Queerdoc, Pllc v. DOJ - United States Department of Justice

FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT QUEERDOC, PLLC, No. 25-7384 D.C. No. Plaintiff - Appellee, 2:25-mc-00042- JNW v. DOJ - UNITED STATES DEPARTMENT OF JUSTICE, OPINION Defendant - Appellant. Appeal from the United States District Court for the Western District of Washington Jamal N. Whitehead, District Judge, Presiding Argued and Submitted March 6, 2026 Seattle, Washington Filed August 14, 2026 Before: Richard A. Paez, Carlos T. Bea, and Daniel A. Bress, Circuit Judges. Opinion by Judge Bea; Dissent by Judge Paez 2 QUEERDOC, PLLC V. USDOJ SUMMARY * Administrative Subpoena The panel reversed the district court’s order quashing in its entirety an administrative subpoena issued by the United States Department of Justice (DOJ) to QueerDoc pursuant to the Health Insurance Portability and Accountability Act (HIPAA), which authorizes the Attorney General or his designee to issue a subpoena in any investigation of a federal health care offense, and remanded for further proceedings. QueerDoc is a telehealth provider of gender affirming care that treats patients, including minors, who suffer from gender dysphoria. Patients of QueerDoc may be diagnosed with gender dysphoria and prescribed puberty blockers and cross-sex hormones. Following President Trump signing Executive Order 14,168, which declared that the United States “recognize[s] two sexes, male and female,” and that “[t]hese sexes are not changeable[,]” and Executive Order 14,187, which declared that the federal government would not “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another[,]” DOJ issued an administrative subpoena to QueerDoc ordering QueerDoc to produce various documents necessary for the investigation of potential violations of federal health care laws. The district court quashed the subpoena in its entirety, finding the subpoena unenforceable because DOJ had issued it for an * This summary constitutes no part of the opinion of the court. It has been prepared by court staff for the convenience of the reader.  QUEERDOC, PLLC V. USDOJ 3 “improper purpose”: to achieve the President’s policy objective of “eliminating gender-affirming care.” The panel held that DOJ issued the administrative subpoena pursuant to statutory authority because 1) HIPAA permits investigations for potential violations of the Federal Food, Drug, and Cosmetic Act’s misbranding prohibitions; 2) DOJ complied with HIPAA’s procedural requirements; and 3) the subpoena requests were relevant to an authorized investigation under HIPAA. The panel next held that QueerDoc did not meet its heavy burden of showing that the subpoena was issued for an improper purpose. Consistent with the presumption of regularity and the high standard required to quash an administrative subpoena on improper purpose grounds, the Executive Branch’s public opposition to “gender-affirming care” is insufficient to show that an agency within the Executive Branch issued an otherwise permissible HIPAA subpoena in bad faith. The President may direct DOJ to exercise its statutory authority in a manner that aligns with his broader policy goals. Because the district court decided only that the subpoena was motivated by an improper purpose and did not rule on QueerDoc’s arguments that DOJ’s subpoena is overbroad and poses an undue burden, the panel remanded for the district court to consider those issues the first instance. Dissenting, Judge Paez wrote that the district court’s finding that DOJ issued the subpoena to QueerDoc in bad faith was not clearly erroneous. Considering the information properly before the district court at the time it rendered its decision, the government failed to satisfy its prima facie burden of showing the information subpoenaed was relevant and material to its purported investigatory purpose. Even if 4 QUEERDOC, PLLC V. USDOJ the government satisfied its prima facie burden, the district court’s decision to quash the subpoena should be affirmed because ample