In our July 11, 2025 blog post, we flagged the Department of Justice’s sweeping subpoenas targeting providers of gender-affirming care for minors as legally aggressive, politically charged, and likely to face serious judicial scrutiny. That prediction has now been borne out.
Federal courts in Massachusetts and Washington have quashed DOJ subpoenas issued to Boston Children’s Hospital and QueerDoc, respectively, finding that the government failed to demonstrate a proper investigative purpose and appeared motivated by political aims rather than legitimate enforcement concerns.
What We Got Right
- The subpoenas were overbroad and vulnerable to challenge. Both courts found the document requests—ranging from patient medical records to staff personnel files—far exceeded what was necessary for any legitimate fraud investigation.
- DOJ’s legal theory was untested and expansive. We noted that DOJ’s reliance on the FDCA and FCA to investigate off-label prescribing and billing practices was novel. Courts agreed, rejecting DOJ’s attempt to criminalize routine medical care and provider-patient communications.
- Political intent matters. Our concern that the subpoenas were part of a broader campaign to end gender-affirming care was confirmed by judicial findings that the subpoenas were issued in bad faith, with the true purpose of intimidating providers and deterring care.
What We’ve Learned
- States are willing to band together. In a powerful show of solidarity, 20 states filed an amicus brief opposing DOJ’s motion to amend the Massachusetts ruling. Their argument: DOJ’s interpretation of the FDCA threatens to criminalize standard medical practice and intrudes on states’ sovereign authority to regulate healthcare.
- Courts are not rubber-stamping federal subpoenas. Both rulings emphasized the need for judicial review of administrative subpoenas, especially when they implicate constitutional rights and state law protections.
- The legal fight is far from over. DOJ has not yet appealed, but its broader enforcement strategy remains in play. More subpoenas may follow, and more challenges are likely.
What to Expect
- Continued litigation. Providers in other jurisdictions may challenge similar subpoenas, especially in states with explicit protections for gender-affirming care.
- Potential appeals. DOJ may seek appellate review to preserve its enforcement authority under § 3486 and the FDCA.
- Legislative and regulatory responses. The controversy may prompt congressional oversight or efforts to clarify the limits of administrative subpoena power.
- Expanded state coordination. The multi-state amicus brief signals a growing coalition prepared to defend gender-affirming care as a matter of public health, civil rights, and state sovereignty.
Strategic Takeaways
- Challenge early and strategically. Courts are willing to scrutinize DOJ’s motives and legal theories. Providers should not assume compliance is mandatory.
- Know your state protections. Massachusetts and other states have codified rights to gender-affirming care. These laws matter in federal subpoena disputes.
- Prepare for public scrutiny. Courts are unlikely to seal these cases. Institutions should be ready to defend their practices publicly and legally.
- Coordinate legal strategy. Multi-state collaboration and amicus support can be powerful tools in resisting politicized enforcement.
Conclusion
The early rulings validate many of the concerns we raised in July and underscore the importance of judicial oversight in politically sensitive investigations. As these cases proceed, courts, providers, and states will continue to navigate complex questions at the intersection of federal enforcement authority, medical ethics, and state sovereignty. The legal landscape remains dynamic—and worth watching closely.