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The U.S. Court of Appeals for the First Circuit refused an emergency bid from Rhode Island’s Child Advocate to stop Rhode Island Hospital from turning over records of minors who received gender-affirming care. The records were being sent to a Texas judge for in-camera review after a Justice Department subpoena. The First Circuit said the emergency relief was not justified, leaving the records in a sealed Texas courtroom while appeals go forward.
What the First Circuit actually decided
A three-judge panel — Judges Gustavo A. Gelpí, Lara E. Montecalvo and Joshua D. Dunlap — denied the Child Advocate’s motion for an injunction pending appeal. The DOJ had issued an administrative subpoena under 18 U.S.C. § 3486 back in July 2025 demanding detailed medical records from Rhode Island Hospital about pediatric gender care. U.S. District Judge Reed O’Connor ordered the hospital to produce the records for in-camera review and to keep them under seal, and the First Circuit held the Child Advocate hadn’t shown the irreparable harm needed for emergency relief.
Judge Dunlap’s warnings and a mess of conflicting orders
Judge Joshua D. Dunlap concurred but didn’t do so quietly. He flagged two big legal questions: whether the Child Advocate even had standing to ask a First Circuit panel to effectively tell a hospital to ignore a Texas court order, and whether the Rhode Island judge — U.S. District Judge Mary S. McElroy — was right to quash the subpoena in the first place. Bottom line: we have competing orders from sister district courts and two appeals now moving in different directions. That’s not efficiency; it’s legal tug-of-war.
Why this matters for privacy and federal power
It’s tempting to write this off as boring courtroom procedure, but it’s not. This dispute puts a federal agency in the position of demanding sensitive health records about children across state lines. The hospital and the Child Advocate argue that the subpoena risks exposing private medical details of minors. The DOJ, via Assistant Attorney General Brett A. Shumate, insists enforcement of lawful process is nonnegotiable. Either the federal government gets to reach into state hospitals with broad subpoenas, or states and parents keep control over private medical files. That’s the choice at stake.
What comes next — and why voters should pay attention
For now, the practical result is simple: the records sit in a Texas court under seal and with promised anonymization while the appeals play out. The DOJ has appealed the Rhode Island quashing order to the First Circuit, and the hospital has appealed the Texas enforcement to the Fifth Circuit. Those appeals will decide whether identifying information stays private or whether the DOJ can obtain it. This case is part of a broader federal push to investigate pediatric gender care. Voters and lawmakers who care about medical privacy, parental rights and limits on federal reach should be watching these appeals closely — because court rulings now will shape policy for years, not just in one hospital.
