Federal Subpoenas for Transgender Care Records Spark Privacy and Legal Concerns

On September 10, 2025, a significant legal development occurred when a federal judge temporarily blocked the Department of Justice's attempt to subpoena medical records related to transgender minors receiving hormone therapy and gender-affirming care at Boston Children's Hospital. This legal action marks the first public ruling following a series of over 20 subpoenas issued by the Justice Department in July to doctors and clinics that treat transgender patients under 19 years old.

The subpoenas sought extensive and highly confidential information, including psychotherapy notes, covering virtually all aspects of the care provided. One notable subpoena to the Children's Hospital of Philadelphia demanded broad documentation on student care, raising serious concerns about privacy and the scope of legal investigations.

The issuance of these subpoenas has stirred fear and uncertainty among patients, families, and healthcare providers. Some providers have even suspended or ceased offering gender-affirming care to minors, even in states where such treatment remains legal. Critics, including legal experts, highlight that these moves challenge established health privacy protections, such as those set forth by HIPAA, and push against legal boundaries.

HIPAA, enacted in 1996, was designed to safeguard medical privacy amidst increasing digital data sharing, prohibiting healthcare entities from disclosing protected health information without patient consent—except in specific legal circumstances such as subpoenas. Under HIPAA, providers are permitted but not required to release information in response to subpoenas, and they must adhere to strict rules, including obtaining patient authorization for sensitive records like psychotherapy notes and notifying patients when their information is being requested.

However, when responding to subpoenas, providers are obliged to disclose only the minimum necessary information and verify the legitimacy and purpose of the request. Given the broad nature of the recent subpoenas, healthcare providers face dilemmas about whether to comply or risk court sanctions, all while respecting patient privacy rights.

States have additional protections through shield laws, which can restrict disclosures and safeguard patients receiving gender-affirming care. Eighteen states plus D.C. have laws that defend against such disclosures, particularly for those traveling across state lines or receiving care in states with more restrictive laws. Nonetheless, the applicability of these shield laws against federal subpoenas remains uncertain, with ongoing legal debates.

The Justice Department's actions are possibly rooted in broader investigations that may involve health care fraud, false claims, or even allegations under laws banning procedures like female genital mutilation. These expansive subpoenas have raised questions about the legality and scope of federal authority in intruding on sensitive medical privacy, especially without concrete evidence of criminal activity.

As legal challenges continue, healthcare providers and individuals affected by these investigations might object or seek to limit disclosures. The situation underscores the ongoing tension between legal authority and patients' privacy rights and could have lasting impacts on the trust and willingness of individuals to seek gender-affirming care.

Source: https://medicalxpress.com/news/2025-09-federal-subpoenas-transgender-medical-privacy.html