Rhode Island judge slams DOJ over probe of gender-affirming care

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In Brief:

• Judge Mary S. McElroy accuses DOJ of forum shopping.
• DOJ subpoena targets Rhode Island Hospital gender-affirming care records.
• Texas Judge Reed O’Connor enforces subpoena despite local objections.
• Rhode Island Child Advocate Katelyn Medeiros files motion to quash subpoena.

An incensed federal judge accused the U.S. Department of Justice of shopping to Texas its bid to force Rhode Island Hospital to turn over medical records for youths receiving gender-affirming care. And she said prosecutors had willfully played “dirty pool” by misleading that court.

“It’s pretty clear to me that this was shopped to Texas,” U.S. District Judge Mary S. McElroy said in a hearing on May 12.

McElroy’s wrath came during a hearing on Rhode Island Child Advocate Katelyn Medeiros’ motion to quash a subpoena that seeks medical records for underage patients who received care for gender dysphoria at Rhode Island Hospital. The hospital has also filed to block the subpoena.

“You sought a favorable forum or what you thought would be a favorable forum,” McElroy said.

Assistant U.S. Attorney Brantley Mayers, who joined the government in November and works out of Washington, D.C., told the court that there is an investigation in Texas into whether pharmaceutical companies are colluding with doctors in Rhode Island in a scheme to prescribe drugs for off-label uses in exchange for financial incentives. Records of false billing could speak to intent under the conspiracy, and federal prosecutors need access to the records, he said.

“If Rhode Island allows billing for off-label, how do we get to criminal conduct?” McElroy asked. “Subpoenas are not supposed to be fishing expeditions.”

Providing gender-affirming medical care to minors is legal in Rhode Island.

Travel of the case

The DOJ originally filed the subpoena in July 2025, with a return date by Aug. 7 of that year.

According to the DOJ, the subpoena is part of a nationwide investigation into alleged violations of the Federal Food, Drug and Cosmetic Act over the use of certain prescription drugs to treat gender dysphoria. Among them are hormone suppressants and puberty blockers.

On April 30, 2026, the agency filed a motion to enforce the subpoena with the U.S. District Court for the Northern District of Texas, claiming Rhode Island Hospital had not complied with it and only produced “one six-page document” in response.

Texas Judge Reed O’Connor approved the motion to enforce within hours of its filing, giving Rhode Island Hospital 14 days to comply with the subpoena. He denied the hospital’s request to stay the matter as it appealed to the 5th U.S. Circuit Court of Appeals. The appeal was denied in a single sentence on May 12 — as arguments were playing out in McElroy’s courtroom.

McElroy lambasted the government for failing to inform O’Connor that it had been in active negotiations with Rhode Island Hospital in the days leading up to the DOJ filing the motion to enforce or that federal prosecutors had been unresponsive to the hospital over the course of 10 months.

Rhode Island Hospital was not alerted about the court action in Texas or notified that other hospitals had reached agreements with the DOJ to release records that could not be linked to an individual, its lawyer Eric G. Olshan said.

“We’re at the end of our tether with the Department of Justice making false representations in this district,” McElroy said, warning that the court would hold people accountable for any untruths.

Mayers pushed back against McElroy’s critiques, denying that the actions were in bad faith. The government argues that Medeiros lacks standing to challenge the subpoena and that Rhode Island Hospital should have asked O’Connor to reconsider his court order.

McElroy stressed that seven federal courts had quashed similar subpoenas and that O’Connor was the only judge to side with the DOJ.

‘There are stories on both sides’

The Child Advocate’s motion was filed by attorneys from the Lawyers’ Committee for Rhode Island and the American Civil Liberties Union of Rhode Island. Medeiros represents the interests of children in state care, some of the most vulnerable in Rhode Island.

“Young adults, and their families, who are being deeply affected by the subpoena and by the government’s attempts to go to Texas to enforce it …. they are terrified that the hospital will be forced to turn over their children’s identities and most intimate medical records to the government that has repeatedly and publicly demeaned them and declared its hostility towards them and their families,” Kevin Love Hubbard argued to McElroy.

He spoke of parents whose children were on the brink of suicide before receiving gender-affirming care.

“They don’t think gender-affirming care is legitimate. They don’t get to make that decision,” Love Hubbard said. He noted that he learned of the subpoena on May 1 through a DOJ press release, before Rhode Island Hospital was even aware.

But Mayers said he had heard “horrific stories” about young people suffering. He cited as questionable a reported spike in children diagnosed with unspecified endocrine disorders and precocious puberty at Rhode Island Hospital.

“That’s getting into whether you agree with it. I don’t care if you agree with it. There are stories on both sides,” McElroy said.

McElroy ordered the government to produce information by May 13 about when a grand jury was convened in Texas to investigate the issue, as well as sworn statements about when the DOJ broached to Rhode Island Hospital that it could produce anonymous records, as other health care providers have. The hospital’s lawyer said no such talks ever took place.

McElroy did not indicate when she would issue a decision, but the clock is ticking on the subpoena.