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.
U.S. District Judge Mary McElroy’s Wednesday ruling is the latest setback for the U.S. Department of Justice, where at least seven other federal courts have 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 expansive scope of the subpoenas, describing the Justice Department as having “immense prosecutorial authority and discretion” but no longer trustworthy it will enforce its power fairly and honestly.
“DOJ has proven unworthy of this trust at every point in this case,” McElroy wrote.
A DOJ spokesperson said Thursday that DOJ would appeal and continue with its investigations.
“The Rhode Island court’s attack on the professionalism and integrity of DOJ attorneys is outrageous and unjustified,” the department said.
DOJ Demands
According to the subpoenas, the DOJ had demanded Rhode Island Hospital hand over the birth dates, Social Security numbers and addresses of every patient who received transgender care over the past five years. It also included instructions to provide all documents detailing adverse side effects in minor patients who received gender-related care, assessments that formed the basis for prescribing puberty blockers or hormone therapy, as well as 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 DOJ said that the investigation was taking place in the Northern District of Texas, where the court’s chief judge ordered Rhode Island Hospital to comply with the subpoena before McElroy’s decision voided the subpoena.
Assistant U.S. Attorney Brantley Mayers told McElroy during the hearing that the DOJ is investigating potential “misbranding” of drugs approved by the U.S. Food and Drug Administration, such as puberty blockers for young people. While off-label prescribing is legal, Mayers said that the DOJ 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 DOJ could interview them.
McElroy rejected that argument.
“The administration has publicly characterized gender-affirming care for minors as abuse, directed the DOJ to bring its practice to an end, and celebrated when hospitals curtailed such programs as a result of this subpoena campaign,” McElroy wrote.
Legal Actions
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 DOJ 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 U.S.
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. But the institution said in its statement Tuesday it was one of several that received a subpoena out of the Northern District of Texas on May 7. It said it was deciding on how to respond.
“The government cannot use its subpoena power to intimidate families out of seeking lawful medical care. To trans and gender-diverse children and their families, we want you to know that you are valued, you are not alone,” Kevin Love Hubbard, an attorney with the Lawyers’ Committee of Rhode Island, who represented the plaintiffs in the case, said in a statement.
Gender-affirming care includes a range of medical and mental health services to support a person’s gender identity, including when it’s 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 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 care for minors, while several others have adopted laws or policies protecting access to transgender health care.
Photo: The main entrance to Rhode Island Hospital is seen in Providence, R.I., on Nov. 27, 2007. (AP Photo/Steven Senne, File)
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