A federal judge has blocked a Trump administration effort to obtain confidential transgender patient information from Rhode Island Hospital, a major provider of gender-affirming care to minors, setting back a broader Justice Department subpoena campaign that has already been limited or rejected in other courts.
U.S. District Judge Mary McElroy issued the Wednesday ruling, describing it as another setback for the U.S. Department of Justice after at least seven other federal courts agreed to quash or limit expansive civil subpoenas that DOJ sent to more than 20 doctors and hospitals last summer, the Associated Press reported.
In her decision, McElroy echoed concerns raised by other judges about the scope of the subpoenas and questioned whether the department could be trusted to exercise its authority fairly and honestly. The judge wrote that the Justice Department had “immense prosecutorial authority and discretion” but “no longer trustworthy it will enforce its power fairly and honestly,” and she stated: “DOJ has proven unworthy of this trust at every point in this case.”
DOJ spokespersons said the department would appeal and continue its investigations. The department characterized the Rhode Island court’s ruling as “outrageous and unjustified,” while also arguing it attacked the professionalism and integrity of DOJ attorneys.
According to the subpoenas, the Justice Department had demanded Rhode Island Hospital hand over identifying information, including the birth dates, Social Security numbers and addresses of every patient who received transgender care over the previous five years. The requests also sought documents describing adverse side effects for minors who received gender-related care, records and assessments tied to prescribing puberty blockers or hormone therapy, and patient intake forms and guardian authorization.
The Justice Department argued that it needed the information to investigate possible fraud or unlawful off-label promotion of drugs. During a hearing in Rhode Island, Assistant U.S. Attorney Brantley Mayers told McElroy the investigation was taking place in the Northern District of Texas and said a chief judge there ordered Rhode Island Hospital to comply before McElroy’s ruling voided the subpoenas.
Mayers also told McElroy that the Justice Department was investigating potential “misbranding” of drugs approved by the U.S. Food and Drug Administration, including puberty blockers for young people. He said off-label prescribing is legal, but DOJ’s concern was that pharmaceutical companies were providing “financial incentives” to Rhode Island doctors to prescribe the drugs, the Associated Press reported. The subpoenas, the government argued, were crucial to identifying children and their families so investigators could interview them, but McElroy rejected that contention.
McElroy wrote that the administration had publicly characterized gender-affirming care for minors as abuse, directed DOJ to end the department’s practice, and celebrated hospitals curtailing such programs as a result of the subpoena campaign. She said the ruling was part of the fight over whether DOJ could use subpoena power to obtain sensitive records from hospitals.
The decision comes as legal challenges continue on multiple tracks. Earlier this week, 11 families filed a class-action lawsuit in Maryland’s federal court seeking to block the Justice Department from obtaining the documents, and the suit is backed by families with transgender children who have received care from hospitals across the United States.
The Associated Press also reported that a New York hospital announced it received a grand jury subpoena from federal prosecutors in Texas seeking information about children who received gender-affirming care and the medical providers who administered it. NYU Langone said it was the first hospital system to publicly acknowledge receiving such a subpoena, and it said it was one of several that received a subpoena out of the Northern District of Texas on May 7; the institution said it was deciding how to respond.
In a statement, Kevin Love Hubbard, an attorney with the Lawyers’ Committee of Rhode Island who represented the plaintiffs, said the government cannot use subpoena power to intimidate families out of seeking lawful medical care. He added: “To trans and gender-diverse children and their families, we want you to know that you are valued, you are not alone,” the Associated Press reported.
Gender-affirming care can include a range of medical and mental health services to support a person’s gender identity when it differs from the sex assigned at birth. The care may include counseling, medications that block puberty, hormone therapy to produce physical changes, and surgeries to alter chests and genitals, though those are rare for minors. Most major medical groups say access to treatment is important for people with gender dysphoria and that gender exists along a spectrum.
At least 27 states have adopted laws restricting or banning care for minors, while several others have adopted laws or policies protecting access to transgender health care.