The hospital has long drawn scrutiny from conservative activists who have urged the federal government to investigate its gender clinic’s practices.

Boston Children’s Hospital, home to the nation’s first pediatric and adolescent transgender clinic, is among the medical facilities that received a Justice Department subpoena earlier this month targeting doctors and clinics that provide gender-transition medical interventions to children, National Review has learned.

Department of Justice officials are probing more than 20 medical clinics and doctors to determine whether their child gender-transition practices constitute health-care fraud and false statements, the department announced in a July 9 statement which did not specify which hospitals and clinics are being targeted. Children’s Hospital Colorado also received a subpoena, the hospital confirmed this month.

The recent subpoena is one of many legal challenges the Massachusetts hospital is currently confronting. Along with Children’s Hospital Colorado and Children’s Hospital Los Angeles, Boston Children’s is also the target of a separate FBI criminal investigation that is probing whether all three hospitals’ child gender-transition practices violate federal statutes barring female genital mutilation, according to a Fox News report.

“Boston Children’s Hospital is committed to providing safe, evidence-based, and compassionate care to every patient and family we serve,” a Boston Children’s hospital spokesperson said in a statement to National Review when asked about the Justice Department probe. “In Massachusetts, access to gender affirming care is a protected right under state law, as outlined in M.G.L. Chapter 12, Section 11I 1/2. We uphold this responsibility with the utmost seriousness. Like other hospitals, we respond to government inquiries as appropriate.”

The hospital did not elaborate on what information the Justice Department has requested as part of its investigation.

A Justice Department spokesman declined to comment on the investigation.

Boston Children’s, the Harvard Medical School research and training hospital specializing in children’s care, has previously insisted to news outlets that the clinic “does not perform genital surgeries as part of gender-affirming care on a patient under the age of 18.” But a Journal of Clinical Medicine study published in March 2022 that was approved by the Boston Children’s Hospital’s institutional review board describes chest surgeries for those over 15, as well as genital surgeries for those over 17.

“The Center for Gender Surgery (CfGS) at Boston Children’s Hospital (BCH) was the first pediatric center in the United States to offer gender-affirming chest surgeries for individuals over 15 years old and genital surgeries for those over 17 years of age,” the study’s authors wrote. “In the four years since its inception, CfGS has completed over 300 gender-affirming surgeries.” Patients included in the study underwent a series of gender-transition surgeries, including “chest reconstruction procedures, vaginectomy and phalloplasty procedures, vaginoplasty surgeries, and metoidioplasty surgical procedures.”

The hospital does not deny performing other invasive procedures, such as the removal of healthy breast tissue, on younger teens.

According to the hospital’s website, Boston Children’s Gender Multispecialty Service (GeMS) program has treated more than 1,000 families to date and welcomes patients as young as three years old. The hospital has long drawn scrutiny from conservative activists who have urged the federal government to investigate its gender clinic’s practices.

The Justice Department’s July subpoenas are part of an administration-wide effort to crack down on gender-transition care for minors, including puberty blockers, cross-sex hormone therapy, and in some cases surgery.

The Health and Human Services Department and Centers for Medicare and Medicaid Services (CMS) began the rulemaking process this month to prohibit the federal government from directly funding sex-trait modifications for minors through Medicaid and the Children’s Health Insurance Program, National Review first reported.

As National Review recently reported, some hospitals have paused some or all of their gender-transition medical interventions for minors — or even closed their clinics entirely — following a Trump executive order urging all relevant White House departments to aggressively push back against the practice nationwide.

The forthcoming Medicaid rule change that HHS and CMS formally submitted this month could have disastrous financial implications for hospitals that do not change their policies.

In May, CMS sent letters to select hospitals urging them to provide detailed information surrounding billing codes for “pediatric sex trait modifications,” as well as facility- and provider-level revenue, profit margins, and revenue forecasts for all medical interventions relating to gender-transition medical interventions that were performed by their medical institutions and had been reimbursed “in whole or in part” by the federal government.

And this month, the Federal Trade Commission conducted a workshop on allegedly deceptive medical practices related to gender-transition care for minors, featuring testimony from adults who underwent transition medical interventions that they now regret.

Over the next few months, the administration is expected to investigate instances of health-care fraud based on whistleblower testimony alleging that hospitals routinely misrepresent billing codes for insurance-coverage purposes.

Testifying before the House Judiciary Committee’s Subcommittee on the Constitution and Limited Government in April, general surgeon Eithan Haim alleged that hospitals regularly use deceptive billing codes so that insurance companies cover gender-transition medical interventions for minors.