In this blog series, we'll be breaking down some of the complex news, legal actions, and policies that are impacting LGBTQ+ folks. Each week we will breakdown one news story, legal action, or policy in clear, plain language without the clickbait, and give you tools to learn more or take action. This week, we are focusing on the recent Department of Justice (DOJ) legal actions against two hospitals providing gender affirming care to transgender minors.
Big-picture summary: DOJ subpoenas hospitals in RI and NY
On May 1st, the U.S. Department of Justice (DOJ) filed legal action in the Northern District of Texas seeking records from Rhode Island Hospital for patients under 18 who received gender-affirming care between 2020 and 2026, with a North Texas judge granting the request within hours.
Main Points
At their core, the lawsuits are asking the court to force the hospitals to turn over records. Specifically, the DOJ wants access to:
Patient medical records (including identities)
Names of doctors and staff involved in care
Billing, coding, and insurance information
Details about how treatments were provided
The DOJ argues it needs this information to investigate possible violations of federal drug laws. The government is claiming that some medications used in gender-affirming care (like puberty blockers or hormones) are being used “off-label” (not specifically approved by the FDA for gender dysphoria).
The DOJ suggests providers might be violating federal law by:
“Misbranding” drugs
Possibly engaging in improper billing or fraud
The “Off-Label” Strategy
This reasoning is being used because:
March 2026 a federal judge ruled HHS overreached in a declaration aimed at cutting funding to hospitals providing gender-affirming care to minors.
This prevented the federal government from enforcing certain restrictions and punitive measures against providers of transgender healthcare.
So, the government needed a new strategy. Using the claim that providers are using treatments “off-label”, possibly engaging in improper billing or fraud, allows the DOJ to side-step the legal argument that they are acting with malice/ill intent toward the trans community.
BUT
Intentional Targeting
These lawsuits don’t ban care directly, but are a tactic to increase hostility and play on threats of legal action and fear.
If these legal actions are successful, they make it possible to:
Expand federal investigations into providers, and patients, nationwide
Put pressure on hospitals to stop offering gender-affirming care
Create fear around patient privacy, and expanding federal investigations into providers nationwide.
Final Points
These legal actions are concerning and a real threat because they target patient records directly.
The DOJ explicitly says patient identities could help find “investigative leads.”
Raise privacy concerns (HIPAA), especially for minors.
May result in providers stopping care out of fear.
The success of these legal actions is not certain. Courts have already rejected similar subpoenas, and there is pushback as the cases were filed in Texas, even though the hospitals are in RI and NY. This is known as forum shopping: choosing a court more likely to agree with them. More on this in Part 2.
What Can You Do?
If you are a trans person or the parent of a trans person:
Know your rights and stay connected to trusted LGBTQ+ legal organizations (Lambda Legal, ACLU, Transgender Law Center, TENT).
Consider discussing/reviewing your providers’ policies regarding your rights and how they respond to subpoenas.
Do your best to establish a support network, even if it is just 2 or 3 people.
Allies:
Follow the organizations listed above. Donate if you can.
Contact local LGBTQ+ orgs, ask what they need, then act on it.
Put pressure on politicians to stop the DOJ’s malicious targeting of trans folks.
Don’t just do these things once. Do them consistently.
Up Next in our Breaking Down the Headlines series, DOJ Subpoenas for Trans Care Records Part 2: Forum shopping and the DOJ Strategy, coming Thursday.
You can also read this blog series on our education and training program, DRIEP's website here.
