In mid-2025, the Department of Justice (DOJ) and the Federal Trade Commission (FTC) began ramping up investigations into gender affirming care. From subpoenas sent to clinics and individual prescribers, to workshops framing care as “dangerous,” these actions are creating real fear among clinicians who provide lifesaving support.

Let’s break down what’s happening, what power these agencies actually have, and what you can do to protect both yourself and your patients while continuing to practice evidence aligned, affirming care.

DOJ Subpoenas: Targeting Clinics and Prescribers

In July 2025, the DOJ issued subpoenas to several major health systems and individual clinicians providing care for transgender youth (The Guardian ).

These subpoenas demand patient records, billing documentation, and internal communications. The stated justification? To investigate possible violations of the Food, Drug, and Cosmetic Act (FDCA) and the False Claims Act (FCA).

• FDCA angle: DOJ claims puberty blockers or hormones prescribed for gender affirmation are “misbranded.”

• FCA angle: DOJ is probing billing codes and insurance claims, suggesting fraud when affirming care is covered.

This is not grounded in clinical evidence—it’s a legal intimidation tactic.

FTC Actions: Weaponizing Consumer Protection

The FTC has also stepped into the fray, holding a July 2025 workshop ominously titled: “The Dangers of Gender Affirming Care for Minors.” This public framing wrongly positioned evidence based, lifesaving care as fraudulent or exploitative.

What does this mean? The FTC could try to pursue actions under “consumer deception” laws, alleging that clinicians or institutions misrepresent the risks and benefits of gender affirming care.

Like the DOJ’s actions, these moves lack grounding in established science or guidelines from WPATH, the Endocrine Society, or UCSF.

What This Means for Clinicians

1. Confidentiality Under Threat
   Patient records requested by subpoenas create risk for privacy breaches. HIPAA protections still apply, but legal exceptions may be argued.

2. Increased Administrative Burden
   Clinics may pause or alter services simply from fear of investigation—already seen in hospitals in California, Illinois, and Colorado.

3. Chilling Effect on Care
   Even without formal charges, the specter of investigation pressures clinicians and institutions to back away from affirming care, worsening access.

What You Can Do Right Now

• Document With Care: Clearly outline patient goals, informed consent discussions, and evidence base in every encounter. This shows alignment with clinical consensus, not fraud.

• Protect Patient Privacy: If contacted regarding a subpoena, do not hand over records without consulting legal counsel or your institution’s compliance team. Patients deserve every layer of confidentiality you can uphold.

• Stay Connected: Engage with peer networks and clinician aligned societies pushing back against federal intimidation. Sharing updates helps prevent isolation and fear.

• Educate Patients With Clarity: Reassure patients that gender affirming care remains evidence based, medically necessary, and supported by every major clinician society.

The DOJ and FTC actions represent political overreach, not scientific reality. Subpoenas and consumer protection rhetoric are being weaponized to intimidate clinicians into abandoning affirming care. But remember: your work is grounded in evidence, shared decision making, and body autonomy.

By documenting carefully, protecting patient confidentiality, and staying rooted in community, you can continue to provide the care your patients need—even when the political winds rage.