In a stunning rebuke of the U.S. Department of Justice (DOJ), Rhode Island District Judge Mary McElroy condemned the department for what she described as an “appalling” lack of candor and misleading conduct in the pursuit of medical records from transgender patients. The criticism centers on the actions of Lisa Hsiao, Acting Director of the Enforcement & Affirmative Litigation Branch at the DOJ, and her handling of subpoenas aimed at healthcare providers offering gender-affirming care.

The controversy began when the DOJ, under Hsiao’s direction, attempted to enforce a subpoena against Rhode Island Hospital, demanding extensive patient records. The move was part of a broader investigation into the off-label use of medications, a practice fully protected under the Food, Drug, and Cosmetic Act which allows doctors to prescribe legally marketed drugs for any condition within a legitimate health care practitioner-patient relationship.

However, the DOJ’s approach has faced significant judicial pushback. Prior attempts to obtain similar records were quashed by courts in other districts, prompting the DOJ to shift their focus to the Northern District of Texas, known for its conservative leanings. Despite this strategic forum shopping, Judge McElroy’s decision in Rhode Island spotlighted deliberate misrepresentations by the DOJ, including false implications that negotiations with the hospital had ceased.

These actions were characterized by Judge McElroy as an effort to manipulate the judicial process and shield the DOJ's controversial tactics from scrutiny. She noted that the government's strategy involved misleading not only the courts but also the parties involved in the negotiations in Rhode Island.

Adding to the controversy, during court proceedings in Rhode Island, a junior attorney, Brantley Meyers, was left to address the court about the DOJ’s actions, while a senior attorney, Jordan Campell, remained silent despite his deeper involvement in the case. This incident further underscored concerns about the DOJ’s handling of the matter.

Ultimately, Judge McElroy quashed the subpoenas, a decision that did not conflict with the enforcement order from the Texas court, emphasizing the autonomy of her judicial reasoning.

The federal government has since appealed the decision, continuing its aggressive pursuit of these records, including a new subpoena issued by the Western District of Texas for NYU Langone’s records on transgender care. This ongoing legal battle highlights not only the contentious nature of the issue but also raises significant concerns about the DOJ’s respect for legal norms and ethical standards in its investigations.