Pennsylvania Gov. Josh Shapiro (D) submitted a court filing on Tuesday opposing President Donald Trump’s attempt to obtain the private medical records of transgender youth from the Children’s Hospital of Philadelphia (CHOP). Shapiro said that complying with Trump’s attempts would erode “trust between doctors and patients,” violate his state’s right to regulate healthcare, and achieve another step in Trump’s quest to end gender-affirming care (GAC) for trans youth despite there being no federal law against it.

In June, Trump’s Department of Justice (DOJ) sent subpoenas to 20 medical providers who offer GAC to trans youth. Under the pretense of finding evidence of healthcare fraud, the DOJ demanded patients’ Social Security numbers, emails, home addresses, and information on the care they received. Additionally, the DOJ sought information about the providers’ employees and their correspondence with pharmaceutical manufacturers, marketing departments, and sales representatives, as well as other sensitive information dating back to January 2020.

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In an “amicus curiae” (or “friend of the court”) brief, Shapiro wrote, “Permitting DOJ to demand the confidential health information of hundreds of patients based on manufactured justification would erode the trust between doctors and patients and undermine state efforts to use their regulatory authority to protect that trust,” The Inquirer reported.

The brief, filed on behalf of the governor and attorneys general from 14 other states, asked U.S. District Judge Mark A. Kearney to grant CHOP’s motion to protect patient privacy by limiting the scope of the DOJ’s subpoena.

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CHOP’s Gender and Sexuality Development Program was created in 2014 and has served hundreds of families. Fewer than 3,000 teens nationwide receive puberty blockers or hormone replacement therapy, according to a 2025 JAMA analysis of private insurance data.

“If enforced, DOJ’s subpoena to CHOP would threaten all states’ ability to regulate the practice of medicine,” wrote Shapiro and the 15 attorneys general. “It is part of an effort to end a specific type of care for a particularly vulnerable population, even though there is no federal law prohibiting such care.”

The DOJ said that its subpoenas seek to prevent healthcare fraud and “off-label” use of puberty blockers and hormones to treat youth gender dysphoria, beyond the “on-label” uses approved by the U.S. Food and Drug Administration. The blockers and hormone treatments have been used safely on children for decades to treat precocious puberty and certain cancers, and off-label uses of these drugs for trans individuals has also occurred safely for decades without any additional federal government oversight.

While no federal law bans gender-affirming care, the current presidential administration has sought to eradicate the practice through a January executive order (that has since been blocked by several courts). The order instructed the DOJ to extend the time that patients and parents can sue gender-affirming doctors and to use laws against false advertising to prosecute any entity that may be misleading the public about the long-term effects of gender-affirming care.

In April, Bondi issued a memo to DOJ employees, telling them to investigate and prosecute cases of minors accessing gender-affirming care as female genital mutilation (FGM); even though hospitals don’t conduct such female genital surgeries. The memo threatened to jail doctors for 10 years if they provide gender-affirming care to young people.

Gender-affirming care is supported by all major medical associations in the U.S., including the American Medical Association, the Endocrine Society, and the American Academy of Pediatrics, as safe and life-saving for young people with gender dysphoria. A recent study following young trans patients for a decade found that 97% of trans youth don’t regret transitioning.

In September, federal Judge Myong J. Joun, an appointee of former President Joe Biden, blocked a similar DOJ subpoena targeting the Boston Children’s Hospital (BCH). Joun’s ruling accused the DOJ of going on a “bad faith” “fishing expedition” to end GAC.

“The Administration has been explicit about its disapproval of the transgender community and its aim to end GAC,” Joun wrote. “The subpoena reflects those goals, comprising overbroad requests for documents and information seemingly unrelated to investigating fraud or unlawful off-label promotion.”

“It is abundantly clear that the true purpose of issuing the subpoena is to interfere with the Commonwealth of Massachusetts’ right to protect GAC within its borders, to harass and intimidate BCH to stop providing such care, and to dissuade patients from seeking such care,” Joun added.

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