Appeals Court Sides With DOJ in Fight Over Trans Youth Medical Records
A divided Ninth Circuit panel ruled the Trump administration can enforce a subpoena for a telehealth provider's patient records, rejecting a lower court's finding that the investigation was launched in bad faith.
A federal appeals court has revived a Department of Justice subpoena demanding the patient records of QueerDoc, a telehealth clinic that provides gender-affirming care, in the first appellate win for the Trump administration’s yearlong campaign of investigative demands against providers who treat transgender minors.
In a 2-1 ruling issued August 14, a Ninth Circuit panel found that a district court judge was wrong to block the subpoena on the grounds that the DOJ’s investigation had an “improper purpose.” The case now returns to the lower court, where QueerDoc can still argue that the subpoena itself is overbroad.
How the case got here
Days after his second inauguration, President Trump signed an executive order declaring it federal policy to “rigorously enforce all laws” against gender-affirming medical care for minors. Then-Attorney General Pam Bondi directed prosecutors to investigate providers and drug manufacturers, and in July 2025 the Justice Department sent more than 20 subpoenas to clinics and doctors involved in prescribing puberty blockers or hormone therapy to trans youth.
QueerDoc, an online clinic that treats patients — including minors — for gender dysphoria, was one of them. The subpoena sought a sweeping set of records, including files on every patient the clinic had prescribed puberty blockers or hormone therapy. QueerDoc sued, arguing the government’s real goal wasn’t investigating fraud but pressuring providers to simply stop offering the care at all.
U.S. District Judge Jamal Whitehead agreed and quashed the subpoena last year, finding the Justice Department had used its investigative powers to advance the administration’s stated policy goal rather than to pursue a genuine violation of law.
What the Ninth Circuit decided
The appeals panel reversed that finding. Writing for the majority, Circuit Judge Carlos Bea — a 92-year-old George W. Bush appointee, joined by Trump appointee Daniel Bress — held that wanting to end gender-affirming care is a legitimate policy position for the executive branch to hold, not evidence of bad faith.
“The goal of ending ‘gender-affirming care’ is not in and of itself an ‘improper’ policy objective,” Bea wrote, adding that the “efficacy and long-term risks” of the treatments are “uncertain” and citing potential effects on “bone density, brain development and fertility” — language that waded directly into the clinical debate the case was ostensibly not about. Bea also wrote that the lower court had improperly “intruded” on the president’s constitutional authority to direct law enforcement priorities.
The panel left QueerDoc one narrower path forward: it can still ask the district court to limit the subpoena’s scope on patient-privacy grounds, and Bea suggested protective orders could be used to shield records from broader disclosure.
Circuit Judge Richard Paez, a Clinton appointee, dissented sharply. “There is a mountain of evidence that corroborates that DOJ used the threat of criminal investigation to pressure health care providers to stop offering gender-affirming care,” he wrote. “The law does not permit the DOJ to initiate sham investigations — even if the President says to do so.”
Reactions and what comes next
Assistant Attorney General Brett Shumate framed the ruling as vindication, writing on X that it confirms the DOJ “can investigate whether hospitals that provide cross-sex hormones and puberty blockers to children have complied with federal law because the trans medical industry is not above the law.”
The ACLU of Washington, which is representing QueerDoc, struck a different note. “Today’s decision sends this case back to the district court, and we’re ready to continue defending one of the most fundamental principles of healthcare: every patient’s right to confidential medical care,” staff attorney Adrien Leavitt said.
The ruling doesn’t end the case — it sends it back to Judge Whitehead to weigh QueerDoc’s remaining arguments about the subpoena’s breadth and patient privacy. But as the first federal appeals court to back one of the DOJ’s roughly 20 subpoenas against gender-affirming care providers, it’s a meaningful marker for where similar cases working through other circuits may be headed, and a signal to providers that the courts may not treat the administration’s broader campaign against trans health care as, on its own, evidence of an unlawful motive.
