Families of children who received gender-affirming care at two Pennsylvania hospitals are fighting a U.S. Department of Justice effort to obtain medical records and personal information about transgender youth.
The Public Interest Law Center in Philadelphia at the law firm Ballard Spahr filed motions Monday to quash subpoenas served on the University of Pittsburgh Medical Center (UPMC) and Children’s Hospital of Philadelphia (CHOP) in June.
They’re among more than 20 doctors and clinics across the country that provided transgender health care that have received demands for sensitive medical records and personal information from the DOJ. The filings by the law center and Ballard were made on behalf of four patients of UPMC and five CHOP patients and their families.
Public Interest Law Center Legal Director Mimi McKenzie said the Trump administration’s description of gender-affirming care as “mutilation” and child abuse has created fear for many families with transgender children.
“Parents and patients are extremely worried about having their identities disclosed to the Department of Justice and the broader world in this political and social climate,” McKenzie said.
In its filings, the law center notes that a federal judge in Massachusetts granted a motion by Boston Children’s Hospital to quash an identical subpoena earlier this month. U.S. District Judge Myong J. Joun found the subpoena was issued improperly to interfere with the right to gender-affirming care in Massachusetts.
Gov. Josh Shapiro has joined a federal lawsuit led by Massachusetts and more than a dozen other Democrat-led states challenging President Donald Trump’s executive orders and regulations that “unlawfully targeted transgender individuals.”
The CHOP and UPMC patients note in their filings that gender affirming care remains legal in Pennsylvania, although the Human Rights Campaign reports 27 states have banned such medical treatment. While U.S. medical associations generally support gender-affirming care, some European countries take a more cautious approach, prioritizing psychological support and restricting some treatments for minors.
The subpoenas request billing records, consent forms, information on the use of puberty blockers and hormones, use of billing codes in connection with gender affirming care, reports of adverse events, doctors’ notes and recordings and patient identifying information for minors who received gender affirming care, including social security numbers and home addresses.
They followed a memo from Assistant Attorney General Brett A. Shumate directing the DOJ’s civil division to prioritize investigations in furtherance of Trump’s Inauguration Day executive orders reversing federal policy recognizing transgender people and health care.
The orders directed Attorney General Pam Bondi, among other things, to investigate “deception of consumers, fraud, and violations of the Food, Drug, and Cosmetic Act by any entity that may be misleading the public,” about the long-term side effects of gender-affirming care, which the order describes as “chemical and surgical mutilation.”
McKenzie said the DOJ’s stated intent is to investigate providers for potential violations of federal law regarding off-label uses of hormones and puberty blockers. The department is also investigating whether providers violated the False Claims Act by submitting claims to federal health care programs for “non-covered services related to radical gender experimentation.”
“What is happening here is the Trump administration is weaponizing the DOJ to threaten providers and intimidate families all in an effort to end this very important care for transgender youth,” McKenzie said.
CHOP still provides gender affirming care through its Gender and Sexuality Development Program. UPMC, however, has ceased some gender-affirming care due to the Trump administration’s memos, directives and subpoenas.
“These actions have made it abundantly clear that our clinicians can no longer provide certain types of gender-affirming care without risk of criminal prosecution. This includes specific restrictions on puberty blockers and hormone therapy for individuals under the age of 19,” a UPMC spokesperson said in a statement.
The hospital continues to provide essential behavioral health support and other care “within the bounds of the law” while maintaining physician-patient confidentiality.
“We empathize deeply with the patients and families affected by these ongoing changes,” the statement says.
CHOP did not respond to the Capital-Star’s request for comment Thursday. The hospital has been fighting the subpoena since July, accusing the DOJ of targeting “patients who have struggled with deeply personal issues concerning gender, and who have been victims of harassment and discrimination.”
A DOJ spokesperson said in a statement that Bondi and the DOJ will use every legal and law enforcement tool available to protect innocent children, referring to gender-affirming care as “mutilation.”
McKenzie said the records targeted in the subpoena are the most sensitive that any person could have and are protected by a constitutional right to privacy. They include information about the patients’ mental health, reproductive health and sexual health. To invade that privacy, the government must have a compelling reason, which the law center argues it does not have.
“If the Constitution means anything, it means the federal government can’t rifle through your child’s medical records in order to intimidate you,” McKenzie said.
The law center’s filings on the families’ behalf also argue the DOJ requests are “hugely broad” (as the Massachusetts judge also noted) and represents “a barely disguised political agenda in search of a health care fraud offense” – all without stating a compelling reason to compromise patient privacy.
The court doesn’t need to read the subtext, “because animus is official policy,” the law center argues.
“The administration has asserted that transgender citizens cannot lead an ‘honorable, truthful, and disciplined lifestyle,’ and that their medical treatment is part of a ‘warped ideology’ and ‘evil and backwards lies’ that cause ‘sexual mutilation,’” the filings say.
