Justice Department Expands Gender Care Probe as Hospital Fights

Justice Department political leaders are probing gender-affirming care services at one of the nation’s largest, most renowned pediatric hospitals, as new details show an aggressive strategy to advance a White House priority targeting the procedures.

Part of a Trump administration initiative to bring criminal and civil cases against medical providers treating transgender youth, DOJ subpoenaed Children’s Hospital of Philadelphia for 15 categories of information on gender-related care, including names, addresses, and Social Security numbers of patients that received treatment.

The administrative subpoena, included in a recently unsealed court filing, demanded records on parents, physicians who provided the treatments, billers, insurers, and the pharmaceutical manufacturers whose drugs were prescribed.

Several of the requests, notably the names and details of patients, drew privacy concerns from the hospital over the sensitive nature of the information. The hospital’s attorneys asked a judge to narrow what they called DOJ’s “uniquely invasive demand for documents from a uniquely vulnerable population.”

The hospital’s effort to protect patient privacy prompted the department to take the highly unusual step of urging the court to grant public access to the litigation. The judge agreed, ordering the docket unsealed on Aug. 4.

DOJ argued the public’s right to learn about these judicial records far outweighs the hospital’s “wholly speculative and vague fears” of children being outed as transgender.

The subpoena represents a dramatic escalation in the administration’s effort to restrict gender-affirming care for minors after President Donald Trump quickly took executive action targeting the practice.

The push to unseal the Philadelphia hospital’s litigation comes after Attorney General Pam Bondi’s rare July announcement that DOJ issued more than 20 subpoenas to doctors and clinics who’ve “mutilated children in the service of a warped ideology.” It fuels criticism from attorneys that the project is more about making a public display to scare hospitals into shuttering gender care programs than building legally justifiable cases.

Four former department lawyers experienced with investigating health-care providers through the same method—a subpoena issued under the Health Insurance Portability and Accountability Act—called it unheard of for DOJ to seek transparency in this scenario. Government attorneys would normally advocate for the opposite approach at an early stage: to keep the investigation covert, they said.

“Federal investigators often favor sealing proceedings when a sensitive investigation is in the initial fact-gathering stages, to preserve the integrity of that investigation,” said Arun Rao, a partner at Mayer Brown and a former deputy assistant attorney general who during the Biden administration oversaw the branch that’s now investigating transgender care.

Likewise, a former US Department of Health and Human Services official said it was unusual and excessive for the DOJ to seek information about every employee involved in the delivery of a type of care.

The DOJ and the hospital didn’t reply to a request for comment.

Subpoena Strategy

Brett Shumate, the head of DOJ’s civil division, signed the subpoena within a few hours of being sworn into office June 11, the court document shows.

Traditionally, the career official directing the consumer protection branch would’ve signed the subpoena. But there’s a vacancy atop the branch after the former director, Amanda Liskamm, departed in May under the Trump administration’s deferred resignation program.

Shortly before she left, Liskamm declined to sign the subpoena, along with multiple others directed at children’s hospitals, said two people familiar with the deliberations.

Liskamm raised serious concerns about collecting children’s health data and whether it was necessary to advance the investigation, said the two people, who were granted anonymity out of fear of reprisal.

A DOJ veteran known for prosecuting cartel leader Joaquin “El Chapo” Guzman, Liskamm and her top deputy, who resigned the same day, also expressed earlier concerns about the initiative to department political leaders. Before the subpoenas were drafted, they told Shumate that investigating providers and doctors for prescribing gender services like puberty blockers would be unlikely to lead to a successful criminal prosecution, said the people.

The branch leaders argued it’s not illegal under the Federal Food, Drug, and Cosmetic Act for physicians to prescribe puberty blockers and related treatment for children who wish to undergo a transition.

Already leading the division before his June Senate confirmation, Shumate wasn’t convinced. He pushed the career lawyers to take a forward-leaning approach, the sources said.

Shumate and Jordan Campbell, his deputy overseeing consumer protection, are listed as points of contact in the filings.

Campbell, who arrived at DOJ in June, is co-founder of the “first and only firm dedicated to exclusively representing detransitioners and victims of radical gender ideology,” his department biography states.

Administration’s Actions

Executive action from Trump directed agencies to move to prohibit medical institutions from providing gender-affirming care.

Bondi issued a memo in April directing US attorneys to investigate suspected cases of gender-affirming care and prosecute “to the fullest extent possible.”

Shumate quickly followed, directing DOJ civil division employees “to prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities” for allegedly helping to provide gender-affirming care.

A coalition of states and Pennsylvania Gov. Josh Shapiro (D) sued the Trump administration over its attack on gender-affirming care for minors, urging a federal judge to declare unlawful the executive action’s directives to the DOJ.

Meanwhile, the Federal Trade Commission began its own look into whether practices of gender-affirming care for minors are deceptive trade practices, issuing a request for public comment in July.

Also this year, an HHS review found “very weak evidence of benefit” of medical interventions for children with gender dysphoria, in a report that was rebutted by medical professionals and advocates.

Children’s Hospital of Philadelphia now awaits a decision from US District Court Judge Mark Kearney on limiting the subpoena.

“DOJ cannot (and should not) use an administrative subpoena to compile a list of patients who wish to maintain anonymity, and then mine their medical records to facilitate an even more intrusive probe into the intimate details of their lives,” the hospital’s attorneys told the judge.

The case is In Re: Subpoena No. 25-1431-014, E.D. Pa., No. 2:25-mc-00039, motion to limit subpoena 7/8/25.