As the Trump administration escalates its efforts to obtain the medical records of transgender adolescents from many of the nation’s major children’s hospitals, patients and their parents are asking federal courts to intervene, arguing that the government is seeking the information under a false pretext and in violation of their constitutional rights.
On Tuesday, a group of transgender young people sued the Justice Department, urging a federal judge in Manhattan to block a criminal subpoena that a federal prosecutor in Texas has issued to NYU Langone, the hospital where they were treated. The subpoena instructs hospital officials to appear before a grand jury this month with documents “sufficient to identify each patient” under 18 who received gender-related treatments since 2020.
Last week, six families sued the Lucile Salter Packard Children’s Hospital at Stanford in California, asking a federal judge in San Jose to bar the hospital from complying with a similar subpoena demanding data on young transgender patients.
And in Baltimore, a federal judge has scheduled a hearing for next week to hear from 11 families whose children received gender-related treatment at several major children’s hospitals, including Connecticut Children’s Medical Center and Michigan Medicine. The families want the court to place a nationwide block on the Justice Department’s demands for information from health care providers, asserting that patients who may want to contest those demands are unaware or “cannot keep pace with the Department’s nationwide investigation.”
The legal battles reflect a mounting standoff between the Trump administration and many young transgender patients and their families. As the government invokes new tactics to press for patient records, lawyers for transgender patients say that the fight to keep those records confidential may increasingly fall to the patients themselves rather than their health care providers.
“This is deeply personal, private information that belongs to these patients and these parents, and their interests are not perfectly aligned with the hospital,” said Karen Loewy, senior counsel at Lambda Legal, a civil rights organization that is representing the New York plaintiffs, along with the A.C.L.U. and the New York Civil Liberties Union. “That’s why we’re asking for the protection of this court, to ensure that their constitutional rights are being safeguarded.”
The government has said it is acting on the behalf of patients and families as it investigates whether health providers and drug companies have illegally promoted off-label use of medications or used fraudulent billing practices to secure insurance coverage for gender-related treatments to minors.
In court documents, government lawyers allude to the need to protect families who may be misled about the risks and effectiveness of gender medications. President Trump has repeatedly described gender-transition treatments for minors as “mutilation.” In a memo authorizing the investigation in April 2025, Pam Bondi, then the attorney general, vowed to “hold accountable those who prey on vulnerable children and their parents.”
Transgender young people and their parents argue that the Justice Department is acting in bad faith, to intimidate hospitals into suspending services that are permitted by their states’ laws and to carry out the Trump administration’s policy goals, which include ending medical transition treatments for adolescents. In addition to concerns about how the government might use private health information, parents said they fear that their children’s records will be held up as part of an investigation that ultimately aims to deny them medical treatment.
“It’s really the providers they’re going after, and that is what we worry about,” said Melissa Combs, the parent of a transgender teenager who is a patient at Yale New Haven Health, one of several dozen children’s hospitals that has recently suspended its gender-transition medical practice. “If there are no people left to provide this care, then it’s gone.”
A Justice Department spokeswoman said the agency does not comment on grand jury subpoenas or activities.
Gender-transition treatment often involves puberty-delaying medication followed by hormone therapy to align physical traits like body hair and voice range with an adolescent’s gender identity. In rarer cases, treatment can include surgery.
The treatments are barred for minors in about half the United States. In states where they are legal, many pediatric clinics and hospitals have stopped providing them, citing pressures from the Trump administration, including an earlier round of Justice Department subpoenas and a proposal by the health department that would make them ineligible to receive Medicaid and Medicare payments for any service if they continued to provide transgender-related care.
An estimated 724,000 minors between 13 and 17 in the United States identify as transgender, according to the Williams Institute, which researches the L.G.B.T.Q. population. That amounts to about 3 percent of the U.S. population in that age group. A small fraction receive medication for gender transition, experts say.
An influential review in Britain in 2024 concluded that the treatments have not been studied well enough to establish whether they are beneficial. In its own assessment, the Trump administration cited the risk of infertility and the regret that some young adults have later expressed about the interventions. But most of the major medical societies in the United States endorse the treatments for children who experience significant distress linked to a conflict between their gender identity and their sex.
In an early round of legal wrangling, related to subpoenas issued last July by the Justice Department’s civil division, several federal court judges have agreed with patients and medical providers that the government’s investigation had been driven by improper political purpose. By last month, at least seven judges had partially or entirely blocked the subpoenas, which sought patients’ diagnoses, dates of birth, Social Security numbers and home addresses, in addition to personnel records of health care employees.
“This court joins the others in finding that the government’s demand for deeply private and personal patient information carries more than a whiff of ill intent,” U.S. District Judge Cathy Bissoon, who was appointed by President Barack Obama, wrote last September in a case brought by patients challenging a subpoena to University of Pittsburgh Medical Center.
Judge Mary McElroy of the U.S. District Court in Providence, R.I., echoed that sentiment last month in a challenge to a subpoena received by Rhode Island Hospital. Judge McElroy, a Trump appointee, found that the Justice Department’s request for “intimate medical details from one of this country’s most vulnerable populations constitutes a drastic overreach of its investigative authority.”
Some providers have already turned over the subpoenaed records, the government said in a recent court filing.
In recent months, the Justice Department has shifted to more aggressive tactics. It has appealed most of the cases in which district court judges initially blocked an administrative subpoena, arguing in one brief that patient medical records are necessary to uncover “the scope of potential violations.” The department has also deployed its criminal investigative authority to demand the same medical records and identifying information of minors that it had previously requested through the consumer protection unit of its civil division.
The legal stakes of a criminal subpoena leave hospitals with “no meaningful discretion to decline production” of patient records, lawyers for families say. The lawsuit against Stanford, brought by GLAD Law and the National Center for LGBTQ Rights, notes that the subpoena includes a three-page “Notice Regarding Liability for Obstruction of Justice,” warning that anyone who impedes the investigation could face fines and up to 20 years in prison.
Secrecy around grand jury proceedings also means that patients may not know all the hospitals that have been served with such criminal subpoenas. NYU Langone informed patients about the subpoena to comply with a New York state law that requires health institutions to provide patients with 30 days’ notice before disclosing their records. Such disclosure rules do not apply in all states, including California.
The plaintiffs in the cases in New York and California argue that the demands for medical records infringe on Fourth Amendment protections against unreasonable search and seizure, and on informational privacy rights under the Fifth Amendment’s due process clause.
In interviews and declarations submitted to federal courts, parents of transgender adolescents said they fear the government will use the records to harm their children in some way. Many parents say they are deeply troubled by the prospect that their children’s medical records are being compiled by an administration that has sought to roll back protections for transgender people across many spheres of public life, including policies on passports and military service.
“It’s hard for your brain not to go wild,” said one parent whose child was a patient at NYU Langone before it stopped providing gender-transition treatment earlier this year.
Justice Department lawyers have told courts that its efforts are clear-cut, simply aimed at seeking out violations of billing patterns, falsely coded diagnoses for insurance and adverse health outcomes.
“That is not hypothetical,” department lawyers wrote in a brief appealing the blocking of a subpoena to Children’s National Hospital in Washington, D.C. “The Department has obtained medical records from other pediatric hospitals as part of this very investigation and obtained directly relevant evidence from those records.”
Seamus Hughes contributed reporting.
Amy Harmon is a Times reporter who covers how shifting conceptions of gender affect everyday life in the United States.
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