A federal judge in Philadelphia became the fourth in the nation last month to rule against the Trump administration by blocking its demand for the identities and medical records of transgender children being treated at one the nation’s preeminent pediatric hospitals.
Transgender health advocates and an attorney in the Children’s Hospital of Philadelphia case said the favorable decision is encouraging for the patients and the broader transgender community. But it’s only one battle won against the Trump administration’s campaign against transgender health care.
And, they warn, the administration’s tactics could be applied to other types of politically-charged areas of health care, such as reproductive care.
“The records the Department of Justice are seeking here are the most sensitive types of medical records,” said Mimi McKenzie, legal director of the Public Interest Law Center in Philadelphia, which represented the families along with lawyers from the firm Ballard Spahr.
“That coupled with the fact this administration has made no secret of its agenda against transgender youth means that this is a really important win for the families,” McKenzie said.
The Children’s Hospital of Philadelphia (CHOP) sued to quash a subpoena from the U.S. Department of Justice in June, that purported to seek the information for an investigation of off-label uses of medications such as puberty blockers that are commonly used in medical care for transgender people.
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It was one of more than 20 similar demands made to hospitals across the country, including the University of Pittsburgh Medical Center Children’s Hospital (UPMC).
“Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice,” U.S. Attorney General Pam Bondi said in a statement announcing the subpoenas.
But the administration is in a position to keep pushing the issue until it gets a favorable ruling, said Michael Ulrich, associate professor at Boston University’s School of Public Health and School of Law.
“All you need is one district court that says it’s fine, or one circuit court, and you can appeal it all the way up to the Supreme Court,” Ulrich said. “If anything, this administration has shown it believes the higher it goes, the more likely it is to win.”
The DOJ declined a request for comment. CHOP also did not respond to a request for comment.
The department has filed an appeal of a September ruling by U.S. District Judge Myong J. Joun in Boston, which was the first to block a DOJ subpoena for patient information and medical records from Boston Children’s Hospital’s gender affirming care program.
It is also appealing a Seattle federal judge’s decision to quash a subpoena issued to QueerDoc, a Washington-based medical clinic that provides gender-affirming health care to adult and adolescent patients.
What this does is entrench from the highest levels that you are different, you are strange, you are not good enough as you are.Michael Ulrich, associate professor at Boston University’s School of Public Health and School of Law
U.S. District Judge Mark A. Kearney, who handled the CHOP ruling, referred in his opinion to a fourth subpoena case filed “completely under seal” in which a federal judge ruled against the DOJ.
That means the indirect effects of the administration’s demands on transgender health care could quietly continue to erode access and cause transgender people to hesitate in seeking appropriate care.
“There’s certainly a strategy behind this in terms of providers constantly having to deal with and worry about it, and they eventually say … it’s not worth dealing with anything close to this because of the target it puts on us,” Ulrich said.
It could have dire consequences for the transgender population, Ulrich said, which experiences mental health issues such as suicidal ideation, self-harm, and substance abuse at significantly higher rates than cisgender people, according to the Williams Institute at the University of California – Los Angeles.
“What this does is entrench from the highest levels that you are different, you are strange, you are not good enough as you are,” Ulrich said, which has the potential to exacerbate mental health problems already fueled by the sense of being ostracized many transgender people experience.
While CHOP did not oppose the DOJ’s request for many of the 15 categories of records the DOJ sought, it told the department it would not compromise the privacy of its patients by providing their confidential health information.
Joined by parents of transgender children treated at the hospital, CHOP argued the DOJ lacked authority to compel the release of the contested records and that the children’s privacy interests outweighed the government’s need for the records.
Kearney agreed, ruling in favor of the hospital and patients.
In the Nov. 21 decision, Kearney found the DOJ did not show the individual records of gender affirming care patients were relevant to its investigation and therefore lacked authority to demand them.
Even if the information was relevant to the investigation the DOJ described, “the children’s and their families’ privacy interests in their highly sensitive and confidential medical and psychological treatment in a charged political environment, which considers their medical treatment to [be] a radicalized warped ideology, far outweigh the Department of Justice’s shifting need for the information,” Kearney wrote.
Fights against the DOJ subpoenas are going on across the country
In federal court in Pittsburgh, the Public Interest Law Center and Ballard Spahr are also representing four families trying to bar the DOJ’s access to their children’s records held by UPMC. The hospital itself has not challenged the subpoena, but disclosed in a filing last month that it has not disclosed to the government any of the challenged records.
The families of 10 transgender children in Maryland last month challenged a subpoena issued for Children’s National Hospital. And in California, six families filed a proposed class action lawsuit to quash a demand for minor patients’ records from the Children’s Hospital of Los Angeles.
Corinne Goodwin, of the Eastern PA Trans Equity Project, noted the DOJ focus on transgender health care for minors has already reduced access. Penn State Hershey Medical Center and Jefferson Health are among Pennsylvania hospitals that have suspended care for transgender youth.
The Trump administration’s proposed rule that would block Medicare and Medicaid reimbursements for any services provided at hospitals that also provide pediatric gender affirming care would have an even greater chilling effect, Goodwin said.
Jennifer Levi, senior director of transgender and queer rights at GLAD Law, which provides legal advocacy for the LGBTQ+ community, said the Trump administration’s attack on the transgender community reaches far beyond health care. She cited the elimination of the non-gender sex marker “X” in U.S. passports, as one example of the broader onslaught against trans-rights.
As a result, families who are caught in the middle of the medical records fight are also unable to obtain or update passports to travel to continue their care abroad.
Levi said the mounting attacks and growing uncertainty make this “a really scary time and vulnerable time for parents with adolescent transgender children.”
“This is a moment when these kinds of attacks by the administration cause so many problems for families, for young adults,” she said. “And that’s why it’s so important for the courts to step up in their traditional roles to protect this community.”
Originally published by our partners at Penn Capital-Star on December 8, 2025.