On a sweltering August day in Philadelphia, the Children’s Hospital of Philadelphia (CHOP) found itself at the epicenter of a legal and ethical storm that’s reverberating nationwide. The Justice Department, under President Donald Trump and Attorney General Pam Bondi, has launched an unprecedented investigation into gender-affirming medical care for minors—a probe that’s sweeping up hospitals, doctors, and, most controversially, the private medical details of hundreds of young patients.
According to The Washington Blade and The Washington Post, the Justice Department issued sweeping subpoenas to at least 20 hospitals and clinics, including CHOP, demanding a trove of sensitive information about transgender patients under 19. The requests, which surfaced publicly in late August 2025, cover records dating back to January 2020—well before many states imposed bans on gender-affirming care. The DOJ sought not only billing records and communications with drugmakers, but also patients’ names, birth dates, Social Security numbers, addresses, emails, Zoom recordings, voicemails, text messages, and essentially “every writing or record of whatever type” providers had generated.
The breadth of the information demanded is, by all accounts, unparalleled. Legal experts told The Washington Post that such a sweeping request for personally identifying data—especially for a group as uniquely vulnerable as transgender youth—is virtually unheard of in federal law enforcement. Jacob T. Elberg, a law professor and former federal prosecutor, noted that federal privacy laws require the DOJ to prove a legitimate law enforcement purpose for collecting such sensitive data.
CHOP, which runs one of the country’s largest programs for transgender and gender-nonbinary youth, was given just one month to comply with the DOJ’s June 11, 2025, subpoena. Instead, on July 8, the hospital took an extraordinary step: it asked a federal judge to intervene, seeking to protect its patients’ privacy and limit the scope of the government’s request. In its legal filings, CHOP argued that releasing the information would “reveal the most intimate, sensitive, and often painful details of their young lives,” and accused the DOJ of unfairly targeting a group that already faces discrimination and harassment.
“Patients of the program harbor substantial fears that they are being surveilled or targeted for exposure by opponents of the treatment,” wrote Linda Hawkins, a licensed professional counselor, and Dr. Nadia Dowshen, medical director of CHOP’s Gender and Sexuality Development Program, in a joint declaration to the court. “This fear will deter them from participating in the activities that are hallmarks of a happy childhood — schools, clubs and other extracurricular activities — out of concern that they will be singled out for being transgender.” They warned that the stress could result in “thoughts of, or completed, suicide.”
The DOJ, however, dismissed these concerns as “wholly speculative” and “meritless.” In its August 4 response, government lawyers insisted that the investigation was focused on potential healthcare fraud, misconduct, and the unlawful promotion or dispensing of puberty blockers and cross-sex hormones for minors. The DOJ cited its authority under statutes prohibiting female genital mutilation and the Food, Drug, and Cosmetic Act’s ban on “misbranding” to justify its probe. “The investigation relates to potential misconduct committed against vulnerable children, leaving lifelong mental and physical side effects and consequences,” DOJ lawyers wrote.
At the heart of the dispute is the tension between patient privacy and the government’s obligation to investigate potential wrongdoing. The DOJ’s requests also included documents about how doctors decide to prescribe puberty blockers and hormone therapy, details about informed consent and parent or guardian authorization, and any disclosures about off-label use or potential risks. While off-label prescribing is legal and common, the DOJ is probing whether pharmaceutical companies illegally promoted such uses, or whether providers misrepresented the effectiveness of these treatments or billed insurance improperly.
CHOP’s legal team argued that the government had “no facts” suggesting any consumer-protection violations or misconduct at the hospital. Joseph St. Geme III, chair of CHOP’s Department of Pediatrics, warned in court filings that granting the DOJ such broad access would set a dangerous precedent, making patients reluctant to disclose sensitive information and making it harder for doctors to provide effective care. “When patients come to CHOP, they do not expect federal prosecutors and investigators to have ‘unfettered access’ to their medical records,” he said.
Meanwhile, the wider political and legal context has grown only more charged. About half of U.S. states have passed restrictions on gender-affirming care for minors, and in the summer of 2025, the U.S. Supreme Court ruled those bans constitutional in U.S. v. Skrmetti. The Trump administration’s January 2025 executive order barred federal funding for gender-affirming care for patients under 19, further escalating the stakes for hospitals like CHOP. In the Philadelphia area, other providers such as Penn Medicine and Nemours Children’s Hospital have already begun limiting such care, wary of legal and financial repercussions.
In court, CHOP sought not only to limit the subpoena but also to seal it from public view, arguing that the mere knowledge of the federal investigation would stoke fear and panic among patients and staff, potentially putting them at risk of threats or violence. U.S. District Judge Mark Kearney, however, denied the hospital’s motion to seal the proceedings. On August 20, 2025, he ordered the DOJ to provide more information within two weeks about the scope of its investigation and whether other healthcare providers had challenged similar subpoenas. The judge also asked for an update by September 24 on the status of the DOJ’s other subpoenas to hospitals and clinics nationwide.
As the legal battle continues, the stakes remain high for all sides. For the DOJ and the Trump administration, the investigation is framed as a necessary measure to protect children from what they describe as unproven and potentially harmful treatments. Critics of gender-affirming care argue that the research supporting these interventions is inadequate and that minors lack the maturity to make such profound decisions. On the other hand, major medical organizations, including the American Academy of Pediatrics, contend that gender-affirming care is medically appropriate and supported by evidence, helping to reduce the higher rates of suicide, depression, and anxiety experienced by transgender youth.
For families and clinicians at CHOP and similar institutions, the fear is palpable. The possibility that the federal government could gain access to their most private information has sent ripples of anxiety through a community already under siege. As Dr. Dowshen and Hawkins put it, “It would be extremely distressing for patients to worry that federal prosecutors may seek to interview them about their care at CHOP. They would worry for their providers and their parents, too.”
As Judge Kearney’s deadline approaches, all eyes are on Philadelphia—and on the broader question of how far the government can go in its quest to regulate controversial medical care. The outcome of this case will likely set a precedent that resonates far beyond the walls of CHOP, shaping the future of medical privacy, transgender healthcare, and the boundaries of federal power in the United States.
