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Author: Wendy Ruderman

  • Federal judge hands CHOP victory in its fight to protect medical records of transgender children

    Federal judge hands CHOP victory in its fight to protect medical records of transgender children

    A federal judge in Philadelphia has blocked President Donald Trump’s administration from obtaining the private medical records of youth who sought gender-affirming care at Children’s Hospital of Philadelphia.

    The decision, issued Friday by U.S. District Court Judge Mark A. Kearney, was a victory for patients’ privacy rights and for CHOP, which had waged a legal battle to limit the scope of a sweeping federal subpoena that sought the names, dates of birth, Social Security numbers, addresses, and parent/guardian information of patients who had been prescribed puberty blockers or hormone therapy.

    In a 54-page opinion, Kearney found that the medical records sought by the U.S. Department of Justice were “beyond the authority granted by Congress” under the Food, Drug and Cosmetic Act, and that “the heightened privacy interests of children and their families substantially outweighs the Department’s need to know” such confidential and sensitive information.

    Neither CHOP nor the DOJ responded to a request for comment late Friday.

    In addition to protecting the identities of patients, Kearney also denied the part of the DOJ subpoena seeking documents related to how doctors make decisions in prescribing medications that help patients to have a body that matches their gender identity, including details such as “clinical indications, diagnoses, or assessments.” Kearney also blocked federal investigators from obtaining documents related to “informed consent, patient intake, and parent or guardian authorization for minor patients.”

    CHOP runs one of the nation’s largest clinics providing medical care and mental health support for transgender and gender-nonbinary children and teens and their families. Each year, hundreds of new families seek care at CHOP’s Gender and Sexuality Development Program, created in 2014.

    Along with CHOP, five parents of transgender children also filed a motion asking the federal court to intervene on their behalf. Kearney’s ruling rendered that motion moot since it sought similar legal relief as CHOP. The motion was filed by the Public Interest Law Center, a Philadelphia-based nonprofit that advocates for the civil, social, and economic rights of marginalized communities.

    Mimi McKenzie, the center’s legal director, said the judge’s ruling was “a complete rebuke” to the DOJ and an affirmation that the federal government has “no authority to root through” private medical records.

    “The court recognized that the Department of Justice is using its subpoena power not as a tool for legitimate inquiry, but as a tool for intrusion, and it’s not allowing that,“ McKenzie said late Friday. ”This is an important victory. Under this court’s ruling their privacy is protected, their medical records are not going to be turned over, and this court is just not going to condone this type of government overreach.”

    The CHOP case against the DOJ has become part of a broader legal battle playing out across the country. As part of an investigation into possible healthcare fraud or potential misconduct, the DOJ had issued subpoenas to CHOP and at least 19 other hospitals nationally that treat transgender youth. In September, a federal judge in Boston blocked the Trump administration’s attempt to subpoena medical records of patients who received gender-affirming care at Boston Children’s Hospital, ruling it was “motivated only by bad faith.” The DOJ has appealed the Boston ruling.

    The Trump administration has said doctors who prescribe to children and teens medications commonly used for gender-affirming care, such as puberty blockers and hormones, are engaging in chemical mutilation, likening it to child abuse. Teenagers are not mature enough to make such major decisions, the administration has argued.

    The American Academy of Pediatrics and other major medical associations, citing research, widely accept such use of these medications as safe, effective, and medically necessary for the patients’ mental health.

    In his ruling, Kearney said the DOJ subpoena was part of the Trump administration’s strategy to end gender-affirming care for minors. Kearney noted a “charged political environment” in which the federal government views “their medical treatment to [be] a radicalized warped ideology.” He concluded that the state and not the federal government has the authority to regulate medical care, and gender-affirming care for minors is legal in Pennsylvania.

  • CHOP lawyers defend transgender care in blistering response to Trump administration seeking patient information

    CHOP lawyers defend transgender care in blistering response to Trump administration seeking patient information

    The Children’s Hospital of Philadelphia called new evidence presented by President Donald Trump’s administration weak and untrustworthy in a blistering legal response to federal efforts to investigate its doctors providing gender-affirming care.

    CHOP’s response, filed late Monday in federal court in Philadelphia, came in defense of accusations by the U.S. Department of Justice that it’s investigating “fraudulent billing practices“ at the hospital. Federal officials say they’re looking into whether CHOP doctors were fudging or lying about diagnoses to get private and public health insurance companies to cover off-label drug prescriptions used to treat patients with gender dysphoria — a medical condition in which a person’s body does not match their gender identity.

    In its filing, CHOP lawyers called the DOJ’s allegations “unreliable,” and urged U.S. District Court Judge Mark A. Kearney to disregard claims that are “threadbare, of dubious origin, and so heavily qualified and caveated as to offer the court no meaningful information.”

