The federal government is escalating efforts to seek private medical data for children undergoing gender-affirming care, as at least one hospital faces the first known criminal probe of its kind. 

Last week, NYU Langone Hospitals in New York City received a grand jury subpoena for information about young patients who received gender-affirming care at their facilities anytime in the past six years. 

A grand jury subpoena indicates that a federal criminal investigation is underway. This would be a first in regards to gender-affirming care. 

The subpoena came from the U.S. Attorney’s Office in the Northern District of Texas, part of the Justice Department. The office is also seeking the names of hospital employees involved in providing gender-affirming care. The government has previously sought medical records of transgender kids from other states, and so have Texas officials, but not like this. 

Parents of trans youth under the age of 18 who have received care at NYU Langone got a notification from the hospital alerting them to the grand jury subpoena. According to that notification and to the hospital’s public statement, NYU Langone is one of several institutions that received a subpoena May 7. The hospital said it is still evaluating how it will respond to it. 

New York law prevents the disclosure of medical records related to gender-affirming care and abortion except in limited circumstances and broadly prohibits law enforcement from cooperating with investigations into gender-affirming care. This sets up a potential legal fight over the subpoena. 

Several legal battles are currently playing out in response to other attempts from the government to obtain trans kids’ medical records. 

Eleven families just filed a class-action lawsuit to block the Justice Department from obtaining confidential information about young trans patients seeking gender-affirming care. The agency sent more than 20 subpoenas last summer to doctors and clinics involved in providing such care, with the intent to investigate “healthcare fraud, false statements, and more.” Both the Justice Department and the Federal Trade Commission (FTC) have sought to investigate gender-affirming care as medical fraud. 

Multiple judges halted these DOJ subpoenas in their tracks, after hospitals fought back. A federal judge in Massachusetts called the agency’s investigations into gender-affirming care “motivated only by bad faith.” A judge in Colorado, who blocked a similar subpoena, said patient medical records must be protected from “improper disclosure.” 

Separately, a federal judge this month temporarily blocked the FTC from investigating two medical groups that support gender-affirming care for transgender people. Those groups, the World Professional Association for Transgender Health (WPATH) and the Endocrine Society, were served civil investigative demands for years of internal records and financial information. Both groups sued. 

Over the past year, hospitals in states like New York, where gender-affirming care is legally protected, have come under pressure by the federal government to halt care for trans youth. For patients, that care has been spotty: earlier this year, NYU Langone halted gender-affirming care for young patients, citing “the current regulatory environment” as a key reason. More than 40 hospitals across the country have done the same, per STAT News. 

Gender-affirming care for trans youth primarily refers to hormone therapy and puberty blockers used to treat gender dysphoria, which is a medical condition that can cause significant distress. Very few transgender youth seek and access surgeries. Restricting gender-affirming care is a top priority of the Trump administration, which has proposed regulations to greatly restrict the care for youth and stated its opposition to trans identity as a whole.