A federal judge blasted the Trump administration for its “reckless” efforts to mislead and manipulate the courts, and target transgender youth by pressuring hospitals to disclose sensitive medical information, according to an order issued Wednesday night.

Judge Mary S. McElroy, who was nominated to the U.S. District Court of Rhode Island by President Donald Trump in 2019, halted the Department of Justice’s subpoena into more than five years of records about transgender minor patients at Brown Health’s Rhode Island Hospital.

“The DOJ has proven unworthy of this trust at every point in this case,” McElroy wrote in a 24-page ruling. “Its representatives have, under oath, misrepresented salient facts.”

McElroy’s ruling is the latest blow to the Trump administration’s efforts to obtain private medical information about transgender youth and their healthcare providers. Thus far, seven other federal courts have blocked the DOJ from enforcing its subpoenas, finding that they were issued for an “improper purpose.”

“The Administration has publicly characterized gender affirming care for minors as abuse, directed the DOJ to bring its practice to an end, and celebrated when hospitals curtailed such programs as a result of this subpoena campaign,” McElroy wrote.

According to the order, the DOJ issued a broad subpoena to the Rhode Island hospital last summer, seeking the names of minor patients, their Social Security numbers, addresses, diagnoses, clinical histories and information about their families.

The Justice Department claimed that the records were needed for an investigation into potential violations of federal food and drug laws related to the off-label prescription of puberty blockers and hormone therapies to alleviate gender dysphoria among transgender youth.

However, McElroy noted that federal courts have allowed the use of FDA-approved drugs for off-label usage and the practice is common in medicine. She concluded that the government’s subpoena, therefore, did not have a “congressionally authorized purpose.”

Roughly 21% of prescriptions are off-label. For example, Ozempic, now popularized as a weight loss drug, was originally approved by the FDA to treat Type 2 diabetes. Minoxidil, a drug approved to treat high blood pressure, is often prescribed to treat hair loss.

Later on in the order, McElroy accused the DOJ of intentionally misleading the courts to try to shop the case to a more sympathetic judge in Texas. After receiving the subpoena, Rhode Island Hospital tried for months to negotiate with the DOJ over its scope, but the DOJ stopped communicating with the hospital altogether. At the same time, DOJ attorneys quietly tried to file a petition to enforce the subpoena in the Northern District of Texas before conservative Judge Reed O’Connor, a George W. Bush-appointed judge who had previously blocked trans-inclusive policies.

“This omission leads the Court to conclude this request was a subterfuge to prevent RIH from realizing that DOJ had decided to go to Texas for an order compelling production of the very records that they had been discussing for months,” McElroy wrote.

McElroy closed her searing order detailing that the disclosure of private medical records would likely violate trans minors’ 14th Amendment rights to informational privacy. DOJ’s continual requests for “intimate medical details” are a “drastic overreach of investigative authority.”

The DOJ has since appealed the decision.

The news comes days after the DOJ took an unprecedented step by launching a criminal probe into a separate hospital that provides gender-affirming care to transgender youth. New York University’s Langone Health posted on its website Monday evening that it had received a federal grand jury subpoena, seeking a wide swath of “de-identified information” about minor trans patients and their healthcare providers.

The federal government’s efforts to gather data about trans patients and their care appear to be inspired by the actions of some Republican officials in Texas and Tennessee who have similarly sought records about transgender youth over the past three years.

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