We have not tested the C# driver in a Medium Trust environment. My
guess is that while adding the Assembly attribute allowed the assembly
to be loaded, the type initializer for ObjectId is still making some
operating system calls that are not permitted in a Medium Trust
environment.
I have created a JIRA issue to investigate whether the C# driver can
be made to run in a Medium Trust environment. See:
https://jira.mongodb.org/browse/CSHARP-348