Ninth Circuit Revives DOJ Subpoena Targeting Gender-Affirming Care Provider
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A divided Ninth Circuit panel has revived the Justice Departmentโs subpoena against QueerDoc, a telehealth provider that offers gender-affirming care, including care to minors. The courtโs August 14, 2026, ruling keeps the subpoena alive but does not immediately require QueerDoc to turn over the requested records.
By a 2-1 vote, the panel reversed a Western District of Washington order that had quashed the subpoena in full. The case now returns to the district court for review of QueerDocโs arguments that the requests are overbroad and unduly burdensome.
What the Ninth Circuit decided
The majority held that the Health Insurance Portability and Accountability Act, or HIPAA, allows the attorney general or an authorized designee to issue subpoenas during investigations of possible federal health-care offenses. The court said that category can include potential violations of the Federal Food, Drug, and Cosmetic Actโs misbranding provisions.
That was a ruling about investigative authority, not a finding that QueerDoc violated federal law. The court accepted the Justice Departmentโs potential theory that statements or other material connected to drugs used in gender-affirming care could be relevant to a misbranding investigation, while noting that the merits of any eventual violation were not before the court at this stage.
The majority also rejected the argument that the administrationโs public opposition to gender-affirming care, or its decision to prioritize related investigations, by itself proved an improper purpose. It said QueerDoc faced a heavy burden to show that the subpoena was issued in bad faith and that policy alignment does not alone overcome the presumption that executive agencies act regularly.
Records sought by DOJ
The subpoena seeks broad categories of information, including personnel files, billing documents, communications with drug manufacturers and records involving patients prescribed puberty blockers or hormone therapy, according to the Ninth Circuit opinion and Associated Press reporting.
The courtโs dissent said some requests seek identifying information for patients, including names, dates of birth, Social Security numbers, addresses and parent or guardian information. The majority noted that three of the subpoenaโs 15 document requests concern patient information and said the district court may consider privacy objections and protective measures when it reviews the subpoenaโs scope.
The sensitivity of the requests is therefore still central to the dispute. The Ninth Circuit did not decide that all of the requested records must be produced, and it did not authorize their public disclosure.
What the dissent said
Judge Richard Paez dissented. He argued that the district courtโs finding of bad faith was not clearly erroneous and that the record showed DOJ was using the threat of investigation to pressure providers to stop offering gender-affirming care.
Paez also wrote that DOJ had not adequately shown that the requested information was relevant and material to its stated investigative purpose. In his view, the subpoenaโs expansive and intrusive demands supported the lower courtโs conclusion that the investigation was a pretext for an effort to eliminate gender-affirming care.
The majority and dissent thus disagreed over how much weight to give the administrationโs policy directives, the scope of the FDCA theory and the evidence offered to show investigative relevance and purpose.
What happens next
The case returns to the Western District of Washington. The district court must consider whether particular requests are overbroad or impose an undue burden, issues it did not reach before quashing the subpoena on improper-purpose grounds.
The Ninth Circuit instructed the parties to cooperate in narrowing or resolving disagreements about the subpoenaโs scope. It also said QueerDoc must make a reasonable effort to reach an accommodation with the government before seeking relief based on overbreadth or undue burden. Any burden showing will have to be supported with specific evidence, such as the number of files involved, estimated work hours and compliance costs.
QueerDoc said it would continue challenging the subpoena. The providerโs position, as described in its August 17 statement, is that the records had not been produced and that the dispute remains active in district court.
Why the ruling matters
For patients and providers, the decision concerns investigative authority and procedure rather than a final finding of wrongdoing. The immediate practical effect is that DOJโs subpoena is no longer quashed in its entirety, but QueerDoc still has an opportunity to seek limits, protections or other relief from the district court.
The case could become an important test of how federal agencies use HIPAA subpoena authority when an investigation overlaps with an administrationโs policy priorities. It also puts medical privacy, executive enforcement power and the limits of administrative subpoenas back before the lower court.
Sources
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