evidence supports its finding that the subpoena was issued in bad faith. COUNSEL Paula Ramer (argued) and Marcus A. Asner, Arnold & Porter Kaye Scholer LLP, New York, New York; Taylor B. Graham, Arnold & Porter Kaye Scholer LLP, Denver, Colorado; Benjamin C. Mizer and Samuel D. Kleinman, Arnold & Porter Kaye Scholer LLP, Washington, D.C.; Jaclyn Machometa, Arnold & Porter Kaye Scholer LLP, Boston, Massachusetts; Jonathan P. Hawley, David B. Robbins, and Harry H. Schneider Jr., Ashurst Perkins Coie LLP, Seattle, Washington; Adrien Leavitt and La Rond Baker, American Civil Liberties Union of Washington, Seattle, Washington; David B. Robbins, Perkins Coie LLP, Seattle, Washington; for Plaintiff-Appellee. Sarah Welch (argued) and Bradley Hinshelwood, Attorneys; Abigail Stout, Counsel to the Assistant Attorney General; Yaakov M. Roth, Principal Deputy Assistant Attorney General; Civil Division; Brett A. Shumate, Assistant Attorney General; United States Department of Justice, Washington, D.C.; for Defendant-Appellant. Kohsei Ugumori, Attorney, Office of Immigration Litigation, Civil Division, United States Department of Justice, Washington, D.C.; Miriam Rosenbaum and Wendy R. Weiser, Brennan Center for Justice at NYU School of Law, New York, New York; Joseph Gaeta, Brennan Center for Justice at NYU School of Law, Providence, Rhode  QUEERDOC, PLLC V. USDOJ 5 Island; Jonah M. Knobler, Caitlin Ross, Bharath Palle, and Gregory L. Diskant, Patterson Belknap Webb & Tyler LLP, New York, New York; for Amici Curiae Former U.S. Department of Justice Attorneys. David M. Zinn, Christopher N. Manning, Dana B. Kinel, Patrick C. Hynds, and Amy M. Saharia, Williams & Connolly LLP, Washington, D.C.; Jeffrey B. Coopersmith, Corr Cronin LLP, Seattle, Washington; for Amicus Curiae Seattle Children's Hospital. Lauryn K. Fraas, Assistant Attorney General; William D. McGinty and Cristina Sepe, Deputy Solicitors General; Nicholas W. Brown, Washington Attorney General; Office of the Washington Attorney General, Olympia, Washington; Adam M. Cambier, Morgan Carmen, and Jak Kundl, Assistant Attorneys General; Allyson Slater, Director, Reproductive Justice Unit; Andrea J. Campbell, Massachusetts Attorney General; Office of the Massachusetts Attorney General, Boston, Massachusetts; Rob Bonta, California Attorney General, Office of the California Attorney General, Oakland, California; William Tong, Connecticut Attorney General, Office of the Connecticut Attorney General, Hartford, Connecticut; Kristin K. Mayes, Arizona Attorney General, Office of the Arizona Attorney General, Phoenix, Arizona; Philip J. Weiser, Colorado Attorney General, Office of the Colorado Attorney General, Denver, Colorado; Brian L. Schwalb, District of Columbia Attorney General, Office of the District of Columbia Attorney General, Washington, D.C.; Kathleen Jennings, Delaware Attorney General, Office of the Delaware Attorney General, Wilmington, Delaware; Kwame Raoul, Illinois Attorney General, Office of the Illinois Attorney General, Chicago, Illinois; Aaron M. Frey, Maine Attorney General, Office of the Maine Attorney 6 QUEERDOC, PLLC V. USDOJ General, Augusta, Maine; Anthony G. Brown, Maryland Attorney General, Office of the Maryland Attorney General, Baltimore, Maryland; Dana Nessel, Michigan Attorney General, Office of the Michigan Attorney General, Lansing, Michigan; Keith Ellison, Minnesota Attorney General, Office of the Minnesota Attorney General, St. Paul, Minnesota; Aaron D. Ford, Nevada Attorney General, Office of the Nevada Attorney General, Carson City, Nevada; Jennifer Davenport, Acting New Jersey Attorney General; Office of the New Jersey Attorney General, Newark, New Jersey; Raúl Torrez, New Mexico Attorney General, Office of the New Mexico Attorney General, Santa Fe, New Mexico; Letitia James, New York Attorney General, Office of the New York Attorney General, New York, New York; Dan Rayfield, Oregon Attorney General, Office of the Oregon Attorney General, Salem, Oregon; Peter F. Neronha, Rhode Island Attorney