District Court Judge Blocks DOJ Subpoena for Medical Records of Transgender Children
Children’s Hospital of Philadelphia (CHOP) has won a legal challenge against the Department of Justice (DOJ) over a request for access to the protected health information of child-patients who received gender affirming care at CHOP. District Court Judge Mark Kearney ruled that the requests for patient data were “beyond the authority granted by Congress.”
CHOP filed the lawsuit in the District Court for the Eastern District of Pennsylvania in response to a DOJ subpoena for fifteen categories of records related to gender-affirming care provided by CHOP. The records were requested as part of an investigation into the labeling and distribution of prescribed clinically authorized puberty blockers and hormone therapy to identify potential fraud and unlawful promotion of hormones and puberty blockers for transgender children, in violation of the Food, Drug, and Cosmetic (FD&C) Act.
CHOP was one of twenty healthcare providers to receive subpoenas from the DOJ requesting information on minor patients as part of its efforts to restrict federal funding for gender-affirming care. The DOJ sought billing and insurance records, communications between CHOP and manufacturers and sales representatives, as well as the names and complete medical and psychological records of minor patients who received gender-affirming care.
CHOP launched its Gender and Sexuality Development Program in 2014 and has been providing gender-affirming care to minors for 11 years, in line with Pennsylvania law. The services provided are based on the needs of individuals and their families, and involve assessments, psychological evaluations, support groups, and, in some cases, treatment such as puberty blocking medication and hormone therapy. Those treatments are only provided with parental consent and the child’s assent.
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In January 2025, President Trump issued an executive order – Protecting Children from Chemical and Surgical Mutilation – to end gender-affirming care for minors. Under the direction of Attorney General Bond, CHOP was served with a subpoena to produce records, including the identities of children, their medical records, and disclosures to their parents or legal guardians. The subpoena was served under the authority granted by Congress in 1996 under the Health Insurance Portability and Accountability Act (HIPAA).
CHOP partially complied with the request, providing most of the requested records, but failed to disclose the identities of the patients or their families, and did not provide access to confidential medical files. Out of the 15 requests, CHOP objected to three specific requests and moved to limit the subpoena for those three requests alone.
- Documents sufficient to identify each patient by name, date of birth, Social Security number, address, and parent/guardian information, who received puberty blockers or hormone therapy
- Documents relating to the clinical indications, diagnoses, or assessments that formed the basis for prescribing puberty blockers or hormone therapy.
- Documents relating to informed consent, patient intake, and parent or guardian authorization for minor patients, including any disclosures about off-label use and potential risks
CHOP believes that were it to comply with those three requests, it would violate its child-patients’ privacy rights, but did not seek to quash the subpoena in its entirety. District Court Judge Kearney ruled that in 1996, Congress granted the DOJ the ability to subpoena documents from healthcare providers relevant to investigations into the labelling and distribution of puberty blockers and hormone therapy under the FD&C Act.
CHOP complied with the request by providing financial, insurance, and billing records consistent with the DOJ’s stated purposes; however, Judge Kearney ruled that the DOJ’s request for information in the above three categories exceeded its authority granted by Congress, and granted CHOP’s motion to strike the three categories from the subpoena, and all information contained in responses to other requests disclosing the same information.
Judge Kearney ruled that “even if this private information could be relevant, the heightened privacy interests of children and their families substantially outweighs the Department’s need to know the children’s names, addresses, and treatment along with disclosures for gender-affirming care at The Children’s Hospital of Philadelphia.”
