1st Circuit Court Dismisses Dispute Over Transgender Child Records

The Trump administration has achieved a significant legal victory as a federal appeals court ruled in favor of granting the government access to data regarding transgender children from a private hospital in Rhode Island.

Back in July 2025, the U.S. Department of Justice (DOJ) issued a subpoena to Rhode Island Hospital, known as the only Level I Trauma Center in the state and the primary teaching facility for Brown University’s medical school.

This subpoena originally demanded that the hospital provide the DOJ with sensitive medical records, including detailed personal and health information of children who had received gender-affirming care, as stated by the 1st U.S. Circuit Court of Appeals.

As discussions continued, deadlines passed while both parties deliberated on the specifics of how the hospital would fulfill this request.

On April 30, the DOJ took further steps to enforce the subpoena by submitting a 13-page petition in the Northern District of Texas.

In a press release announcing this legal maneuver, Brett A. Shumate, Assistant Attorney General for the Civil Division, emphasized, “The Department of Justice expects and demands full compliance with validly issued subpoenas like the one at issue here. Non-compliance with lawful process is never an option.”

Later that same day, Chief U.S. District Judge Reed O’Connor, a George W. Bush appointee, ruled in the government’s favor.

“The Court finds that the subpoena was issued within the Department of Justice’s statutory authority, the subpoena seeks documents reasonably relevant to the investigation, and the subpoena’s demands are reasonable,” the Lone Star State federal court said.

Earlier this month, the Child Advocate for the State of Rhode Island, a state office in charge of protecting the rights of children under state care, moved to quash the subpoena in a Rhode Island district court.

“The sweeping Subpoena seeks an extraordinarily broad set of sensitive medical records—including the identities, diagnoses, clinical assessments, and intimate personal details—of minor patients who received gender-affirming medical care,” the 47-page motion to quash argues. “This unprecedented intrusion into the private medical information of children, many of whom are among the most vulnerable in our state’s care, cannot be justified by any legitimate law enforcement purpose.”

The motion to quash also suggests the DOJ was wrong to try to enforce the subpoena in Texas — without explicitly making the argument. The motion does, however, complain about the DOJ conducting such efforts ex parte and “without any filed opposition.”

“The Child Advocate was not a party to, and had no notice of, the Texas proceeding, and has had no opportunity to be heard on the Subpoena in any court,” the motion to quash goes on.

Days later, the DOJ contested the motion to quash and also moved to transfer venue on the basis of having filed in Texas first.

In turn, U.S. District Judge Mary S. McElroy, who was appointed by President Donald Trump during his first term, denied the transfer motion by citing the ex parte nature of the Texas case and by noting that different “constitutional privacy rights” were at stake since the Child Advocate represents patients instead of the hospital itself. The Ocean State judge also quashed the subpoena.

“The district court found that the Subpoena lacked a congressionally-authorized purpose, was issued for an improper purpose, and violated the Fourteenth Amendment privacy rights of the Hospital’s child patients,” the U.S. Court of Appeals for the 1st Circuit summarized. “The Rhode Island Order quashed the Subpoena and enjoined the DOJ from seeking or receiving patient-identifying information or protected health information responsive to the Subpoena.”

In each case — in each state — the relevant parties appealed.

What on the surface appears to be a complex legal battle between various judicial systems, judges, defendants, and the government, was given short shrift by the Boston-based appellate court.

In a three-page opinion, the three-judge panel ruled against the advocate — declining to issue an injunction pending appeal “that would order the Hospital not to turn responsive records over to anyone.”

A long sentence in the terse opinion notes the myriad issues at play:

In deciding that request, we set aside a host of procedural problems, such as whether the Child Advocate may obtain an injunction against the Hospital that would subject the Hospital to mutually irreconcilable orders issued by courts in two different federal circuits, whether the injunction the Child Advocate now requests would be an impermissible collateral attack on the May Texas Order, or whether the Child Advocate may obtain such an order — against a nonparty it has not sued — by application to this court without first seeking relief in the district court.

But, as the panel says, all of those issues are being shelved in order to determine whether, at this stage, the advocate was able to show that enforcing the subpoena would result in “irreparable harm.”

And, at this stage, the court says the government’s request is relatively harmless due to the nature of what, exactly, will be provided – and due to the safeguards provided by the court system itself.

“In its order, the Northern District of Texas assured the parties that the documents would be held ‘in camera pending the outcome of the appeals’ and would be provided to the DOJ only ‘should the courts of appeals rule against [the Hospital],’” the ruling notes.

Notably, the judges say the produced documents are not subject to review by “an adverse party” — at least not anytime soon.

“The Child Advocate cites no authority for the proposition that providing anonymized records to a court — particularly one that has assured the parties that the records will not be disseminated unless and until the parties’ appeals are resolved — could constitute irreparable harm,” the order concludes.