General, Office of the Rhode Island Attorney General, Providence, Rhode Island; Charity R. Clark, Vermont Attorney General, Office of the Vermont Attorney General, Montpelier, Vermont; Joshua L. Kaul, Wisconsin Attorney General, Office of the Wisconsin Attorney General, Madison, Wisconsin; for Amici Curiae Washington, Massachusetts, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Wisconsin. Amy Whelan, National Center For LGBTQ Rights, Sacramento, California; Jennifer L. Levi and Donovan C. Bendana, GLBTQ Legal Advocates & Defenders, Boston, Massachusetts; for Amici Curiae National Center for LGBTQ Rights, National Center for Youth Law, and GLBTQ Legal Advocates & Defenders.  QUEERDOC, PLLC V. USDOJ 7 Joel McElvain and Alethea A. Swift, Democracy Forward Foundation, Washington, D.C., for Amicus Curiae American Academy of Pediatrics. Karen L. Loewy, Lambda Legal Defense & Education Fund Inc., Washington, D.C.; Omar Gonzalez-Pagan, Lambda Legal Defense & Education Fund Inc., New York, New York; Morgan Walker, Lambda Legal Defense & Education Fund Inc., Dallas, Texas; A.D. Lewis, Lambda Legal Defense & Education Fund Inc., Los Angeles, California; for Amicus Curiae Lambda Legal Defense & Education Fund Inc. OPINION BEA, Circuit Judge: As part of an ongoing investigation into potential violations of federal health care laws, the United States Department of Justice (DOJ) issued an administrative subpoena to QueerDoc pursuant to the Health Insurance Portability and Accountability Act (HIPAA). QueerDoc is an online medical clinic that treats patients, including minors, who suffer from gender dysphoria. An interested patient, after an introductory meeting and the completion of some online forms, can have a “medical visit” that consists of a videoconference with a licensed medical professional. After this virtual appointment, a patient may be diagnosed with gender dysphoria and prescribed puberty blockers and cross-sex hormones. 8 QUEERDOC, PLLC V. USDOJ QueerDoc commenced this action by filing a motion to quash the subpoena in federal district court. The parties did not dispute that DOJ had statutory authority to issue the subpoena. However, the district court found the subpoena unenforceable because DOJ had issued it for an “improper purpose”: to achieve the President’s policy objective of “eliminating gender-affirming care.” The district court thus quashed the subpoena in its entirety. We hold that QueerDoc has not met its heavy burden of showing that the subpoena was issued for an improper purpose. Consistent with the presumption of regularity and the high standard required to quash an administrative subpoena on improper purpose grounds, the Executive Branch’s public opposition to “gender-affirming care” is insufficient to show that an agency within the Executive Branch issued an otherwise permissible HIPAA subpoena in bad faith. The President may direct DOJ to exercise its statutory authority in a manner that aligns with his broader policy goals. Accordingly, we reverse the district court’s order quashing the subpoena in its entirety and remand for further proceedings. I A The Health Insurance Portability and Accountability Act of 1996 (HIPAA) authorizes the Attorney General or his designee to issue a subpoena in “any investigation of . . . a Federal health care offense.” 18 U.S.C. § 3486(a)(1)(A)(i)(I). “Federal health care offense,” defined at 18 U.S.C. § 24(a), includes any prohibited acts under the Federal Food, Drug, and Cosmetic Act (FDCA) and related conspiracies. See 21 U.S.C. § 331.  