    CHOP and the DOJ are locked in a legal battle over a sweeping federal subpoena sent to the hospital in June. The subpoena seeks patient names, Social Security numbers, addresses, diagnoses, and treatment notes, in addition to doctor emails and encrypted text messages.

    In July, CHOP filed a motion to limit the scope of the subpoena to protect patient privacy. Judge Kearney is now weighing CHOP’s motion.

    In the latest filing, CHOP’s lawyers argued the DOJ’s “new evidence” against the hospital was unfairly “shoehorned” into a separate but related case filed last month by a group of CHOP patients and their families who also want Kearney to block the release of private medical records to the DOJ.

    “That new evidence should not be considered because it is not before the Court in this case and is unreliable in any event,” CHOP lawyers wrote in the filing. “The government (still) cannot establish that its need for extraordinarily sensitive and personal patient information outweighs the highest-order privacy interests on the other side of the ledger.”

    The DOJ did not immediately respond Tuesday to a request for comment.

    Feds seek patient information from CHOP

    In April, U.S. Attorney General Pam Bondi issued a memo, entitled “Preventing the Mutilation of American Children,” in which she tasked the DOJ with enforcing measures targeting gender-affirming care for youth.

    About two months later, the DOJ sent subpoenas to CHOP and at least 19 other hospitals nationally that are under scrutiny for treating transgender youth. The subpoenas sparked legal opposition playing out in federal courts in Pennsylvania and across the nation.

    The DOJ’s key focus is how doctors are prescribing puberty blockers and hormones “off-label,” meaning for a condition not specifically approved by the U.S. Food and Drug Administration.

    Once a drug is approved by the FDA, it is legal for doctors to prescribe it to treat other conditions that could benefit from the medication. Off-label prescribing is a common and widely accepted medical practice, especially in pediatrics.

    Gender-affirming care for children and adolescents has been deemed medically appropriate by the American Academy of Pediatrics and other major medical and mental health organizations. Research shows young people with gender dysphoria suffer higher rates of suicide, self-harm, depression, and anxiety.

    Transgender kids’ lives are on the line as CHOP fights Trump over patient medical records, parents say

    CHOP’s Gender and Sexuality Development Program, created in 2014, is one of the nation’s largest such clinics and provides medical care and mental health support to hundreds of new families each year.

    CHOP’s legal fight for patient privacy

    Late last month, families and patients joined in CHOP’s fight against the federal subpoena by filing a separate motion to protect their privacy rights. That motion was filed on behalf of five parents with transgender children and one adult who received care at CHOP.

    In response to that case, the DOJ filed a “Declaration,” or sworn statement, from Lisa Hsiao, acting director of the DOJ’s Enforcement and Affirmative Litigation Branch, formerly known as the Consumer Protection Branch. In it, Hsiao said the government has new evidence “particular to CHOP that raises concern that federal healthcare offenses may be occurring there.”

    Hsiao said the government analyzed CHOP’s insurance claims and found that between 2017 and 2024, CHOP providers diagnosed 250 minors with central precocious puberty at age 10 or older, “including numerous teenagers aged 14 to 18.”

    “This is well beyond the age at which children are typically diagnosed with precocious puberty,” Hsiao stated. The government, she said, suspects doctors are improperly using the precocious puberty diagnosis to get insurance coverage for treatment of gender dysphoria.

    In Monday’s court filing, CHOP lawyers accused the DOJ of attempting to “shoehorn its new evidence into CHOP’s case” through the other case.

    CHOP also argued Hsiao’s declaration provides nothing to support its contentions surrounding precocious puberty diagnosis.

    “Moreover, the government fails to contextualize the findings of its rudimentary analysis, offering no comparator for the use of the code for precocious puberty at peer hospitals, let alone hospitals that, like CHOP, have providers who specialize in treating endocrine disorders,” CHOP lawyers wrote.

    The source of “the data set is entirely unknown,” CHOP’s lawyers noted, adding the declaration never says how many patients were treated for gender dysphoria during that time frame.

    The CHOP lawyers also criticized Hsiao for writing in her sworn declaration that the government was aware of a lawsuit filed against CHOP that alleges doctors hastily prescribed puberty blockers and hormones to a minor who later regretted it.

    Hsiao later refiled the declaration to remove any reference to a lawsuit after learning that it hadn’t been filed.

    CHOP lawyers wrote they believe the lawsuit reference came from a news article about a former CHOP patient. The article said the patient “was suing the hospital.” However, CHOP was unaware of any such lawsuit.

    “The similarities between the report and the allegations in the Hsiao Declaration — including the reference to a lawsuit — raise suspicions that, in looking to justify its investigative interest in CHOP, the government simply searched the internet for stories fitting its narrative and presented the one it found as fact without adequately scrutinizing its veracity.”