Government’s demand for trans care info sought addresses, doctors’ notes, texts

The Justice Department is demanding that hospitals turn over a wide range of sensitive information related to medical care for young transgender patients, including billing documents, communication with drug manufacturers and data such as patient dates of birth, Social Security numbers and addresses, according to a copy of a subpoena made public in a court filing this week.

The June subpoena to Children’s Hospital of Philadelphia requests emails, Zoom recordings, “every writing or record of whatever type” doctors have made, voicemails and text messages on encrypted platforms dating to January 2020 — before hormone therapy, puberty blockers and gender transition surgery had been banned anywhere in the United States.

About half of states have since passed laws prohibiting all or most gender treatment of minors. The Supreme Court ruled in June that a Tennessee ban did not violate the Constitution.

Attorney General Pam Bondi said last month that the Justice Department had issued more than 20 subpoenas seeking to hold “medical professionals and organizations that mutilated children in the service of a warped ideology” accountable. It is highly unusual for the nation’s chief law enforcement officer to announce such legal activity. Bondi did not identify who received the subpoenas, what information the government sought or what potential law violations it is investigating.

According to seven people familiar with the subpoenas, speaking on the condition of anonymity because they feared retribution, the subpoenas targeted care for patients younger than 19 and went to providers in states that still allow gender care for minors, as well as states where it has been banned. The subpoena, as well as public statements by Bondi’s chief of staff, indicate the federal government is attempting to build cases against medical providers that allege they may have violated civil and criminal statutes while providing care that was legal in their states.

Jacob T. Elberg, a former federal prosecutor specializing in health care fraud, said Bondi’s statement suggests the government “is using its investigative powers to target medical providers based on a disagreement about medical treatment rather than violations of the law.”

Elberg, now a law professor at the Center for Health & Pharmaceutical Law at Seton Hall University, said that the subpoena itself is not wildly broad for a health-care-fraud case. But he noted that under a federal privacy law, the Justice Department must show that any information it demands on patient identities is relevant to a legitimate law enforcement probe.

“Frankly, I’m looking over my shoulder driving home,” said one Midwestern doctor who had to turn over a work cellphone to supervisors after their hospital received a Justice Department subpoena; the doctor asked not to be identified for fear of drawing additional law enforcement scrutiny.

Dozens of hospitals, doctors and small clinics contacted by the Washington Post declined to say whether they had received a subpoena. Some providers said they were reluctant to be interviewed because they had received violent threats. Others said they feared government reprisal.

“The subpoena is a breathtakingly invasive government overreach,” said Jennifer L. Levi, senior director of transgender and queer rights at GLAD Law, a legal advocacy group. “It’s specifically and strategically designed to intimidate health care providers and health care institutions into abandoning their patients.”

The subpoena to Children’s Hospital of Philadelphia was filed in court by the Washington state attorney general’s office, which in January successfully sued the Trump administration over two executive orders that sought to withhold federal money from institutions that offer gender care to minors. State Attorney General Nicholas W. Brown said in legal documents that he added the subpoena to the court record because President Donald Trump has “only escalated” his attack on this type of medical care since a federal judge issued a preliminary injunction in March.

In a separate lawsuit filed this month, Democratic attorneys general from 16 states alleged the administration is intentionally and unlawfully intimidating providers to “trammel on state power” and end access to care even where legal.

Chad Mizelle, Bondi’s chief of staff, said publicly last month that prosecutors would use their tools to thwart what he called “one of the greatest frauds on the American public.”

The Justice Department declined to comment on its plans. Spokeswoman Natalie Baldassarre said in a statement that the department intended to use “every legal and law enforcement tool available to protect innocent children” from what she described as “being mutilated under the guise of ‘care.’”

Starting in 2021, Republican-led states across the South and Midwest have banned doctors from treating trans young people with puberty blockers, estrogen or testosterone and surgical procedures.

By late last year, key players in the conservative movement told the Post they had “maxed out” what they could achieve at the state level and, with Trump’s help, hoped to secure a federal ban on gender transition care for minors.

The president has signed multiple executive orders that seek to narrowly define sex and withhold money from hospitals that offer the care to trans people under the age of 19. Multiple judges have blocked those efforts for now, saying they are discriminatory and appear to breach the separation of powers between Congress and the president.

