A federal judge has delivered a significant blow to the Trump administration’s extensive efforts to obtain confidential transgender patient information from Rhode Island’s largest hospital providing gender-affirming care to minors.
U.S. District Judge Mary McElroy’s ruling on Wednesday marks another setback for the U.S. Department of Justice (DOJ), following at least seven other federal courts that have quashed or limited similar broad civil subpoenas issued to over 20 doctors and hospitals last summer.
Judge McElroy’s decision echoed concerns raised by other judges regarding the subpoenas’ expansive scope.
She acknowledged the Justice Department’s “immense prosecutorial authority and discretion” but stated it could no longer be trusted to wield its power fairly and honestly.
“DOJ has proven unworthy of this trust at every point in this case,” McElroy wrote.
An email seeking comment was sent to the DOJ on Thursday.
The subpoenas had demanded Rhode Island Hospital surrender birth dates, Social Security numbers, and addresses for every patient who received transgender care over the past five years.
They also sought all documents detailing adverse side effects in minor patients receiving gender-related care, assessments forming the basis for prescribing puberty blockers or hormone therapy, patient intake forms, and guardian authorizations.
The Justice Department consistently argued this information was crucial for investigating potential fraud or unlawful off-label drug promotion, stating the investigation originated in the Northern District of Texas.
Assistant U.S. Attorney Brantley Mayers informed Judge McElroy during a hearing that the DOJ was probing potential “misbranding” of FDA-approved drugs, such as puberty blockers for young people.
While off-label prescribing is legal, Mayers expressed concern that pharmaceutical companies were offering “financial incentives” to Rhode Island doctors to prescribe these drugs.
The DOJ asserted that the subpoenas were vital for identifying children and their families for interviews.
However, Judge McElroy firmly rejected this 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,” she wrote.
The Rhode Island decision is the latest development in the ongoing legal battle over transgender youth health records.
Earlier this week, 11 families filed a class-action lawsuit in Maryland’s federal court, seeking to prevent the DOJ from acquiring these documents. Separately, NYU Langone, a New York hospital, announced it had received a grand jury subpoena from federal prosecutors in Texas for information on children who received gender-affirming care and their medical providers.
NYU Langone is the first hospital system to publicly confirm such a subpoena as part of a federal criminal investigation, noting it was one of several institutions to receive one from the Northern District of Texas on May 7.
Gender-affirming care encompasses a range of medical and mental health services designed to support an individual’s gender identity, particularly when it differs from the sex assigned at birth.
This care can include counseling, puberty-blocking medications, hormone therapy to induce physical changes, or, rarely for minors, surgeries to transform chests and genitals.
Most major medical groups affirm the importance of access to such treatment for individuals with gender dysphoria, recognizing gender as existing along a spectrum.
Nationally, at least 27 states have enacted laws restricting or banning gender-affirming care for minors, while several others have adopted laws or policies aimed at protecting access to transgender health care.