QUEERDOC, PLLC V. USDOJ 9 The FDCA outlaws the introduction into interstate commerce of “any new drug” unless the Food and Drug Administration (FDA) has approved a new drug application (NDA) for that drug. 21 U.S.C. §§ 331(d), 355(a). The NDA must demonstrate that a drug is safe and effective for a certain range of uses; the FDA approves the drug only for those specified uses. Id. § 352(f); 21 C.F.R. § 201.5. The FDA also approves the drug’s labeling, which specifies the approved uses and provides directions for administering the drug in accordance with those uses. 21 C.F.R. §§ 201.5, 201.55–201.57. Manufacturing, promoting, or labeling a drug for non-FDA-approved uses, known as “off-label uses,” may violate the FDCA’s prohibition on misbranding. See 21 U.S.C. §§ 352(a), (f), 355(a). QueerDoc operates in this highly regulated industry. QueerDoc holds itself out as a “telehealth provider of gender affirming care” that offers services to patients, including minors, in ten states. A person who lives in one of these states and believes that he may suffer from gender dysphoria can go to QueerDoc’s public website and register for a free fifteen-minute consultation regarding potential treatment plans. See QueerDoc, Telemedicine Services, https://perma.cc/EQW5-C7WT; QueerDoc, Youth Gender Care, https://perma.cc/23UZ-7YWE. Assuming the prospective patient wishes to proceed, he will upload various medical records and consent forms to QueerDoc’s online “patient portal” and will then have an hour-long medical visit by videoconference with one of QueerDoc’s licensed medical professionals. See QueerDoc, Telemedicine Services. After the visit, the doctor may render a diagnosis (here, of gender dysphoria), refer the patient to another clinic for testing or further treatment, and prescribe drugs for the patient. See QueerDoc, Telemedicine Services; QueerDoc, 10 QUEERDOC, PLLC V. USDOJ Youth Gender Care; QueerDoc, Our Pricing, https://perma.cc/FZ7E-MTT2. The drugs that QueerDoc prescribes to its patients fall within one of two categories: “puberty blockers” and “cross- sex hormones.” The term “puberty blockers” refers to a set of prescription drugs that block the natural production of sex hormones, thereby suppressing the effects of normal puberty in an adolescent’s body. Report, U.S. Dep’t of Health and Human Services, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices (“HHS Report”) at 116–17 (Nov. 19, 2025), https://perma.cc/ZMA3-YPQ2. The term “cross-sex hormones” refers to a set of prescription drugs intended to alter a person’s secondary sexual characteristics so that they resemble those of the opposite sex (e.g., estrogen for males; testosterone for females). Id. at 123. Neither puberty blockers nor cross-sex hormones have been approved by the FDA for the purpose of treating gender dysphoria. 1 All use of these drugs to treat gender dysphoria is “off-label.” 1 The FDA has approved puberty blockers for other uses, including the treatment of central precocious puberty (CPP), a condition in which the pituitary gland is activated prematurely, sometimes during infancy or early childhood. See HHS Report, supra, at 115–16. CPP is associated with many “negative health outcomes,” including decreased adult height. Id. Thus, puberty blockers are approved to treat CPP in youths but not to treat gender dysphoria. Moreover, because puberty blockers are administered to CPP patients differently from the way they are administered to patients with gender dysphoria, the side effects of the latter treatment are unknown. See United States v. Skrmetti, 605 U.S. 495, 533 (2025) (Thomas, J., concurring) (“To treat precocious puberty, puberty blockers are administered until the age appropriate for puberty; to treat gender dysphoria, however, puberty blockers are administered to stop puberty throughout the years it would normally occur.”).  QUEERDOC, PLLC V. USDOJ 11 Although QueerDoc prescribes puberty blockers and cross-sex hormones, it does not manufacture or distribute these drugs. In addition to providing medical services, QueerDoc operates a public website that informs readers about various matters pertaining to “gender-affirming care.” For example, two of QueerDoc’s webpages provide written and visual instructions for injecting cross-sex hormones into one’s own body. QueerDoc, Tips for Less Painful Injections, https://perma.cc/6TC5-T84R; QueerDoc, Self-Injections, https://perma.cc/3UTA-QKEQ. Other webpages provide links to pharmacies from which a person may obtain