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Gender-affirming health records from UPMC can’t be made anonymous, federal judge rules

U.S. District Judge Cathy Bissoon said the DOJ’s request carries a “stench” of ill-intent

With a stinging rebuke of the credibility and motives of the U.S. Department of Justice, a federal judge issued a final order rejecting the agency’s demand for medical records of minors who received gender-affirming care at a Pittsburgh hospital.

The DOJ subpoenaed the University of Pittsburgh Medical Center Children’s Hospital last year for records relating to transgender patients. It was one of more than 20 similar demands made of hospitals across the country, including the Children’s Hospital of Philadelphia.

The subpoenas were met with opposition by the parents and guardians of transgender patients and state attorneys general and governors, including Gov. Josh Shapiro. He argued the DOJ was infringing on the states’ regulation of the practice of medicine.

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U.S. District Judge Cathy Bissoon said Monday the families of four UPMC patients who fought the demand have persuaded her that the records could not be effectively stripped of identifying details, given the depth of the DOJ’s request.

DOJ lawyers argued courts have long trusted the adequacy of its safeguards in handling sensitive and confidential information in criminal investigations. Bissoon said in the order that the agency assurance of trust “are cold comfort.”

“Reliance on historical norms, standards and, frankly, decency, cannot be seen as given,” she wrote.

“Left to its devices, the DOJ would trample states-rights to amass deeply personal information ‒ regarding minor children ‒ in service of its crusade to eliminate medical care that, until recently, was in its own eyes legal. It remains so in the Commonwealth of Pennsylvania,” Bissoon said. “Righteousness and rhetoric, regardless of how fervent, is no substitute for political- and legislative-process.”

She added that the government’s rhetoric surrounding gender-affirming care “reflects callous indifference, if not abject cruelty.”

“There is more than a ‘whiff’ of ill-intent,” Bissoon wrote, referencing her Dec. 24 opinion that initially denied the UPMC subpoena. “Arguably, it is closer to a stench.”

[Transgender health advocates see long fight to keep children’s medical records private]

In a footnote to the order, Bissoon noted the DOJ has publicly touted its “core purpose” of defending the Constitution and “God-given rights of every single American.”

“Transgender Americans surely would appreciate its commitment to honoring and protecting theirs. They have reason to question, however, where in its vision they fit,” she said.

The department’s demands for the records followed President Donald Trump’s Inauguration Day executive orders in 2025 reversing federal policy recognizing transgender people and gender-affirming care.

They direct U.S. Attorney General Pam Bondi and others to investigate fraud and violations of federal law by entities providing gender affirming care. The DOJ directed the investigations to focus on whether they mislead the public about the long-term side effects of gender-affirming care, which the order describes as “chemical and surgical mutilation.”

Public Interest Law Center Legal (PILC) Director Mimi McKenzie said Tuesday that the decision soundly rejected that the highly detailed personal records could be anonymized. She called it “a good day for the rule of law.”

PILC represented the UPMC families with attorneys from the law firm Ballard Sphar. The DOJ declined to comment.

Reliance on historical norms, standards and, frankly, decency, cannot be seen as given.

– U.S. District Judge Cathy Bissoon

“At a high level, the court is simply not allowing our government to trample the privacy rights of transgender minors,” McKenzie said, adding that Bissoon called out the DOJ’s conduct, “for what it really is … an effort to intimidate medical providers and the families of transgender youth from seeking appropriate care.”

Bissoon issued the order Monday to clarify that the one in December was not final, notwithstanding the government’s appeal in the U.S. 3rd Circuit Court of Appeals late last month.

She noted the appeal was premature because the DOJ’s own request to consider releasing the records without personal identifying information, also filed in December, was still pending.

Bissoon is the sixth judge to deny a subpoena for gender-affirming health care records. In November, U.S. District Judge Mark A. Kearney ruled in favor of Children’s Hospital of Philadelphia’s effort to block its subpoena. The DOJ is also appealing that ruling.

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