A state investigation into the Washington University Transgender Center at St. Louis Children’s Hospital has expanded to target therapists and social workers who may have minors seeking gender-affirming care.

Missouri Attorney General Andrew Bailey is seeking redacted or lightly redacted medical records of patients who received care at the facility. The state investigation of the center is one of many currently underway, including one by U.S. Sen. Josh Hawley.

The move left the state’s trans and healthcare communities with concern over future access to gender-affirming care for transgender youth in the state, the Missouri Independent reported.

“The attorney general has created a hostile environment for medical providers where they are afraid to stay and practice medicine,” Katy Erker-Lynch, executive director of PROMO, an LGBTQ+ advocacy group in the state, said.

Bailey is reviewing the records at the Missouri Division of Professional Registration which oversees the state’s medical licensing as part of the investigation. He had earlier targeted Planned Parenthood Great Plains and Children’s Mercy, a hospital in Kansas City.

Bailey has reportedly interviewed 57 healthcare professionals in connection with the investigation.

Licensed clinical social worker Kelly Storck spoke with senior investigator Nick McBroom as part of the investigation.

McBroom confronted Storck, who brought an attorney with her to the meeting, with a file of letters she had written to Washington University Transgender Care in support of patients seeking gender-affirming care at the facility. Some of the letters had been scrutinized, with many showing some sentences were underlined in green.

When McBroom asked Storck to detail in writing her process for recommending gender-affirming, she refused. The case was subsequently closed, but Storck still has questions and concerns about the investigation.

“I still have a lot of distrust about who initiated it and who was in my documents,” Storck told the Independent.

The Center earlier turned over a spreadsheet providing information regarding patients seeking gender-affirming care, including visits, medications, and other normally private information.

The mother of one patient who received care at the Center, a 17-year-old trans boy named Levi, described the investigation as “invasive” and said it was causing unwarranted disruption in their lives.

“The state has already basically disrupted our lives,” Becky Hormuth told the Independent. “They’ve disrupted our families, our children’s lives with the legislation that has passed. Then for him to continue going on is even more invasive and damaging.”

After Missouri passed a ban on gender-affirming care for minors last year, Bailey issued an emergency rule banning similar care for trans adults as well. In the document laying out the policy, he said these treatments “lack solid evidentiary support” and “pose very serious side effects.” He withdrew the rule when state lawmakers acted. Missouri Gov. Mike Parson, a Republican, signed the ban into law in June. It was quickly challenged in court, but a judge allowed it to go into effect.