puberty blockers and cross-sex hormones and advise the reader on how to submit insurance claims for these drugs. QueerDoc, Pharmacy Options, https://perma.cc/XLL9- 9286; QueerDoc, Insurance Dictionary, https://perma.cc/PRC8-KVKT. On another webpage, QueerDoc claims that the effects of puberty blockers are “completely reversible.” QueerDoc, Youth Gender Care, https://perma.cc/23UZ-7YWE. It is generally understood that the FDCA does not regulate core aspects of medical practice, such as a doctor’s choice of which drug to prescribe to a patient. See, e.g., U.S. Food and Drug Admin., Legal Status of Approved Labeling for Prescription Drugs; Prescribing for Uses Unapproved by the Food and Drug Administration, 37 Fed. Reg. 16,503, 16,504 (Aug. 15, 1972) (“Congress did not intend the [FDA] to regulate or interfere with the practice of medicine.”). State law and professional standards of practice regulate a doctor’s ability to prescribe drugs for off-label uses. The FDCA, in contrast, regulates the labeling and branding of drugs and their distribution into the national market. As relevant here, the FDCA prohibits the “misbranding” of a drug. 21 U.S.C. §§ 331(a)–(b), 352. One way to 12 QUEERDOC, PLLC V. USDOJ “misbrand” a drug is to publish false or misleading labeling of that drug. Id. § 352(a). Under the FDCA, “labeling” includes all “labels and other written, printed, or graphic matter (1) upon any article or any of its containers or wrappers, or (2) accompanying such article.” Id. § 321(m). A piece of “labeling” may “accompany” a drug even if it is physically separated from the drug’s container. See Kordel v. United States, 335 U.S. 345, 350 (1948) (“No physical attachment . . . is necessary.”). The FDA has given “labeling” a broad definition that includes virtually any “printed, audio, or visual matter descriptive of a drug.” 21 C.F.R. § 202.1(l)(2). The off-label use of puberty blockers and cross-sex hormones to treat minors with gender dysphoria is the subject of “fierce scientific and policy debates,” United States v. Skrmetti, 605 U.S. 495, 525 (2025), and reflects a “deep conflict over human nature.” State v. Loe, 692 S.W.3d 215, 239 (Tex. 2024) (Blacklock, J., concurring). The Trump Administration has taken one side of this dispute. On January 20, 2025, President Trump signed Executive Order 14,168 (EO 14,168), which declared that the United States “recognize[s] two sexes, male and female,” and “[t]hese sexes are not changeable.” Exec. Order No. 14,168, 90 Fed. Reg. 8615, § 2 (Jan. 20, 2025). On January 28, 2025, President Trump signed Executive Order 14,187 (EO 14,187), which declared that the federal government would not “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.” Exec. Order 14,187, 90 Fed. Reg. 8771, § 1 (Jan. 28, 2025). Section 8(c) of EO 14,187 directed DOJ to “prioritize investigations” into “violations of the [FDCA] by any entity that may be misleading the public about long-term side effects of chemical and surgical mutilation.” Id. § 8(c). Section 11(b)  QUEERDOC, PLLC V. USDOJ 13 provided that EO 14,187 “shall be implemented consistent with applicable law.” Id. § 11(b). On April 22, 2025, then-Attorney General Pamela Bondi circulated to all DOJ employees a memorandum (the “Bondi Memo”) to implement § 8(c) of EO 14,187. To that end, the Bondi Memo directed the Consumer Protection Branch, an office within the Civil Division of DOJ, to conduct “appropriate investigations of any violations of the [FDCA] by manufacturers and distributors engaged in misbranding by making false claims about the on- or off-label use of puberty blockers, sex hormones, or any other drug used to facilitate a child’s so-called ‘gender transition.’” The Bondi Memo took the position that “the promotion of off-label uses of hormones . . . run[s] afoul of the FDA’s prohibitions on misbranding and mislabeling.” The Bondi Memo stated a goal: to “bring [gender-affirming care] to an end.” On June 11, 2025, Brett Shumate, Assistant Attorney General for the Civil Division, circulated