Appeals Court Sides With Trump in Fight Over Subpoena of Gender-Affirming Care Provider
核心洞察
A divided 9th U.S. Circuit Court of Appeals ruled that President Trump's goal of ending gender-affirming care is not improper and cannot justify quashing a Justice Department subpoena against telemedicine provider QueerDoc (搜索).
The 2-1 decision reversed a lower court ruling, sending the case back to the district court to weigh QueerDoc (搜索)'s arguments that the subpoena is overbroad and burdensome.
The subpoena seeks personnel files, billing documents, communications with drug manufacturers, and records of patients prescribed puberty blockers (搜索) or hormone therapy.
A divided federal appeals court ruled Friday that President Donald Trump's goal of ending gender-affirming care is not improper and cannot serve as the basis for quashing a subpoena issued by the Justice Department against a provider of medical treatment for transgender youth.
In a 2-1 decision, a panel of the 9th U.S. Circuit Court of Appeals said the efficacy and long-term risks of the treatments are "uncertain," and that the president has the power to align the Justice Department's enforcement priorities with his broader policy goals. "Every President has law enforcement priorities, just as every President has signature policies (often, the former are components of the latter)," wrote Judge Carlos Bea.
Bea, a nominee of Republican President George W. Bush, was joined in the opinion by Daniel Bress, a Trump nominee. They reversed a ruling that quashed the subpoena against telemedicine provider QueerDoc (搜索), sending the case back to the district court to consider other arguments.
Scope of the Subpoena
The subpoena seeks QueerDoc (搜索)'s personnel files, billing documents, communications with drug manufacturers and records of patients who were prescribed puberty blockers (搜索) or hormone therapy, among other information, according to the 9th Circuit decision.
The Justice Department announced last year that it had issued more than 20 subpoenas to doctors and clinics that provide gender-affirming care as part of an effort to investigate healthcare fraud. Federal judges have quashed many of the subpoenas as illegitimate efforts to intimidate providers into ending care.
Legal Response and Next Steps
American Civil Liberties Union attorney Adrien Leavitt, who represented Washington state-based QueerDoc (搜索), said the ACLU would continue fighting the subpoena in district court. QueerDoc has also argued the subpoena is overbroad and burdensome. The Justice Department has said it has reason to believe the company may be misleading people about puberty blockers (搜索) and hormones.
"We're ready to continue defending one of the most fundamental principles of healthcare: every patient's right to confidential medical care," Leavitt said in a statement. He noted that the San Francisco-based 9th Circuit was the first appeals court to weigh in on the subpoenas.
Policy Context
Trump has signed one executive order defining sex as only male or female — and as unchangeable — and another that seeks to end federal funding of the care for patients under 19. The latter order also directs the Justice Department to "prioritize investigations" into violations of a drug safety law by "any entity that may be misleading the public about long-term side effects of chemical and surgical mutilation."
Gender-affirming care includes a range of medical and mental health services to support a person's gender identity, including when it's different from the sex they were assigned at birth. It encompasses counseling, medications that block puberty and hormone therapy to produce physical changes as well as surgeries to transform chests and genitals, though those are rare for minors.
Most major medical groups say access to the treatment is important for those with gender dysphoria (搜索) and see gender as existing along a spectrum. The 9th Circuit majority called discussion around gender-affirming care "an unsettled scientific debate," and said the Trump administration could also justify its opposition to the treatment on ethical or philosophical grounds.