The Department of Justice has issued criminal subpoenas to children's hospitals, demanding extensive medical records related to gender-affirming care for transgender youth. This move is part of a wider investigation that has led to increased scrutiny of medical institutions providing such services.
One parent, identified as JD, described receiving a call from Mount Sinai Health System informing him of the Justice Department's request for his teenage daughter Winter's medical records. Winter had previously been a patient at the hospital's youth gender center. JD expressed that the request felt like intimidation, stating, “Getting a call like that, it was chilling.”
The Trump administration has been a vocal critic of transgender identity and gender-affirming care, baselessly alleging that doctors providing such care engage in insurance fraud for profit. In its efforts to restrict care for transgender minors, the administration has utilized federal agencies to investigate transgender health associations and threatened to withdraw federal funding from hospitals offering these services. The administration also issued a rule to end coverage for such care under the Affordable Care Act.
Last summer, the Justice Department escalated its tactics by issuing over 20 civil subpoenas to children's hospitals, seeking six years of data on adolescent gender-affirming care. This data included insurance billing, diagnostic codes, internal communications, and patient identification information. After federal courts blocked these civil subpoenas, the department shifted to criminal subpoenas, demanding similar information under the threat of criminal charges.
These subpoenas have created significant challenges for healthcare providers and heightened anxiety for patients. Several hospitals, including Mount Sinai, have ceased providing care for transgender youth, even in states with protective laws. Transgender youth and their families have been compelled to seek care elsewhere or forgo it entirely, facing uncertainty over government intrusion into their private medical information.
"This is not just about trans people getting healthcare. It’s about patient privacy and your right to a private therapeutic experience with your provider," said Dr. Crystal Beale, founder of Queer Doc, a telehealth provider of gender-affirming care that received a subpoena. Beale noted that the subpoenas have fostered a climate of fear for both young people and medical professionals, stating, "One day your job is legal, and the next day it is a felony."
Jennifer Levi, senior director of transgender and queer rights at GLBTQ Legal Advocates & Defenders, views these cases as a broader "test case" for the Justice Department's authority to investigate not only hospitals but also perceived political opponents. She warned that the methods used could have far-reaching implications beyond transgender healthcare, potentially impacting reproductive care, mental health treatment, and other sensitive medical information.
At least three hospitals, Mount Sinai and New York University Langone Hospitals in New York, and Lucile Packard Children’s Hospital at Stanford in California, have received criminal subpoenas. These actions have been met with criticism from federal judges who have questioned the Justice Department's justification for the broad requests. At least eight federal district courts have blocked the department's efforts to obtain sensitive medical information through civil subpoenas.
U.S. District Judge Katherine Polk Failla blocked a criminal subpoena targeting NYU Langone in June, protecting minor patients receiving gender-affirming care in New York. Judge Failla criticized the Justice Department's actions as potentially judge-shopping and described the government's behavior as "the most egregious official conduct." The Justice Department has appealed this ruling.
Kiersten Pels, a spokesperson for the Justice Department, stated that the department will continue "using every available tool to protect children, parents, taxpayers, and the integrity of our healthcare system," asserting that providers who "misrepresent the truth to children, parents, insurers, or federal health care programs to promote or obtain payment for interventions that can permanently harm children, that is not care — it is unlawful deception."
Alex Sheldon, executive director of GLMA: Health Professionals Advancing LGBTQ Equity, described the DOJ's strategy as an "extralegal intimidation" campaign that undermines trust between patients and hospitals. "The subpoena itself has become a form of punishment even if no wrongdoing is found," Sheldon said. "Institutions are spending an enormous amount of time, money, and attention responding to these instead of caring for patients."
Two hospitals have reached settlements with the DOJ. Texas Children’s Hospital agreed to pay $10 million and establish a clinic for detransitioners over allegations of false insurance billing. Cleveland Clinic agreed to pay $308,000 and halt transgender care for minors for 20 years to resolve similar allegations.
While some legal challenges have been successful in blocking subpoenas, the process has been complex. Rhode Island Hospital was compelled to release medical records to a Texas court despite challenging a civil subpoena. The secrecy surrounding grand jury proceedings, which issue criminal subpoenas, makes it difficult to ascertain the full extent of data collection.
Evidence from a lawsuit suggested that the DOJ's investigation may have relied on a database of hospitals offering transgender youth programs compiled by the right-wing organization Do No Harm. This organization, founded in 2022, advocates against LGBTQ+ rights and has ties to conservative funding networks.
Leavitt of the ACLU expressed concern about the long-term impact on transgender youth, stating, "Regardless of the outcome in all of this litigation, even if in the end everyone won every single case, that fear and vulnerability is still going to be felt."
For JD and Winter, the investigation prompted them to move to the Netherlands in early July, seeking a gender clinic where Winter can continue hormone therapy without fear. Winter plans to study biology at a Dutch university and expressed that it was clear since before Trump's election that he intended to target transgender individuals.