Rhode Island’s child welfare watchdog agency asked a federal judge on Monday to stop the U.S. Department of Justice from using a subpoena enforced by a Texas court to procure the medical records of minors treated for gender dysphoria at Rhode Island Hospital
The 47-page motion to quash — which would void the subpoena if granted — was filed Monday in U.S. District Court for the District of Rhode Island by the Office of the Child Advocate, an independent watchdog agency which looks out for the rights of children in care or custody of the state Department of Children, Youth and Families (DCYF).
“The medical records of these children contain private information that is protected under the law which exists to safeguard confidentiality, privacy, and the dignity of every patient. When those protections are disregarded — especially for children — it is not merely a violation of the law but a breach of trust that could have profound lifelong consequences,” Child Advocate Katelyn Medeiros said in a statement Monday.
Medeiros’ office has, in the motion’s words, “a statutory duty to protect these children’s rights, including their constitutional right to privacy in their medical records and their right to access lawful medical treatment without federal government interference or intimidation.”
According to Monday’s filing, the administrative subpoena served by the DOJ on Rhode Island Hospital in July 2025 directly interferes with those rights. The subpoena — which a federal judge in Texas ordered the hospital to comply with on April 30 — demands “an extraordinarily broad range of sensitive information.”
The Justice Department asked for “the identities and complete medical histories of every minor patient who received medical care for gender dysphoria at RI Hospital over more than five years,” according to the court filing.
“The medical records responsive to these requests contain the most intimate details imaginable: children’s mental health struggles, experiences with bullying or discrimination, family dynamics, sexual development, gender identity, trauma histories, suicidal ideation, and deeply personal conversations with physicians and therapists,” the motion reads, adding that records of children in the care of DCYF may also contain information on histories of abuse, neglect, or foster placements.
The motion does not provide an estimate of how many DCYF youths would be affected by this request, but it does explicate clearly the harm it imagines might come to these children should the records be relinquished.
“In other words, for a population of children that already lacks trust in the legal and medical systems, DOJ now seeks unfettered access to everything from their Social Security numbers and addresses to the intimate details about their state of mind, their sexual orientation and gender identity, and the course of treatment they chose with their physician and custodians,” the motion reads.
An unsigned statement issued Monday by a spokesperson for Brown University Health, the health system to which Rhode Island Hospital belongs, said: “We recently became aware of the motion filed by the Department of Justice and are currently reviewing it carefully with counsel. We are not in a position to provide further comment at this time.”
The medical records of these children contain private information that is protected under the law which exists to safeguard confidentiality, privacy, and the dignity of every patient. When those protections are disregarded — especially for children — it is not merely a violation of the law but a breach of trust that could have profound lifelong consequences.
The DOJ did not immediately reply to a request for comment Monday, but its stance is articulated in its petition to enforce the subpoena, filed on April 30 in U.S. District Court for the Northern District of Texas. The hospital received 15 document requests, the DOJ wrote, but at the end of April it had “produced only one six-page document in response,” according to the filing.
The DOJ alleges that the records are germane to an investigation of possible violations of the Federal Food, Drug, and Cosmetic Act, specifically in the context of puberty blockers and sex hormone therapy. Puberty blockers delay or pause the body’s pubescent processes which define sex characteristics, while hormone therapy involves the use of agents like estrogen or testosterone to induce physical traits that align with a patient’s gender identity.
The FDA approved these drugs for select use, the DOJ argued, but “has not determined that any of these drugs are safe or effective for the treatment of gender dysphoria.”
The use of “public or private insurance plans” to fulfill “claims related to off-label use of puberty blockers and cross-sex hormones” could pitch the issue onto federal turf, if any off-label use of these medicines could be connected to misbranding, fraudulent billing or other willfully deceptive prescribing conduct — all possible federal health care offenses, in the DOJ’s view.
The DOJ wrote that it needs the records before it can “fully determine the scope of the violations, identify patterns of misbranding or fraudulent billing, or assess whether the conduct was undertaken with intent to defraud or mislead.”
The Child Advocate’s legal team — a mix of lawyers from the Lawyers’ Committee for Rhode Island, the ACLU of Rhode Island, and the Providence firm DeLuca, Weizenbaum, Barry & Revens Ltd. — argues that the DOJ’s subpoena is a bad faith pretext cloaked as a fraud investigation.
The subpoena “represents a barely disguised political agenda in search of a healthcare offense,” the motion argues, with the DOJ demanding first, justifying later.
“If DOJ were investigating off-label promotion by manufacturers, it would not need patient records at all,” the motion reads. “If it were investigating billing practices, anonymized records would suffice. There is no compelling explanation for why DOJ needs to know the names, addresses, and Social Security numbers of minor patients, or to read the intimate details of their mental health assessments.”
The motion also leans on Rhode Island’s healthcare provider shield law. The 2024 law was designed specifically to prevent litigation from afar and shield doctors against out-of-state investigations regarding transgender health care in the Ocean State.
What was the rush to enforce subpoena?
The feds elected for a circuitous route toward the data, and issued the subpoena via the DOJ’s Washington, D.C.-based Enforcement and Affirmative Litigation Branch. After nearly 10 months passed without a response from the hospital which the feds found satisfactory, the DOJ sent its petition to enforce to the U.S. District Court for the Northern District of Texas, where Chief District Judge Reed O’Connor approved the demand with haste.
The feds filed a petition to enforce the subpoena on April 30, and O’Connor approved it the same day — within “a few hours,” according to the Child Advocate’s motion.
O’Connor wrote that Rhode Island Hospital “has neither filed a motion to quash nor shown just cause for noncompliance,” and that “the subpoena’s demands are reasonable.” According to the order, the hospital had an original due date of Aug. 7, 2025, to comply with the subpoena.
Monday’s motion argues instead that Rhode Island’s federal courthouse “is unquestionably the proper venue in which the Child Advocate should bring this motion to quash,” and cites the case’s clear basis in Rhode Island as well as the federal statute which governs “administrative subpoenas in Federal health care investigations.” Per that law, records need not be produced “at any place more than 500 miles distant” from where the subpoena was served.
“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 reads.
Per O’Connor’s order, Rhode Island Hospital is supposed to comply within 14 days, or by May 13, which is why Rhode Island’s court must act soon, the Child Advocate’s motion argues.
“The Court is not writing on a blank slate,” the motion argues, before citing a lengthy list of precedents in which federal judges have quashed or delimited comparable subpoenas for transgender medicine.
The DOJ served more than 20 similar subpoenas on healthcare providers nationwide, according to the motion, and seven federal court decisions thus far have swatted down or narrowed those subpoenas.
One of those decisions came from over the state line in September 2025 when, in U.S. District Court for the District of Massachusetts, U.S. District Judge Myong J. Joun granted Boston Children’s Hospital’s motion to quash, thereby flattening the DOJ’s subpoena.
The Rhode Island case has been assigned to U.S. District Judge Mary S. McElroy, with a motion hearing set for May 12 over Zoom at 2:30 p.m.
This story was originally published by the Rhode Island Current.
