The Trump administration’s attempts to block transgender care for young people has led to protests like this one in February in Washington.
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In a case that could extend the Trump administration’s war against transgender care to states like California where the medical treatment is legal, a federal appeals court ruled Friday that the Justice Department can order a clinic to release records of doctors who provide gender-affirming care and patients who receive it.
“The President may have moral and political objections to gender-affirming care, wish to end it, and take steps to achieve that goal consistent with law,” the 9th U.S. Circuit Court of Appeals said in a 2-1 ruling.
While states regulate the practice of medicine within their borders, Judge Carlos Bea said in the majority opinion that a state “cannot shield a resident company from having to comply with federal law.” And in this case, Bea said, President Donald Trump’s Justice Department was conducting “an ongoing investigation into potential violations of federal health care laws.”
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The Justice Department has ordered QueerDoc, a small telehealth clinic for transgender youths in Washington state, to turn over records identifying its doctors and patients, including the patients’ addresses and parents or guardians, and the medication they have received.
The ruling doesn’t necessarily require QueerDoc to release all its records. While the court overturned a decision by U.S. District Judge Jamal Whitehead that the Justice Department lacked authority to demand the records, the appeals court majority said Whitehead could still consider restrictions on the government’s access to protect patients’ privacy.
Although “the administration’s hostility to transgender medical care is disturbing, today’s decision doesn’t mean that the courts can’t act to protect patients and providers,” said Christopher Stoll, an attorney with the National Center for LGBTQ Rights in San Francisco.
But the case has a potential impact beyond the geographic boundaries of last year’s Supreme Court ruling upholding laws in Tennessee and 26 other states that do not allow minors to be given puberty blockers and hormone treatment that support their transgender identity.
That ruling did not directly affect other states, like California, which allow gender-affirming care and have become a source of medication and treatment for youths from other states. Friday’s appeals court ruling, if it stands, would apply to California, which is part of the 9th Circuit, and it could extend nationwide if the case reaches the Supreme Court.
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The Trump administration “seeks to intimidate medical providers from offering critical, medically necessary health care to transgender youth,” lawyers for California, 19 other states and the District of Columbia told the appeals court in a January filing by Washington Attorney General Nicholas Brown. “These laws are necessary to protect the health and well-being of our communities and to uphold the rights and dignity of our transgender residents.”
Bea, an appointee of President George W. Bush, was joined in Friday’s ruling by Judge Daniel Bress, appointed by Trump. In dissent, Judge Richard Paez, appointed by President Bill Clinton, said the government was conducting a sham investigation into alleged violations of federal law.
There was strong evidence supporting Whitehead’s conclusion, when he rejected the Justice Department’s subpoena demanding information from QueerDoc, that it was a “pretext for its real goal of eliminating gender-affirming care,” Paez wrote.
“Disclosure of patients’ names and personally identifying information intimidates current patients and deters prospective patients from seeking care. Patients may choose to forgo care rather than risk public intolerance, hostility, or violence.”
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But the court majority said the clinic might be violating the law – by misbranding its drugs, for example, or illegally prescribing them – and there was no evidence that the government was acting in bad faith or concealing its motives for seeking the records.
Trump, Bea wrote, clearly has the power to direct his Justice Department “to exercise its statutory authority in a manner that aligns with his broader policy goals.”