A Seattle HIV Clinic Is Now Shipping Blood Samples to a Texas Lab, and Queer Advocates Are Worried

For years, LGBTQ+ Americans have been moving out of Texas and into Washington state to get away from Attorney General Ken Paxton’s escalating campaign against queer medical records. This month, some of their most sensitive health data is making the opposite trip: from Seattle to San Antonio, in the form of blood.

The Seattle LGBTQ+ Center’s HIV and STI testing has historically run through Public Health – Seattle & King County’s own labs. That changed after the Washington State Department of Health told the center it had to switch providers, according to reporting by Seattle Gay News. The new lab is the Center for Disease Detection, a LabCorp-owned facility in San Antonio, Texas — meaning blood samples, along with identifying information including sex assigned at birth, now travel to the same state whose attorney general has spent years trying to compile lists of transgender residents and subpoena hospitals for gender-affirming care records.

Why the destination matters

Paxton’s track record is the reason this particular lab switch is setting off alarms rather than passing unnoticed. In 2024, it took a court settlement to stop him from demanding Seattle Children’s Hospital hand over gender-affirming care records for trans minors, a request built on a claim — always denied by the hospital, including under oath — that Texas-based patients were being treated there. He was the first known elected official in the country to order the compilation of a list of transgender residents, and he directed the Texas Department of Public Safety to stop processing gender-marker changes on driver’s licenses even when a court ordered otherwise, routing information about anyone who tried into a dedicated tracking account. Earlier this year, he won a Texas Supreme Court ruling forcing PFLAG and other advocacy groups to turn over membership records as part of an investigation into banned gender-affirming care for minors.

Against that backdrop, sending HIV test results — plus the identifying details attached to them — into a Texas-based lab reads differently than a routine vendor change.

What the health department says

Seattle LGBTQ+ Center executive director Nakita Venus told SGN the center didn’t have a say in the switch: the contract sits between the Washington Department of Health and King County, not the center itself, and the center’s priority was making sure testing continued without a gap. Department of Health spokesperson Mark Johnson said the decision came down to cost. “The price differential between the local lab and the CDD is quite significant,” he said, adding that the gap is large enough to cover shipping samples to Texas and back, and that no other lab could match the Center for Disease Detection’s pricing. Johnson also said the switch has sped up turnaround times, letting people diagnosed with HIV, syphilis, gonorrhea, chlamydia, or hepatitis C get linked to care and treatment faster.

Those are real, defensible reasons for a public health agency operating on a tight budget. They don’t cancel out the discomfort of routing queer Washingtonians’ health data through a lab located in a state actively building infrastructure to identify and track trans and queer residents.

The bigger picture

Washington has become one of the most visible landing spots for LGBTQ+ people leaving red states, a trend significant enough that the Seattle LGBTQ Commission pushed the city earlier this year to declare a state of emergency to free up resources for the new arrivals. The HIV testing lab switch is a reminder that geography alone doesn’t fully insulate people from the reach of states pursuing their medical information — data infrastructure crosses state lines even when people are trying not to.

No one involved has suggested the lab switch was designed with data-gathering in mind, and the Department of Health’s cost and speed rationale is plausible on its own terms. But given how directly Texas has pursued LGBTQ+ medical records elsewhere, it’s a reasonable thing for patients to ask their providers about — and a reasonable thing for Washington’s health agencies to account for the next time a contract comes up for renewal.