Rhode Island Hospital has begun releasing records related to treating children with gender-affirming care to a federal court in Texas, in response to a legal order for documents.
Records will be “anonymized and de-identified,” according to a Tuesday court filing, and will be held securely by the Texas court pending further legal decisions.
“No production to the court – not yesterday’s and none in the future – will include patient identifying information,” a Brown University Health spokesperson said on Wednesday. (Rhode Island Hospital is part of the Brown University Health system.) “Our actions are focused on ensuring we meet our legal obligations while safeguarding the confidential information entrusted to us.”
The Department of Justice had originally subpoenaed the medical records, including the identities and treatment information of children who received care at Rhode Island Hospital, in 2025 as part of a nationwide investigation into gender-affirming care. In April, a federal court in Texas ordered that Rhode Island Hospital comply with the subpoena for records by May 14.
Rhode Island legal groups mobilized against the order, and last week, a federal court in Rhode Island voided the DOJ’s subpoena. The DOJ appealed the Rhode Island decision to the First Circuit Court of Appeals in Boston.
Then, on Monday, in an unusual legal move, the Texas court circumvented the Rhode Island judge’s decision, ordering that Rhode Island Hospital must send records to the court itself.
The Child Advocate of Rhode Island, an attorney charged with representing children in the state’s care, looked to stop the order for records by filing an emergency motion with the appellate court in Boston. The DOJ responded in a filing saying it would dial back its contested subpoena and no longer seek patient-identifying information.
On Tuesday evening, the Boston appellate court denied the Child Advocate’s motion. In its decision, the Boston appellate court said responding to the Texas Court’s order for documents would not constitute “irreparable injury,” since the health records would be anonymized, and that the Texas Court pledged that documents would not be shared with the DOJ unless directed by a higher court.
“While we are disappointed in this result, this decision is not the end of our fight to protect Rhode Island children’s medical privacy. We know that even if the DOJ is not receiving these records now, the uncertainty generated by this ongoing legal battle has been harmful,” The Child Advocate said in a statement. “We will do everything in our power to protect the privacy, dignity, and constitutional rights of the children in our state.”
An ongoing dispute
Tuesday’s decision is the latest development in an ongoing dispute over health care for transgender youth.
The DOJ said it is seeking the records as part of a nationwide investigation into how gender-affirming care – like prescriptions for puberty blockers or hormones – could be violating the Federal Food, Drug, and Cosmetic Act, according to court records. The DOJ has issued more than 20 similar subpoenas across the country.
Legal opponents in Rhode Island say the subpoena for records at Rhode Island Hospital aims to harass families and discourage hospitals from providing gender-affirming care.
“DOJ issued the Subpoena as part of a coordinated campaign by the Trump Administration to eliminate access to medical care for gender dysphoria – lifesaving care that is recognized as medically necessary by every major medical association – even where it is expressly protected by state law, as it is in Rhode Island,” said Rhode Island’s Child Advocate, in a motion filed earlier this month.
What’s in the records
The DOJ originally requested information, including patient identities, their clinical records, billing codes and insurance claims from Rhode Island Hospital dating back to 2020.
“Without this information, the Government cannot 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 DOJ wrote in an April petition to the U.S. District Court for the Northern District of Texas.
Legal groups in Rhode Island said the order would violate children’s privacy rights.
“The records at issue include the most intimate details of vulnerable children’s lives, including their identities, diagnoses, gender identity, mental-health history, family circumstances, foster-care information, parent or guardian information, clinical assessments, consent records, and treatment histories,” Rhode Island’s Child Advocate wrote in a motion opposing the order.
Since then, the DOJ has said in a Rhode Island hearing, and in a filing with the First Circuit Court of Appeals, that it would accept anonymized records and no longer seek patient-identifying information.
What’s next
Rhode Island Hospital said that it will take months to fully comply with the Texas Court’s request for records. In Tuesday’s filing, the hospital said that it would share some “non-privileged” information with the court by its deadline, and would send another cache of documents, plus a schedule for future releases, by Friday, May 29.
Meanwhile, the legal dispute over whether the Rhode Island Hospital must ultimately share medical records with the DOJ – and what information that includes – is ongoing. Cases are being considered in the First and Fifth Circuits, appellate courts in Boston and New Orleans.
