Last September, Riley headed to their clinic at Vanderbilt University Medical Center, which was usually brimming with chatter about the days research and patient needs.

But that fall morning, Vanderbilt was thrown into chaos, and the clinic for gender-affirming surgeries, which serviced both trans youth and adults, had been shut down for the day. The health care worker, who is using a pseudonym in fear of retaliation from their employer, said the atmosphere among their colleagues in the trans health clinic was a mix of fear and concern.

Rileys clinic remained open, and their colleagues debated whether they were safe at work or should go home. Riley said local police were lined up outside the medical centers doors, serving as extra security for employees.

All day people whispered about the social media posts by right-wing blogger Matt Walsh, which had gone viral the day before for claiming that doctors at Vanderbilts transgender health clinic castrate and sterilize children.

At the time, Riley hadnt heard of Walsh. They didnt have social media and rarely watched the news.

But over the next year, Riley would witness firsthand again and again how misinformation and right-wing attacks on the transgender health clinic severely restricted the kinds of care they could provide at Vanderbilt. In those months, trans Tennesseans have felt more intimidated and desperate than ever, as they have been forced to decide whether to pack up their lives to find a place where they can exist without the fear of the government, or right-wing provocateurs, meddling in their private medical information.

One of the first changes Riley saw was Vanderbilt moving the stand-alone transgender health clinic inside the universitys main campus in Nashville, Tennessee. The clinic also adopted new security measures, including an armed guard behind the desk, and required patients and providers to be buzzed inside.

Riley said the medical center has even canceled appointments for certain surgeries for cisgender youth that currently do not fall into the category of gender-affirmation but that critics could see as pathways to gender affirmation.

By the end of September 2022, Tennessees attorney general, John Skrmetti, said his office had opened an investigation into Vanderbilts transgender health clinic. Over the next few months, Skrmetti broadened the scope, first requesting specific patient medical records, and then information on Vanderbilt employees and volunteers at the transgender health clinic. The following spring, Republican Gov. Bill Lee signed a ban on gender-affirming care for transgender children, effectively suspending all operations at VUMCs pediatric transgender clinic.

Riley said they were one of more than a dozen clinicians who were told by Skrmettis office that their emails could be subpoenaed as part of the investigation.

It feels like a witch hunt, Riley told HuffPost. What are you going to find in my emails? Obviously, theres not a conspiracy here.

That Is Why I Am Working With Matt Walsh

In September 2022, Walsh, a prominent Nashville-based right-wing talk show host and blogger, accused Vanderbilt University Medical Centers transgender health clinic of only existing to turn a profit. He also claimed that Vanderbilt doctors castrate, sterilize, and mutilate minors.

In a series of tweets, Walsh argued that the clinic was drugging and sterilizing children, and used language that LGBTQ+ advocates and Vanderbilt employees say grossly distorted the reality of pediatric transgender care. Walsh posted a video of one Vanderbilt doctor Dr. Shayne Taylor, who founded the clinic in 2018 discussing how gender-affirming surgeries, like double mastectomies and genital surgeries, could bring in a lot of money for the medical center. (In this video, Taylor, who did not respond to HuffPosts request for comment, was mostly referencing surgeries for trans adults, as Vanderbilt never performed genital surgeries for minors.)

In another video Walsh posted, a different doctor cautions that employees who dont want to treat transgender patients on the grounds of religious objections probably shouldnt work at Vanderbilt. At the end of the thread, Walsh wrote that the clinics peer support group, Trans Buddy Program, was in fact a gang of trans activists acting as surveillance in order to force compliance.

Walsh tweeted later that evening that his report was just the beginning. We are not going to let up, he wrote. We will shut this down.