Texas Judge Orders Rhode Island Hospital to Produce Gender-Affirming Care Records for DOJ Investigation

U.S. District Judge Reed O’Connor (Northern District of Texas) issued an order on May 1, 2026 requiring Rhode Island Hospital—affiliated with the nonprofit Brown University Health system—to turn over patient, billing, coding and corporate-oversight records related to gender-affirming care for minors. The order gives the hospital 14 days to comply or face contempt sanctions.

Reuters

The Department of Justice (DOJ) has been pursuing a nationwide inquiry into the distribution of puberty blockers and cross-sex hormones to minors, alleging that such use is “off-label” and not FDA-approved for gender dysphoria. The investigation stems from an executive order signed by former President Donald Trump that labeled gender-affirming care a “dangerous trend” and directed the DOJ to prioritize related probes. The DOJ’s subpoena to Rhode Island Hospital, originally issued in July 2025, is one of more than 20 subpoenas sent to health providers across the United States.

Reuters

• Judge Reed O’Connor – Appointed by President George W. Bush; sole judge in Fort Worth federal court.

Reuters

• Brett Shumate – Assistant Attorney General, DOJ Civil Division, author of the subpoena.

Reuters

• Rhode Island Hospital – Main teaching hospital of Brown University, part of Brown University Health (BUH).

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• Christina Paxson – President of Brown University, board member of BUH.

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• LGBTQ advocacy groups – Oppose the investigation, asserting the medical necessity of the treatments.

Reuters

The subpoena contains 15 distinct requests covering: personnel files of prescribers, billing and insurance coding records, financial relationships with drug manufacturers, and patient charts dating back to 2020. According to the DOJ petition, the hospital has supplied only a single six-page document in response to the 15 requests.

Tampa Free Press

The DOJ reiterated that compliance with “validly issued subpoenas” is mandatory and warned that non-compliance “is never an option.” The hospital’s spokesperson said the institution had only recently become aware of the motion and was reviewing it with counsel. Judge O’Connor’s order affirmed that the subpoena is within DOJ authority and seeks documents “reasonably relevant” to the investigation.

Reuters

LGBTQ groups and gender-affirming-care advocates argue that puberty blockers and hormone therapy are medically necessary and safe for transgender youth, contesting the DOJ’s premise that the treatments are fraudulent or unsafe. They view the subpoena as an attempt to intimidate providers and restrict access to care.

Reuters

• The speed of the order—issued the same day the petition was filed—was described as “highly unusual” and left no opportunity for the hospital to file a motion to quash.

Reuters

• The DOJ filed the enforcement action in Texas, though the subpoena’s compliance location is not clarified, prompting questions about jurisdiction.

Reuters

• No comment has been received from Brown University regarding the investigation’s broader implications for its academic mission.

Reuters

If Rhode Island Hospital fails to produce the requested records within the 14-day window, Judge O’Connor may hold it in contempt, potentially leading to fines or other sanctions. The DOJ is expected to continue its review of the supplied documents and may pursue additional enforcement actions against other providers.

Reuters

• “The Department of Justice expects and demands full compliance with validly issued subpoenas like the one at issue here,” — Brett Shumate, Assistant Attorney General, Civil Division, DOJ

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• “Non-compliance with lawful process is never an option.” — Brett Shumate, DOJ

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• “We recently became aware of the motion filed by the Department of Justice and are currently reviewing it carefully with counsel.” — Spokesperson, Brown University Health

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• “In fact, it has produced only one six-page document in response,” — DOJ petition

Brown U. Health must turn over gender-affirming care records to DOJ, judge rules

• “In a two-page order, the judge said the subpoena was within DOJ's authority and seeks documents reasonably relevant to the department's investigation.” — Judge Reed O’Connor, order excerpt

Reuters