Justice Department Subpoenas Doctors and Clinics Providing Gender-Affirming Healthcare

In an unprecedented move, the Justice Department has issued subpoenas for confidential patient data, from physicians and hospitals providing gender-affirming care for minor patients. The New York Times’s Azeen Ghorayshi and Glenn Thrush reported the development on Thursday afternoon, July 10, writing that “The Justice Department has issued subpoenas demanding confidential patient information from more than 20 doctors and hospitals that provide gender-related treatments to minors, according to officials with knowledge of the move. The action marks a new turn in the Trump administration’s efforts to limit transgender medical care. Most of the subpoenas, issued through a unit that typically investigates health care fraud, attempt to pierce powerful federal confidentiality protections for patients and their medical providers,” they wrote.

As the Times reporters noted, “Officials briefed on the investigation described the action as a fact-finding mission, an effort to determine whether any laws have been broken and a spur to kick-start negotiations with the providers over transgender treatment policy. Investigators could eventually seek criminal charges if evidence of fraud is uncovered, officials said. But critics say the motivation is more political than investigative — a campaign of intimidation. The subpoenas are part of a coordinated effort between the Justice Department and the White House to fulfill President Trump’s promises to curtail pediatric gender care. Pam Bondi, the attorney general, said in a statement Wednesday that ‘medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable.’”

The Justice Department confirmed the action on Wednesday, July 9, in a statement posted to its website. “Today, the Department of Justice announced that it has sent more than 20 subpoenas to doctors and clinics involved in performing transgender medical procedures on children. The Department’s investigations include healthcare fraud, false statements, and more.” And it quoted Attorney General Pam Bondi as stating that “Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice.”

Meanwhile, NBC News’s Jo Yurcaba wrote on Thursday evening that “The department’s brief announcement did not name any of the 20 doctors or clinics, or say where they were. It also did not specify what constituted ‘transgender medical procedures,’ but said its investigations ‘include healthcare fraud, false statements, and more.’ Also Wednesday, the Federal Trade Commission hosted an all-day workshop on the “dangers of gender-affirming care.” In his opening remarks, FTC Chairman Andrew Ferguson suggested that such care is deceptive and requires greater scrutiny by the commission. The workshop and the Justice Department’s announcement mark the latest escalation of the Trump administration’s ongoing campaign to restrict transgender rights and access to transition-related medical care.”

Indeed, Yurcaba wrote, “The FTC’s panel on Wednesday featured more than a dozen speakers who criticized transgender health care, including people who received such care as minors and now say they regret it; doctors and psychologists who disagree with the current standards for providing such care; and political scientists and lawyers who oppose access to transition care for minors.”

The Times’s Ghorayshi and Thrush reported that “Revelations of the subpoenas come in the wake of a Supreme Court decision that upheld state laws banning youth gender medicine in about half the country. Hospitals and doctors in other states, where legislatures are unlikely to enact such bans, have faced increasing threats from the federal government. In response, a small number of clinics have limited their treatments or closed altogether. It is unclear which hospitals and doctors received the subpoenas. But in May, nine leading children’s hospitals across the country received letters from the Centers for Medicare and Medicaid Services, demanding data on revenue from pediatric gender treatments and the rates of regret among patients, according to a person with knowledge of the effort.”

The Guardian’s Sam Levine wrote late on Wednesday that “Several medical associations have said that transgender care can provide lifesaving treatment for both children and adults, the Guardian has reported. A 2022 study by researchers at Stanford University found better mental health outcomes for transgender people who started receiving hormone therapy as teens compared with those who waited until they were adults. Bondi’s April memo said the department would investigate manufacturers and distributors engaged in misbranding by making false claims about the on- or off-label use of puberty blockers, sex hormones or any other drug used to facilitate a child’s gender transition. The department has yet to file charges against anyone in connection with providing transgender care. Nonetheless, the point of the investigation may be to intimidate those who provide care from doing so.”

Levine reported a statement that Robin Maril, a law professor at Willamette University, had told NBC News in April; according to Levine’s report, Maril had stated that “It’s meant to have a chilling effect on physicians providing access to necessary care, fearing that it will be characterized as chemical and surgical mutilation of children.” Levine noted that, “In a 6-3 decision last month, the U.S. Supreme Court upheld Tennessee’s ban on gender-affirming care for minors. In total, 27 states have laws that limit gender-affirming care for minors, according to the Kaiser Family Foundation.”

STAT’s Theresa Gaffney wrote on Wednesday evening that “The announcement is the latest Trump administration move to target providers of gender-affirming care. In June, the FBI requested tips from the public on clinics that provide this care, and in May, the Centers for Medicare and Medicaid Services sent letters to nine hospitals requesting information about their protocols. The actions follow the executive order President Trump issued one week into his presidency that directed the withholding of federal funds from any hospital that provides gender-affirming care to people under age 19. Separately, the Supreme Court last month ruled to uphold Tennessee’s ban on gender-affirming care for minors.”

What’s more, Gaffney reported, at the FTC workshop on Wednesday, Justice Department chief of Staff Chad “Mizelle and other FTC and DOJ leaders spoke during a daylong workshop featuring longtime anti-trans activists and clinicians, as well as patients who have gone through, then reversed, medical transition. Most of the event focused on the ability of the FTC to investigate this type of health care under its authority to protect consumers from unfair or deceptive practices.” She quoted FTC Commissioner Melissa Holyoak as stating that “The FTC cannot make policy decisions limiting sex transition treatments for minors. What the FTC can and should do is protect children from deceptive statements regarding such treatments.”

Gaffney reported that “Holyoak, like many other speakers throughout the day, cited a question that some clinicians purportedly ask of a parent: ‘Would you rather have a dead son, or a live daughter?’ This question alone, Holyoak said, is ‘not a truthful representation of the consequences of gender-affirming treatment’ and could constitute fraud or deception.”

But Gaffney also spoke with Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, a nonprofit focused on LGBTQ+ healthcare, who told her that such statements amount to a weaponization of clinician and parental concerns for young people’s safety. Baker told Gaffney that there is overwhelming evidence that young trans people, particularly when they are not able to access care, are at higher risk of thinking about and attempting suicide — and that hormone treatment is associated with lowered risk. “Taking something out of context and deploying it as evidence of a matter that the FTC is authorized to investigate — what this is really saying is that the FTC belongs in exam rooms, standing between doctors and families,” Baker told Gaffney.