Appeals Court Supports Subpoena in Gender-Affirming Care Investigation
In a significant ruling, a divided federal appeals court has upheld a Justice Department subpoena targeting a provider of gender-affirming care for transgender youth. The decision aligns with former President Donald Trump’s policy goals of scrutinizing such medical treatments.
Last year, the Justice Department issued over 20 subpoenas to healthcare providers offering gender-affirming care, as part of a probe into potential healthcare fraud. Many of these subpoenas had been dismissed by federal judges, who viewed them as attempts to pressure providers into discontinuing care.
The 9th U.S. Circuit Court of Appeals, in a 2-1 decision, highlighted the uncertainty surrounding the efficacy and long-term risks of these treatments. The court stated that the president has the authority to direct the Justice Department’s enforcement priorities to align with broader policy objectives.
Judge Carlos Bea, joined by Judge Daniel Bress, reversed a lower court ruling that had quashed a subpoena against QueerDoc, a telemedicine provider. The case has been sent back to the district court for further consideration of other arguments. The subpoena demands extensive documentation from QueerDoc, including personnel files, billing records, and patient data related to puberty blockers and hormone therapy.
Adrien Leavitt, an attorney from the American Civil Liberties Union representing QueerDoc, expressed determination to continue contesting the subpoena in district court. QueerDoc argues that the subpoena is excessively broad and burdensome. Meanwhile, the Justice Department maintains that there is a basis to suspect the company might be providing misleading information regarding puberty blockers and hormones.
“We’re ready to continue defending one of the most fundamental principles of healthcare: every patient’s right to confidential medical care,” said Leavitt in a statement.
This marks the first time the San Francisco-based 9th Circuit has addressed the subpoenas. Trump’s administration has been active in defining sex strictly as male or female through executive orders and has sought to end federal funding for gender-affirming care for minors. Another executive order directs the Justice Department to prioritize investigations into misleading information about the long-term effects of such treatments.
Gender-affirming care includes various medical and psychological services to support an individual’s gender identity, differing from their birth-assigned sex. This care can involve counseling, puberty blockers, hormone therapy, and, though rare for minors, surgeries.
Leading medical organizations emphasize the importance of such treatments for individuals with gender dysphoria and recognize gender as a spectrum. However, the 9th Circuit majority acknowledged the ongoing scientific debate around gender-affirming care and noted the Trump administration’s potential justification for its stance based on ethical or philosophical grounds.
