the justice department wants trans kids' medical records from two hospitals. an appeals judge asked if this is all just a pressure campaign. say it louder.

via the First Circuit's argument audio, Talking Points Memo and Bloomberg Law

The government's best evidence that it is running a real investigation was filed at 10:30 p.m. The deadline was 6 p.m. That came out on Wednesday morning in a Boston appeals court, from the Justice Department's own lawyer, who told the judges nobody had ever claimed the four and a half hours hurt anyone. She also conceded the department had not offered any explanation for it at the time.

It was a long morning for the government.

what the court heard

A panel of the U.S. Court of Appeals for the First Circuit, Judges Gelpí, Thompson and Montecalvo per the court's calendar, heard two appeals back to back. In both, the Justice Department is trying to revive administrative subpoenas for records about gender-affirming care for minors. One went to Boston Children's Hospital, and U.S. District Judge Myong Joun quashed it in September 2025, finding it was issued in bad faith, as Reuters and NBC News reported. The other went to Rhode Island Hospital, and U.S. District Judge Mary McElroy quashed it in May, after a federal judge in Texas had already ordered the hospital to comply, per the Boston Globe and the AP.

DOJ lawyer Sarah Welch told the court the investigation is about misbranding under the Food, Drug, and Cosmetic Act, that six hospitals have already settled, and that a government with policy views on an industry can still check whether that industry follows the law. One judge asked her, more or less, how a campaign of subpoenas that ends with hospitals agreeing to stop the care entirely is anything other than a way to coerce them into stopping it.

the hospitals' answer

Douglas Hallward-Driemeier, arguing for Boston Children's, said the subpoena reached roughly 2,000 hospital employees and asked for patients' names, Social Security numbers and dates of birth. "The government has made explicitly clear its detest for these individuals," he said, as TPM also reported. "They know that asking for that information is going to keep those people from getting the care they need."

The Rhode Island case is messier, because the government went to Texas. "The government moved to enforce a subpoena in a Texas court 1,500 miles from the hospital, its many patients and the records sought by the subpoena," said Eric Olshan, for Rhode Island Hospital. Judge Lara Montecalvo's question was short: "Is forum shopping evidence of bad faith?" Olshan said it was. Judge Thompson called the dueling courts a "quagmire," since the Texas order is on appeal at the Fifth Circuit at the same time.

why boston matters

Hallward-Driemeier's point was that states, not Washington, regulate the practice of medicine, and blue states have leaned on exactly that; New York City is now paying for this care directly. A federal subpoena is how you get around that, which is why these two cases matter well beyond New England. The panel did not rule from the bench. If it ends up disagreeing with the Fifth Circuit, Rhode Island Hospital's own lawyer acknowledged in court that the split could end up at the Supreme Court, which, if you have been following along, is not the fun part.