks to the institution, given dynamics at the federal government level.” OHSU did not frame the pause as a reversal on the underlying medicine; it framed it as risk management.
“Risks to the institution, given dynamics at the federal government level.”
Dr. Shereef Elnahal · OHSU President, on the paused surgeries
Leadership at the agency Terdal is suing has also changed hands. Gov. Tina Kotek’s (D-OR) office announced an OHA leadership transition in July 2026: Dr. Sejal Hathi is resigning as OHA director effective August 1, and Fariborz Pakseresht was named interim director on July 6. Neither official has issued a confirmed direct statement on the Terdal litigation specifically. Separately — and this should not be conflated with Terdal’s case — Attorney General Dan Rayfield (D-OR) is leading a different lawsuit, Oregon v. Kennedy, defending the state’s gender-affirming-care policies against the Department of Health and Human Services: a different plaintiff, a different target, and a different legal theory than Terdal’s records fight.
Gov. Tina Kotek (D-OR) — announced OHA’s July 2026 leadership transition; no confirmed statement on the Terdal case.
AG Dan Rayfield (D-OR) — leads the separate, unrelated Oregon v. Kennedy lawsuit defending gender-affirming-care access.
State Rep. Lisa Fragala (D-Eugene) — chief co-sponsor of HB4088.
Sen. Floyd Prozanski (D-Eugene) — chief co-sponsor of HB4088.
State Rep. Rob Nosse (D-Portland) — defended Oregon’s 2023 shield law, HB 2002, as “ultimately about insurance coverage, not treatment modalities.”
State Rep. Virgle Osborne (R-Roseburg) — voted no on HB4088.
State Rep. Ed Diehl (R) — on the 2023 shield law: “It’s indisputable that some youth are being harmed.”
None of this is Oregon’s first fight over how gender-transition treatment for minors gets discussed in public. In 2023, when the Legislature passed HB 2002 — a “shield law” for gender-affirming and reproductive care — Rep. Nosse defended it as “ultimately about insurance coverage, not treatment modalities,” while Rep. Diehl countered that “it’s indisputable that some youth are being harmed.” Three years later, the argument hasn’t moved past that same split — except now it isn’t only about which treatments are permitted — it’s about whether the public gets to see the numbers behind them at all.
Terdal’s lawsuit and HB4088 are two sides of the same question: who controls the data that would let anyone outside Oregon’s own health bureaucracy verify what taxpayer-funded pediatric gender-transition treatment in the state actually looks like. Terdal says the totals he’s already found, and the state’s shifting explanations for withholding more, are themselves the story. OHA says its March 2025 denial was about a genuine HIPAA problem, not obstruction. Both claims now sit before a federal judge — and if HB4088 stands, it will be one of the last times anyone outside Salem gets to ask the state to show its work.
