L, a transgender girl living in Rhode Island, loves taking her dog to the beach. But these days, there are other things on her mind.
“Every week there’s something new,” the teenager said. “One week, they try to ban care. Another week, you find out that they want to know your personal information.”
L’s medical records, and the records of other transgender children in Rhode Island, are currently the subject of a legal battle over gender-affirming care and patient privacy. Two federal appellate courts are considering whether Rhode Island Hospital must turn over to the U.S. Department of Justice the medical records of youth who received gender-affirming care.
L and her parent, R, are being identified only by the initials of their first names because their family has faced harassment and threats in the past. Now, they’re caught in a legal tug-of-war between the Justice Department and their medical team.
“She doesn’t get to just be, you know, a typical kid,” R said. “She has to be a political debate — not by her choice.”
The legal battle
Days after his inauguration, President Donald Trump signed an executive order against gender-affirming care for youth. In December, the administration announced a policy banning that care and vowing to investigate hospitals that provide it.
The past several weeks have seen a flurry of legal activity in Rhode Island. In April, a federal court in Texas ordered Rhode Island Hospital to send the records of minors who received gender-affirming care – including information such as names, birthdates, Social Security numbers and addresses – to the DOJ. A group of Rhode Island attorneys challenged the subpoena, arguing that it violated privacy, and on May 14, a Rhode Island federal judge voided it.The DOJ appealed the decision to the First Circuit Court of Appeals in Boston. But the Texas court took an unusual legal move when it ordered Rhode Island Hospital to send the records directly to the court itself until higher courts decide whether the records should be released. Rhode Island attorneys asked the First Circuit Court of Appeals to block the latest order, but after the DOJ said it would accept anonymized records, the appeals court declined to intervene.
Rhode Island Hospital began sending anonymized records to the Texas court on May 19. The hospital said it will take months to gather the requested documents and that the data will not include patient-identifying information. The court plans to hold the documents securely until higher courts decide whether records will be released to the DOJ, and what information they will contain.
RI families oppose subpoena
For Rhode Island families with transgender children, the shifting legal landscape has created anxiety, frustration, anger and fear.R said that they do not believe the DOJ should have access to their daughter’s records.“The government doesn’t need to be involved in this,” they said. “This is something that is done between the child, the parent and the doctor.”
L has identified as a girl since she was a toddler, her parent said.
“She would hear us talking to other people and be like, ‘No, you mean girl. I’m a girl,’” R said. “She was very vocal about it.”L began counseling as a child and started gender-affirming medical care as a preteen.
Now a high schooler, she says the care allows her to move through the world the way she sees herself—as a girl.
“I have not had anybody treat me differently for a very long time,” she said. “One of the reasons why this care is so important is because people would treat me differently if I did not have it.”Another Rhode Island family shares similar concerns.C, a 20-year-old transgender man, always gravitated toward traditionally masculine clothes and toys. (C and his mother, S, are also being identified by the first initial of their first names for safety reasons.)C loved superheroes and Star Wars as a child. His mom recalls him preferring to be the ring bearer, rather than the flower girl, at a wedding. But as he got older, his mom noticed his emotional distress intensifying.
“Starting at around age 11, he started talking to us about believing and feeling like he was a boy,” S said.
She said puberty brought severe anxiety, depression and suicidal thoughts. C came out as transgender to friends, and then began going by his chosen name at 14. But some traits were more difficult to change.
C loved musical theatre, but not the pitch of his voice. Although he could have been a soprano, he preferred to sing the lower alto part, he said. He recalled one day in choir class, when he was having trouble singing the lower notes.
“It hit me... my voice was high,” he said. “It felt like someone else’s voice.”
It was a breaking point, he said. Originally, C and his mom S had discussed waiting until college to begin medical transition. But after the episode, C felt he needed to go to a doctor for help.
At 15, C began puberty blockers and hormone therapy. As he hit milestones, like shaving for the first time or hearing his voice deepen, his mother said she saw his confidence grow.
“Those were all parts of him that made him feel less like he was shrinking and hiding,” S said, “and much more like he was his full and true self.”
C has now been on testosterone for more than five years. He underwent top surgery at 17 and a hysterectomy at 19.
Now, he worries about being able to access testosterone, as hospitals across the country face mounting political and legal pressure over gender-affirming care.
C’s mother believes that the DOJ’s campaign to seek information from hospitals is an effort to intimidate hospitals into stopping gender-affirming care.“I think the initial goal is to scare health care providers, both individual clinicians and hospitals, to no longer offer gender-affirming care by putting at risk their hospitals and larger operations,” she said.
The family also worries about how records identifying transgender individuals could be used. When C went to renew his passport last year, he encountered a new federal form asking passport applicants to identify whether they are transgender.
“So there are many, many avenues now for the administration, if they want to create a list and target these young people and their families,” S said.
C said he struggles to understand why transgender people have become the focus of political battles.“We are truly just trying to survive, and this is the way that we can survive by accessing necessary treatment,” he said. “And I don’t think we should be punished for wanting to survive in a way that’s not harming other people.”
An uncertain future
For Ace and Pluto Mosier, 19-year-old twins from Barrington, the political climate has already shaped major life decisions. Both are transgender men who received gender-affirming care at Rhode Island Hospital and whose records fall under the DOJ subpoena.
Ace attends college at the University of Vermont, while Pluto studies at the University of Toronto.
“The fact that I am at a Canadian university is due in no small part to the fact that when I was applying to universities, that was when Trump was elected, and I was really concerned about what my future in the United States was going to be like,” Pluto said.
Now, both brothers are applying for Canadian citizenship. They said they had already been interested in citizenship for multiple reasons, but the legal battles over transgender health care have increased their urgency.
“My reaction to (the subpoena for records) could be summarized as kind of like a small pit of horror in my stomach at all times,” Pluto said.
The twins said they have also noticed health care providers becoming more cautious since President Donald Trump’s election.
Ace recalled a psychiatrist appointment shortly after the 2024 election in which the psychiatrist expressed hesitation about prescribing hormone therapy, citing uncertainty about whether patients would be able to continue treatment if federal restrictions were enacted.
Now, Ace has been on testosterone for more than a year. Physical changes, like growing facial hair and developing a deeper voice, have helped him feel more comfortable in public.
“For years before I started hormones, I felt afraid when I had to use a public restroom,” Ace said. “I feel much safer now.”
He worries about losing access to hormone therapy.
“Losing access…wouldn’t make me stop identifying as a man,” he said, “but it would cause my body to re-feminize, which would put me in danger.” As the legal battle continues in multiple courts, families are facing uncertainty — whether access to gender-affirming care will change, and how much of their private lives may become subject to government scrutiny.
“We’re kids,” said L. “We’re not something that people have a right to know information about. We’re not a specimen to be monitored, and we’re not pawns to be used in achieving a political goal.”
R says they will do whatever it takes to make sure their daughter is safe and healthy.
“This is affecting our children on a personal level,” R said. “These are actual humans with feelings. Just as much as you would protect your child, I’m going to protect mine.”
