On May 12, NYU Langone Health, a major hospital network in the state of New York, disclosed that it had received a federal grand jury subpoena from prosecutors in Texas state. The subpoena demands the names of every patient under 18 who received gender-affirming care at NYU Langone hospitals since 2020, as well as every provider, administrator, and volunteer involved in their care. The public only learned of the subpoena because NYU Langone, citing New York’s Shield Law, warned families that Texas prosecutors could receive their private records within 30 days.

The Texas subpoena is sweeping. It demands complete personnel files for all staff involved in these cases—whether they provided care, handled billing, or supervised staff—as well as copies of all internal rules, training materials, and billing-related emails. Most striking, it demands information identifying every patient and their full medical history, from first visit to latest treatment. Yet it never specifies what crime is under investigation or which law was allegedly broken.

The subpoena centers on a term the government has used across its legal actions since 2025: “sex-rejecting procedures.” US Health Secretary Robert F. Kennedy formalized the term in a December 18 declaration, stating that gender-affirming care “fail[s] to meet professionally recognized standards of health care”—a finding that has empowered federal officials to exclude healthcare providers from government-run programs, Medicare and Medicaid. The US Department of Health and Human Services (HHS) General Counsel Mike Stuart then threatened to publicly refer at least 17 children’s hospitals to federal investigators for exclusion, including NYU Langone, each time invoking “sex-rejecting procedures.” The term has now migrated into the criminal subpoena as its foundational legal definition, explicitly overriding medical terminology and potentially recasting standard billing practices as evidence of fraud.

Courts have rejected this framing. In Oregon v. Kennedy, Judge Kasubhai vacated the Kennedy Declaration entirely and refused to use the government’s terminology, writing, “In this Court, all people will be treated with dignity. The Court will use the appropriate term ‘gender-affirming care.’” The government’s own HHS report on pediatric gender care, which serves as its stated scientific basis for these actions, never uses the term ” sex-rejecting ” once.

This subpoena to NYU Langone comes as legal challenges ramp up. Last week, eleven families represented by GLAD Law (GLBTQ Legal Advocates & Defenders), the National Center for LGBTQ Rights, and Brown, Goldstein & Levy filed a lawsuit in the US District Court for the District of Maryland, seeking emergency nationwide relief to block the US Department of Justice (DOJ) from obtaining or retaining patient records pending litigation. The filing argues that “once medical records are turned over to the federal government, the harm becomes irreversible, even if courts later determine the subpoenas were unlawful.”

In announcing the lawsuit, Brown, Goldstein & Levy attorney Eve Hill stated, “History has shown what happens when the government collects lists of the members of groups it disfavors. We cannot allow that history to repeat itself.” That comparison is not rhetorical. Perhaps most concerning is not just the legal mechanics of this subpoena, but what history tells us about where such list-making leads.

For years before the Nazis came to power, police across Germany had kept lists of suspected homosexuals. In fall 1934, the Gestapo instructed local police forces to send those lists to Berlin, centralizing—for the first time—a national registry of men believed to have engaged in same-sex behavior. These lists have come to be known as the “pink lists.” They were used to identify, arrest, and deport gay men to concentration camps. The 1942 Japanese American internment followed a similar pattern: federal agencies had spent years compiling lists before Executive Order 9066 authorized mass incarceration. When the order came, the lists were already ready.

At least seven federal courts have resisted the civil subpoena campaign, but none more directly than the US District Judge Mary S. McElroy. Her May 13 order quashing the Rhode Island subpoena found that the DOJ was “unworthy of trust;” a senior DOJ official’s sworn declaration was “clearly misleading, if not utterly false”; the government had engaged in “subterfuge” to obtain a Texas enforcement order while concealing its tactics from her court; and the subpoena itself lacked any congressionally authorized purpose. As McElroy wrote, “the off-label prescribing conduct at the core of the DOJ’s theory is not illegal under the Federal Food, Drug, and Cosmetic Act.” The DOJ immediately appealed to the First Circuit, sending the conflict between her order and the Texas enforcement order to appellate courts.

Right now, the Shield Law offers protection, but most states lack such laws. Families in those states may not even know if their children’s records have already been sent to the government. Lawmakers in states without these protections should act now—not wait for the next subpoena. Hospitals have both the legal right and the moral duty to fight these subpoenas before handing over any records.

NYU Langone has 30 days, and the countdown has begun for every hospital that received a subpoena. All eyes are on the Maryland court. If emergency relief does not come before hospitals in unprotected states comply, it will be too late to wonder what the government will do with those records. History is clear: the time to protect people is before a list is created, not after it falls into government hands.

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