US judge blocks DoJ’s demand for Rhode Island hospital’s records of trans patients

A federal judge has blocked the Trump administration’s sweeping demands for confidential transgender patient information from Rhode Island’s largest hospital that provides gender-affirming care to minors.

The US district judge Mary McElroy’s ruling on Wednesday is the latest setback for the US Department of Justice, with at least seven other federal courts having agreed to quash or limit the expansive civil subpoenas sent to more than 20 doctors and hospitals last summer.

McElroy’s decision also echoed similar concerns raised by judges surrounding the broad scope of the subpoenas, describing the justice department as having “immense prosecutorial authority and discretion” but no longer being trustworthy that it will enforce its power fairly and honestly.

“[The justice department] has proven unworthy of this trust at every point in this case,” McElroy wrote.

An email seeking comment was sent to the justice department on Thursday.

According to the subpoenas, the justice department had demanded that the Rhode Island hospital hand over the birthdates, social security numbers and addresses of every patient who received gender-affirming care over the past five years.

It also included instructions to provide all documents detailing adverse side effects in minor patients who received gender-affirming care, assessments that formed the basis for prescribing puberty blockers or hormone therapy, and patient intake forms and guardian authorization.

The justice department has repeatedly argued that the information sought in the subpoenas is needed to investigate possible fraud or unlawful off-label promotion of drugs. Most recently during a hearing in Rhode Island, the justice department said that the investigation was taking place in the northern district of Texas, where the court’s chief judge ordered the Rhode Island hospital to comply with the subpoena before McElroy’s decision voided the subpoena.

Assistant US attorney Brantley Mayers told McElroy during the hearing that the justice department is investigating potential “misbranding” of drugs approved by the US Food and Drug Administration, such as puberty blockers for young people. While off-label prescribing is legal, Mayers said the justice department is concerned that pharmaceutical companies are providing “financial incentives” to Rhode Island doctors to prescribe the drugs.

The subpoenas were crucial in getting the names of children and their families so the justice department could interview them.

McElroy rejected that argument.

“The administration has publicly characterized gender-affirming care for minors as abuse, directed the [justice department] to bring its practice to an end, and celebrated when hospitals curtailed such programs as a result of this subpoena campaign,” McElroy wrote.

The Rhode Island decision is the latest development in the fight over transgender youth health records. Earlier this week, 11 families filed a class-action lawsuit seeking to block the justice department from obtaining the documents. The lawsuit, filed in Maryland’s federal court, is backed by families with transgender children who have received care from hospitals across the US.

And separately, a New York hospital announced that 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 is the first hospital system to publicly acknowledge receiving a subpoena for such records as part of a federal criminal investigation. It said on Tuesday that it received a subpoena out of the northern district of Texas on 7 May, and it was deciding on how to respond.

Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it is different from the sex they were assigned at birth. It may include counseling, medications that block puberty, hormone therapy to produce physical changes, or surgeries to transform chests and genitals, although those procedures are rare for minors.

Most major medical groups say access to the treatment is important for those with gender dysphoria and see gender as existing along a spectrum.

At least 27 states have adopted laws restricting or banning the gender-affirming care for minors, while several others have adopted laws or policies protecting access to transgender healthcare.