Since then, the Centers for Medicare and Medicaid Services — which administers federal health insurance programs for the poor and elderly — have sent letters to hospitals requesting information about their transition care protocols. In June, the FBI requested tips from the public on providers.

Last month, the Federal Trade Commission hosted a day-long workshop on gender care, titled “The Dangers of ‘Gender-Affirming Care’ for Minors.” The speakers included Mizelle, who said his office was targeting false-claims frauds in what he called “the billion-dollar industry of harming our kids.”

“We’re investigating violations such as health care fraud, false statements, all of this, which could result in either civil or criminal liability for these clinics,” Mizelle said.

Though Mizelle did not give specific examples of fraud, one panelist, Miriam Grossman, a child psychiatrist and prominent critic of gender care, said stickers featuring pronouns and medical terms such as “hormone replacement therapy” violate FTC rules. Grossman also described Kaiser Permanente’s use of terms like “assigned male at birth” to describe trans women and girls as both FTC violations and Orwellian, “designed to change the way that we think about male and female and to mislead consumers in a material way.”

Grossman showed records from specific hospitals and patients, including the professional address of one provider in North Carolina. She suggested doctors were ripping off insurance companies by using fraudulent billing codes — for example, diagnosing trans people with unspecified endocrine disorders.

The Justice Department’s subpoenas would have been unthinkable years ago, advocates say, but such information-gathering efforts have recently become more common — and are not just limited to the trans community.

Officials in Texas and Tennessee have either forced or tried to force doctors to hand over information about trans patients. Last month, Florida Attorney General James Uthmeier (R) demanded that a restaurant in Vero Beach turn over all video footage and ticket sale information about adults who attended a drag show. And Trump has directed states to turn over personal and sensitive data about millions of low-income Americans who receive federal aid to buy food.

“The DOJ using its broad powers to prevent fraud as a tool to target a disfavored minority group is deeply troubling” said Elizabeth Gill, senior counsel for the American Civil Liberties Union. “Not just for trans people but for anyone that the administration decides they don’t approve of.”

The subpoena to Children’s Hospital of Philadelphia came from the Justice Department’s Consumer Protection Branch and said information must be handed over to the Justice Department by July 9, the same day Bondi announced the subpoenas in a three-paragraph news release. Hospital officials did not respond to a request to confirm receipt of the subpoena or whether they had complied.

The Consumer Protection Branch is overseen by a Trump political appointee named Jordan Campbell. He previously ran a Texas law firm dedicated to representing people who had undergone gender transitions and then halted that treatment, a process known as detransitioning. The Justice Department’s website says Campbell represented “victims of radical gender ideology” when he was in private practice.

Some who received the subpoenas said they were too afraid to share them with colleagues who do similar work, out of fear that the government was tracking them. Medical providers who once were open to being interviewed about their treatment practices said they were afraid to discuss the subpoenas even on the condition of anonymity and on encrypted platforms such as Signal.

Providers who did answer questions from the Post said they were balancing concerns for their own safety while also trying to help their patients, many of whom are vulnerable and may be at serious physical and psychological risk as they suddenly lose access to medications that had eased their gender dysphoria. Patients who abruptly end hormonal care could experience mood swings or menopausal-like symptoms, and they are likely to develop unwanted physical changes.

At the Midwest hospital system, the doctor who handed over a work phone said senior hospital administrators began notifying patients under the age of 19 in June that some surgeries would be canceled and hormone treatments ended. The doctor said the colleagues who called families described those conversations as “painful” and the loss of care amounts to a “toxic plan” that would force some patients to detransition.

“This goes way beyond any degree of moral or ethical dilemma that any of us have ever experienced,” the doctor said. “It is completely scientifically and medically unfounded.”

In California, a woman named Emily is scrambling to find hormone therapy for her 17-year-old son after Children’s Hospital Los Angeles announced it was closing its Center for Transyouth Health and Development, the largest public provider of such care in the U.S.

“It’s absolutely terrifying,” said Emily, who asked that the family’s last name not be used for fear of law-enforcement scrutiny. “We always felt we had some level of protection living in a blue state.”