JUANA SUMMERS, HOST:
One of New York City's largest hospital systems says that it's received a grand jury subpoena to access patient medical records. NYU Langone Health says the subpoena seeks information about patients under 18 who've received gender-affirming care since 2020. It also asks for the names of hospital staff who provided such care. For more, we've called up reporter Orion Rummler. They wrote a piece about this for The 19th. Welcome to the program.
ORION RUMMLER: Thanks so much, Juana, great to be here.
SUMMERS: So just to start, Orion, what does a grand jury subpoena do, and how is that different than other Department of Justice subpoenas for the medical records of trans minors?
RUMMLER: So, this grand jury subpoena, it indicates that a federal criminal investigation is underway. A criminal subpoena like this will be harder to quash than a lot of these civil ones that the DOJ has been putting out for the past year to get information on minors getting this care. Federal judges have been swatting most of those away.
SUMMERS: Orion, how hard would it be to stop a criminal subpoena?
RUMMLER: I mean, I'm not a lawyer, but...
SUMMERS: Yeah.
RUMMLER: ...From what I've heard from lawyers and attorneys who work in this space, this is a process where evidence is gathered and then presented to a grand jury to decide if there is enough evidence for an indictment. And, you know, an investigation that's criminal in nature, the stakes are a lot higher for what the outcome could be, and the government can be pretty aggressive about pursuing them.
SUMMERS: And what does the Department of Justice give as their reason for the subpoena? Why are they doing this?
RUMMLER: The DOJ and the Trump administration, they've made it really clear that to them, in their words, they see gender-affirming care as child mutilation, which actual advocacy groups against child female genital mutilation have said that that's an inaccurate conflation. But the administration has made it very clear that they disagree with gender-affirming care being provided to minors, and they want to stop it.
SUMMERS: NYU Langone said in a statement that it was one of a number of institutions to receive a grand jury subpoena earlier this month, but so far, I believe it's the only hospital system that's publicly announced it. Do you have a sense of how extensive the Department of Justice's efforts are to get access to the medical records of trans youth?
RUMMLER: The Justice Department, they're looking for hospital data from January 1, 2020, all the way through May 5, 2026 from this New York hospital. They want documents to identify each patient under 18 who got this care. They want complete personnel files for every employee, contractor, anyone affiliated with the hospital who evaluated anyone young related to gender-affirming care, including people from the hospital billing department. They want insurance claims, internal protocols and diagnosis codes for gender-affirming care. And that includes just diagnosing a kid with gender dysphoria, which does not automatically mean that kid is getting puberty blockers or hormones.
SUMMERS: Right.
RUMMLER: It just means a medical professional has said this kid has dysphoria related to their gender.
SUMMERS: I mean, hearing you describe this, it just brings to mind the fact that under the Health Insurance Portability and Accountability Act, which many people know as HIPAA, sensitive personal medical information is federally protected. Is there a chance that this subpoena could get around HIPAA?
RUMMLER: I'm really curious to see if it will because it also goes against New York state law, which very specifically prevents the disclosure of medical records related to gender-affirming care and abortion.
SUMMERS: How has NYU responded to this subpoena?
RUMMLER: According to New York state law, they have to publicly disclose that this has happened to them. And under New York state law, they have 30 days before they have to make a formal response to the government about what they're going to do. So far, the hospital has said they're still considering what their next move is.
SUMMERS: Just taking a step back here and looking at this big picture, what do you think this move by the Department of Justice says about the state of gender-affirming care for young people in this country?
RUMMLER: Yeah. I mean, it's something I think about a lot because the question is starting to become, where are minors getting this care? Because it's...
SUMMERS: Yeah.
RUMMLER: ...Banned in over half the states in the country, and then in states like New York where it's protected, these hospitals are sometimes pulling away from it and coming under this kind of scrutiny.
SUMMERS: Do you think that it all has a chilling effect on people pursuing that care or causes fear or concern if people's medical records, perhaps, are not able to be kept private?
RUMMLER: Parents of trans youth are really concerned about this. And the Human Rights Campaign had a press call, and they brought on an anonymous parent of trans youth who moved from the South to the North, moving from a state where this care is banned to a state where it should be accessible, but then Trump comes into office and their hospital shuts it down. And now they're hearing all this news about what's happening with their kid's medical records. These parents are feeling really scared because a lot of them thought, if I move to a Northern state, if I move to a blue state, then it'll be easier. It will be protected. But the Trump administration is showing that's not really the case.
SUMMERS: We've been speaking with The 19th's Orion Rummler. They cover how LGBTQ+ people navigate the American healthcare system.
Orion, thanks so much.
RUMMLER: Thank you so much. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
