Several hospitals have received federal grand jury subpoenas regarding the provision of gender-affirming care to minors, according to a statement from NYU Langone, a step that suggests the Department of Justice has begun a criminal investigation.
The inquiry for NYU records, sent last week by the U.S. Attorney’s Office in the Northern District of Texas, directs the hospital to turn over information on minors who received care between 2020 and 2026, the clinicians who saw them, and anyone else involved.
“What we’re seeing out of NYU and any other institution that got a similar subpoena is quite different than the DOJ subpoenas that institutions received over the last year,” said Lindsey Dawson, director of LGBTQ health policy at KFF. Previous inquiries DOJ sent to hospitals were administrative subpoenas, which don’t require advance judicial review or authorization. If a grand jury has now been convened, that “likely means [the subpoena is] related to a criminal investigation and thus could carry more significant penalties,” she said.
So far, NYU is the only hospital to publicly announce the receipt of a grand jury subpoena, but the statement claims that it is “one of several institutions” that the DOJ is looking into. Last year, administrative subpoenas were sent to around 20 hospitals that offer pediatric gender care, requesting extensive, identifiable patient records. Many were quashed at the district court level before the Trump administration began pursuing appeals.
DOJ declined to comment on the subpoena. NYU did not respond to STAT’s request.
The details of the federal investigation have not been made public, so the focus of the investigation, including its possible targets, and whether the new subpoena is related to an ongoing investigation or an entirely new one, is unknown. The Trump administration over the last year has asserted the possibility of fraud in relation to the off-label promotion of gender-affirming hormones and puberty blockers. Administration officials and DOJ lawyers have repeatedly said that, despite the legality of off-label prescribing, clinician conversations about the drugs or materials provided to patients could be potentially fraudulent.
Some advocates of gender-affirming care, including Harvard Law Cyberlaw Clinic instructor Alejandra Caraballo, have said that sending a subpoena to New York from a court based in Texas is an instance of “judge shopping,” suggesting that the government is choosing a jurisdiction to bring a potential case where it thinks it can win favorable rulings. For years, the Northern District of Texas has been favored by conservative litigants. In late April, the DOJ filed a motion in the same district to enforce an administrative subpoena of a Rhode Island hospital, which a judge approved within hours. The hospital has appealed that decision and questioned whether the Texas district is the correct jurisdiction for the case.
The subpoena to NYU could serve as a major test of New York’s shield law, which requires that institutions attempt to notify patients at least 30 days before providing information in response to judicial requests for information. The law is meant to stop investigations from other states or federal entities into the basic provision of politicized care. In its statement, NYU said it was weighing its next moves.
Over the last year, patients and providers of gender-affirming care have largely found success when challenging the Trump administration in court. The biggest win for proponents of the care came this spring, when a federal judge in Seattle decided to vacate health secretary Robert F. Kennedy Jr.’s declaration that pediatric gender-affirming care does not meet medical standards of care.
Many supporters believe the decision, which also applied to “any materially similar policy” superseding states’ standards of care, could also be used to stop serious penalties for providers of gender-affirming care for minors included in proposed rules from the Centers for Medicare and Medicaid Services. But Trump’s DOJ has repeatedly signaled that it will push forward with its campaign despite judicial rulings.
In an April hearing in a federal court in Boston, DOJ attorney John Bailey said that even if the judge vacates federal guidance including an executive order and ensuing directive from former U.S. Attorney General Pam Bondi, “it is not going to have an effect on ongoing DOJ investigations.”
To Carmel Shachar, director of the Health Law and Policy Clinic at Harvard Law School, the statement signals that, even if courts rule against the legitimacy of the Trump administration’s overarching directives on gender-affirming care, officials will attempt to execute restrictive policies.
“This sounds like somebody who still thinks there’s a leg to stand on somewhere,” Shachar said. “They’re trying not to concede the proposed regulations that are out there.”
As the Trump administration targets gender-affirming care for youth, dozens of hospitals around the country have paused or ended transgender services, citing legal pressures. Caraballo believes headlines about a potential criminal investigation may be more important to the Trump administration than any actual results, as the move alone could intimidate doctors into stopping the provision of care.
“All of this is mounting pressure that creates enormous stress on providers,” KFF’s Dawson said.