A federal judge has blocked the Department of Justice from forcing Rhode Island's largest hospital to turn over confidential health records of transgender minors who received gender-affirming care, dealing another blow to the administration's sweeping records demands across the country.
US District Judge Mary McElroy ruled Wednesday that the government's subpoena was too broad and that the Justice Department had forfeited the trust necessary to wield such investigative power responsibly. "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 subpoena sought patient birthdates, Social Security numbers, home addresses, and detailed medical records spanning five years. The Justice Department also demanded internal assessments behind prescribing decisions for puberty blockers and hormone therapy, along with guardian consent forms.
At least seven other federal courts have already quashed or limited similar subpoenas issued to more than 20 doctors and hospitals nationwide. McElroy's decision echoes judges' recurring concerns about the scope of the government's demands and its intentions. She wrote that the Justice Department "has proven unworthy of this trust at every point in this case."
Federal prosecutors in Texas have claimed the investigation targets potential drug "misbranding" and illegal financial incentives from pharmaceutical companies to doctors. While off-label prescribing is legal, prosecutors say they need patient names and contact information to conduct interviews about how drugs like puberty blockers were promoted and prescribed.
McElroy rejected that rationale, emphasizing that the government's public statements about gender-affirming care demonstrate an intent beyond neutral criminal investigation. She found the demands incompatible with constitutional protections for medical privacy.
The Rhode Island ruling arrives as pressure on hospitals intensifies from multiple directions. A New York federal court received a similar grand jury subpoena this month, with NYU Langone becoming the first major health system to publicly acknowledge the demand. The hospital said it received the subpoena from prosecutors in Texas's northern district on May 7 and was weighing its response.
Separately, a federal judge in Maryland is now reviewing a class-action lawsuit filed by 11 families seeking to block all such record demands. The plaintiffs include families with transgender children treated across the country who fear their personal information could be exposed.
Gender-affirming care encompasses counseling, puberty blockers, hormone therapy, and sometimes surgeries, though surgical intervention remains rare in minors. Major medical organizations including the American Medical Association support access to these treatments for youth with gender dysphoria, describing gender identity as existing on a spectrum.
State-level battles over access continue. At least 27 states have banned or restricted the care for minors, while several others have enacted protections ensuring access.
Author James Rodriguez: "McElroy's ruling cuts through prosecutorial theater and names what's really happening here: a political campaign dressed up as a drug-fraud investigation."
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