
Recent legal developments have produced contrasting outcomes regarding gender-affirming care and patient privacy protections. A federal appeals court panel issued a decision that diverged from the majority position taken by judges in prior cases on the same issue. Two of the three judges on the panel determined that the Justice Department’s request for patient records from the telehealth provider QueerDoc did not constitute an overreach or improper government action, marking a departure from how most judges had characterized similar requests. Legal observers have suggested the case may be eligible for en banc review, in which the entire court would reconsider the matter.
The QueerDoc case represents the first appeal of a rejected records request by federal law enforcement. Since oral arguments were presented in March, the Justice Department shifted its strategy on subsequent subpoenas, directing efforts toward a Texas federal district court known for its conservative orientation. At least one additional criminal subpoena related to medical records from NYU was temporarily blocked by a New York federal court.
In a contrasting development, transgender patients and advocates secured a court victory when a district court invalidated a Trump administration regulation designed to remove gender-affirming care from the list of “essential health benefits” that Affordable Care Act marketplace insurance plans must provide. The court’s ruling centered on procedural grounds, determining that the administration failed to follow proper procedures when proposing the regulatory change. While only a limited number of states explicitly list transgender health care as an essential benefit, such services are frequently covered under other protected categories, including prescription drug benefits. The court’s reliance on procedural arguments may not apply to a separate regulation preventing Medicaid from covering gender-affirming care services.
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