CHOP, Nemours targeted by Trump administration over transgender care

Escalating President Donald Trump’s fight against transgender rights, a top official at the Department of Health and Human Services on Thursday asked the department’s inspector general to investigate two Philadelphia-area children’s hospitals over their gender-affirming care for transgender children.

The Children’s Hospital of Philadelphia (CHOP) and Nemours Children’s Health in Wilmington are among a dozen hospitals that HHS general counsel Mike Stuart said in posts on X he has referred to the agency’s Office of the Inspector General (OIG) in recent days.

A CHOP spokesperson declined to comment on Friday, and Nemours did not immediately respond to a request for comment.

Both hospitals treat children and teens with gender dysphoria — a medical condition in which a person’s body does not match their gender identity. Doctors can prescribe hormone therapy and puberty blockers to treat the condition, although Nemours has already limited its use of these treatments in response to threats from the Trump administration.

The administration has targeted CHOP and other hospitals that treat transgender youth with subpoenas demanding patients’ medical records, including their dates of birth, Social Security numbers, and addresses, as well as every communication by doctors — emails, voicemails, and encrypted text messages — dating back to January 2020.

CHOP filed legal action in response, asking a federal judge in Philadelphia to block the parts of the subpoena that sought detailed medical records of patients. In November, the judge ruled in CHOP’s favor.

The Trump administration appealed the decision Friday. It has argued that it needs the records as part of its investigation into possible healthcare fraud or potential misconduct by the hospitals.

Stuart said in his Thursday post on X that the administration is investigating hospitals in order to safeguard children from “sex-rejecting procedures.” “There is no greater priority than protecting our children,” he said.

Corinne Goodwin, executive director of the Eastern Pennsylvania Trans Equity Project, called Stuart’s post part of the Trump administration’s ongoing efforts to intimidate doctors and hospitals that provide gender-affirming care to those under 19.

“This action by the Department of Health and Human Services is yet another attempt to intimidate healthcare providers and to harm young people who simply want access to proven healthcare that helps them to live happy and productive lives,” said Goodwin, whose nonprofit organization provides services to transgender individuals in 42 counties, including Montgomery, Bucks, and Delaware.

In the last year, the president has signed a slew of executive orders aimed at transgender Americans.

The administration has said it recognizes only two genders, limited research into LGBTQ+ health, and phased out gender-affirming care at the Department of Veterans Affairs.

Directly targeting children’s hospitals, HHS Secretary Robert F. Kennedy Jr. issued a declaration in December rejecting gender-affirming procedures for minors, including puberty blockers, hormone therapy, and surgeries.

The American Academy of Pediatrics and other major medical associations, citing research, widely accept such care as safe, effective, and medically necessary for the patients’ mental health.

HHS’s OIG declined Friday to confirm or deny the existence of an investigation.

Last month, the U.S. Senate confirmed Thomas “March” Bell to serve as inspector general over HHS. During his confirmation hearing, Bell submitted written testimony saying, “If confirmed as inspector general, I will examine, evaluate, audit, and investigate to support the initiatives of President Trump and Secretary Kennedy.”

CHOP runs one of the nation’s largest clinics providing medical care and mental health support for transgender and nonbinary children and teens and their families. Each year, hundreds of new families seek care at CHOP’s Gender and Sexuality Development Program, created in 2014.

Nemours’ Gender Wellness Clinic, launched in 2018, provided hormone therapy and puberty blockers, as well as mental health support to transgender patients in Delaware, and is the only hospital in the state that provides gender-affirming care for children.

Starting last July, its clinic began accepting only new patients who need behavioral healthcare. Existing patients receiving hormones or puberty blockers at the clinic were allowed to continue their treatment, the hospital said at the time.

On Thursday, Stuart said that CHOP and Nemours “appear to continue to operate outside recognized standards of healthcare and entirely outside @SecKennedy’s declaration that sex-rejecting procedures for children and adolescents are neither safe nor effective," Stuart wrote on X.

Kennedy’s December declaration says that these procedures “do not meet professionally recognized standards of health care.” Doctors who perform such procedures could be barred from participating in federally funded healthcare programs like Medicaid and Medicare, he said.

More than a dozen state officials from around the country, including Pennsylvania Gov. Josh Shapiro, filed a lawsuit in late December to block the declaration‘s enforcement.

The lawsuit says Kennedy has no authority to define “a national standard of care,” and that any substantive changes to Medicare rules are legally required to be subjected to a decision-making process that includes 60 days of public comment.

The Centers for Medicaid and Medicare Services have started that process, announcing alongside Kennedy’s declaration that they are proposing a new rule that would bar hospitals from Medicaid and Medicare if they offer gender-affirming care to children under 19. They also proposed that Medicaid should not cover gender-affirming care for minors.

But those rules have not yet been instituted, and the lawsuit alleges that Kennedy’s declaration is skirting the law by immediately imposing restrictions on gender-affirming care in hospitals.

The Public Interest Law Center, a Philadelphia-based nonprofit that advocates for the civil, social, and economic rights of marginalized communities, is representing five parents of transgender children in legal motions seeking to protect their medical records.

Mimi McKenzie, PILC’s legal director, said the federal judge in Philadelphia was “very clear and on firm ground” when he ruled in November that the DOJ had no authority to issue the sweeping subpoena and it violated the privacy rights of children.

She noted that six other courts around the country have similarly ruled that DOJ “has no right to rifle through children’s medical records,” McKenzie said.

“Gender-affirming care is legal in Pennsylvania and endorsed by every leading medical association,” she said. “This is just another tactic in their ongoing attack against providers and patients.”