A federal appeals court handed the Trump administration its first appellate victory in the fight to subpoena clinics and doctors accused of providing sex-change drugs and surgeries to children, a ruling the ACLU immediately vowed to challenge on remand.
The U.S. Court of Appeals for the Ninth Circuit issued a 2-1 decision Friday reversing a lower court order that had blocked a Department of Justice subpoena against QueerDoc, a Washington state-based telemedicine clinic. The ruling marks the first time an appeals court has upheld one of the DOJ's subpoenas targeting providers of transgender medical procedures for minors under the Trump administration, after federal judges at the trial-court level had repeatedly quashed similar demands.
Judge Carlos Bea, a George W. Bush appointee, authored the majority opinion. Judge Daniel Bress, a Trump nominee, joined him. The two-judge majority found that the administration's stated opposition to sex-change procedures for children does not, by itself, establish an improper purpose behind the subpoena. The case now returns to the lower court for further proceedings.
The decision lands squarely in the middle of a broader legal and policy confrontation between the Trump administration and providers who prescribe puberty blockers and cross-sex hormones to minors. The DOJ announced last year that it had issued more than 20 subpoenas to doctors and clinics as part of an investigation into alleged healthcare fraud and false statements. Federal courts had, until Friday, largely blocked those efforts.
The majority opinion addressed head-on whether a president's policy priorities can lawfully shape the DOJ's investigative focus. Judge Bea wrote:
"Every President has law enforcement priorities, just as every President has signature policies (often, the former are components of the latter)."
The panel went further. It described the long-term risks of sex-change drugs for minors as "uncertain" and characterized the broader question of such procedures for children as "an unsettled scientific debate." The majority wrote that the Trump administration can justify its opposition on "ethical and philosophical grounds", language that gives the executive branch wide latitude to pursue its investigation.
That framing matters. The lower court had halted the subpoena on the grounds that the DOJ acted in bad faith. The Ninth Circuit disagreed, ruling that a president directing DOJ to exercise its statutory authority in line with his broader policy goals does not amount to an improper purpose. The Washington Examiner reported that Assistant Attorney General Brett Shumate responded bluntly: "The trans medical industry is not above the law."
The Trump administration has fought a running series of legal battles across multiple federal courts, with mixed results. In some cases, appeals courts have rejected administration policies, while in others, the DOJ has secured significant wins at both the district and appellate levels.
The subpoena at issue targets a wide swath of QueerDoc's internal records. The DOJ is seeking the clinic's personnel files, billing documents, communications with drug manufacturers, and records of patients who were prescribed puberty blockers or cross-sex hormones.
QueerDoc, represented by the ACLU, argued that the subpoena was too broad and too burdensome. ACLU attorney Adrien Leavitt issued a statement after the ruling:
"We're ready to continue defending one of the most fundamental principles of healthcare: every patient's right to confidential medical care."
Leavitt said the ACLU plans to continue fighting the subpoena when the case returns to district court. The framing, patient confidentiality versus law enforcement oversight, will likely define the next phase of the litigation.
The administration's legal push has scored victories in other arenas as well. A federal judge recently struck down Illinois tuition benefits for illegal immigrants, adding to a string of court wins that have energized the administration's broader enforcement agenda.
Two Trump executive orders form the policy backbone of the DOJ's investigation. One eschews the concept of "gender identity" and reaffirms what the order calls "the biological reality of male and female." A second seeks to end federal funding for sex-change procedures for minors and directs the DOJ 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."
The DOJ contends that QueerDoc "could be misleading people about sex change drugs." The investigation covers potential healthcare fraud and false statements, charges that, if substantiated, would carry serious federal penalties.
The administration's willingness to use executive orders to direct DOJ enforcement has drawn legal challenges across multiple policy areas, from immigration to voting. The DOJ has taken some of those fights all the way to the Supreme Court after lower courts blocked enforcement.
The Ninth Circuit's characterization of the science as "unsettled" aligns with warnings from mainstream medical institutions. The Mayo Clinic has flagged long-term impacts of puberty blockers on bone growth, bone density, and growth spurts, risks that are central to the DOJ's argument that providers may be understating side effects.
The World Professional Association for Transgender Health, or WPATH, a leading organization in the field, has advocated for removing age limits on sex-change procedures. WPATH's guidelines have influenced major hospitals and health organizations across the country, but the group has faced public scrutiny over its standards and practices. The Federal Trade Commission has separately pursued action against WPATH over what it described as deceptive claims.
Not every Trump administration legal effort has succeeded. A Trump-appointed judge sided with Minnesota in dismissing a DOJ sanctuary-policy lawsuit, a reminder that the courts remain an unpredictable venue for any administration's enforcement agenda.
Friday's ruling is significant precisely because it is the first. More than 20 DOJ subpoenas remain in various stages of litigation. Lower courts had, until now, largely sided with providers who challenged them. The Ninth Circuit's decision does not resolve the QueerDoc case, it sends it back for further proceedings, but it establishes that the DOJ's investigative authority is not automatically tainted by the president's policy views.
Several questions remain unanswered. The identity of the dissenting judge in the 2-1 ruling was not disclosed in available reporting. The specific federal drug-safety statute underlying the DOJ's investigation has not been publicly identified. And it is unclear how many of the other 20-plus subpoenas have been contested, or where those cases stand.
The ACLU will get its next shot in district court. The DOJ now has appellate precedent at its back. For parents, taxpayers, and anyone who believes children deserve protection from irreversible medical decisions made on uncertain science, that precedent is long overdue.