A federal judge on Tuesday blocked the U.S. Justice Department's attempt to subpoena medical records of transgender patients who have received gender-affirming care at Boston Children's Hospital, saying the demand was improper and “motivated only by bad faith.”
U.S. District Judge Myong Joun found the administrative subpoena sought by the Justice Department reached well beyond a legitimate probe of possible fraud or unlawful off-label promotion of drugs and instead appeared aimed at harassing the hospital and discouraging patients from seeking care. "The Administration has been explicit about its disapproval of the transgender community and its aim to end GAC," Joun wrote, using the abbreviation for gender-affirming care, and added that the subpoena's true purpose was to interfere with Massachusetts' right to protect such care and to dissuade patients from obtaining it.
The Justice Department argued the information was necessary to investigate potential violations related to off-label prescriptions and healthcare fraud. The subpoena, however, requested voluminous materials, including actual patient records and personally identifiable information about minors who had been prescribed puberty blockers or hormone therapy, the judge said. Joun wrote that the records sought appeared unrelated to the stated enforcement objective.
Boston Children's Hospital asked the court to quash the subpoena on July 8, saying the Justice Department sought nearly every document related to the hospital's provision of gender-affirming care during the previous five-and-a-half years. The hospital characterized the request as an overbroad intrusion into highly sensitive patient information.
In a separate move, the Justice Department's Civil Division announced it would use "all available resources to prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities" in what officials described as a review of "radical gender experimentation." Attorney General Pam Bondi said in a July 9 statement that the department had sent more than 20 subpoenas to doctors and clinics providing care to transgender patients under 18, characterizing the inquiries as part of investigations into "healthcare fraud, false statements, and more." Phone messages left with the Justice Department attorney identified in court filings and with a Justice Department public affairs officer were not immediately returned.
Joun's ruling emphasized constitutional protections in Massachusetts, noting the state constitution protects the right to gender-affirming care, and questioned how the Justice Department's broad demand served any legitimate federal investigatory purpose within that context. The judge concluded the subpoena amounted to an effort to "harass and intimidate" the hospital and to impede the state's authority to regulate medical care within its borders.
Gender-affirming care encompasses a range of medical and mental health services that support a person's gender identity and can include counseling, puberty blockers, hormone therapy and, in rare cases for minors, surgery. Major medical organizations generally consider access to such care important for people with gender dysphoria and recognize gender as existing along a spectrum. The issue has become politically charged in the United States: at least 27 states have enacted laws restricting or banning gender-affirming care for minors, while others have adopted measures to protect access.
The court's decision to block the subpoena marks a legal setback for the Justice Department's efforts to investigate providers of gender-affirming care and could shape how federal investigators pursue similar inquiries elsewhere. Boston Children's Hospital and its lawyers successfully argued that the scope and nature of the subpoena threatened patient privacy and state authority over medical regulation.
The ruling does not preclude other lawful investigations, and the Justice Department may seek to appeal the decision or pursue narrower requests. For now, the order prevents the department from enforcing the administrative subpoena as written while the case proceeds through federal court.