to all Civil Division employees a memorandum (the “Shumate Memo”) that further refined the directives in EO 14,168, EO 14,187, and the Bondi Memo. Relevant here, the Shumate Memo directed the Civil Division to “prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities” for “possible violations of the [FDCA].” B 1 On June 11, 2025, Assistant Attorney General Shumate served QueerDoc with the present subpoena. The subpoena 14 QUEERDOC, PLLC V. USDOJ ordered QueerDoc to produce, no later than July 9, 2025, the following documents: Request 1: Personnel files for (i) QueerDoc executives; (ii) QueerDoc employees or contractors who are authorized to prescribe medications or perform medical evaluations; and (iii) QueerDoc employees or contractors who are engaged in billing activities. Requests 2–6: Documents relating to billing, coding, and reimbursement practices in the provision of “gender- related care” to minors, including billing records, insurance claims, internal protocols, and training materials. Requests 7–9: Communications between QueerDoc and drug manufacturers, salespeople, and pharmacies relating to the use of puberty blockers and hormones in minors for the purpose of “gender- related care.” Request 10: Records of sponsorships or contracts between  QUEERDOC, PLLC V. USDOJ 15 QueerDoc and any manufacturer of puberty blockers or hormones or any pharmacy that distributes these drugs. Requests 11–13: Patient records for any patient who was prescribed puberty blockers or hormone therapy, including medical records describing the basis for the prescription. For minor patients who were prescribed puberty blockers, documents relating to informed consent, patient intake, and parental authorization, including disclosures about off-label use of puberty blockers and the associated risks. Requests 14–15: Records of communications between QueerDoc and drug manufacturers, pharmacies, or government agencies relating to the safety of puberty blockers and hormones in the treatment of minors. Documents relating to any adverse effects or “unfavorable consequence[s]” of 16 QUEERDOC, PLLC V. USDOJ “gender-related care” in minor patients. The subpoena stated that production of the documents was “necessary in the performance of the responsibility of the [DOJ] to investigate Federal health care offenses as defined in 18 U.S.C. § 24(a).” On June 26, 2025, QueerDoc’s counsel and three DOJ attorneys met by videoconference to discuss the subpoena. QueerDoc’s counsel asked about the basis for DOJ’s investigation of QueerDoc. One DOJ attorney referred to the directives contained in EO 14,168, EO 14,187, and the Bondi Memo, and explained that his office had been “tasked with investigating potential violations of the [FDCA],” but did not offer specific reasons for investigating QueerDoc other than its prominence as a provider of “gender-affirming care.” DOJ stated that although it would require QueerDoc to begin production by July 9, it did not expect that production would be completed by that date. 2 On July 8, 2025, QueerDoc filed a motion to quash the subpoena in the United States District Court for the Western District of Washington pursuant to 18 U.S.C. § 3486(a)(5). See Motion to Quash Subpoena, No. 2:25-mc-00042-JNW (W.D. Wash., July 8, 2025), ECF Doc. 1. QueerDoc did not claim that DOJ lacked statutory authority to issue this subpoena. See id. at 9. QueerDoc instead argued that the subpoena was unenforceable, irrespective of statutory authority, because DOJ had issued it for an “improper purpose.” Id. at 6–9. Alternatively, QueerDoc argued that the subpoena was invalid because its document requests  QUEERDOC, PLLC V. USDOJ 17 were “overbroad” and compliance with them would be “unduly burdensome.” Id. at 9–12. QueerDoc asserted that the “improper purpose” for this subpoena originated “[a]t the highest levels of government.” Id. at 8. QueerDoc argued that the “true purpose” of § 8(c) of EO 14,187 was to “downsize or eliminate all gender- affirming care.” Id. at 7 (emphasis in original) (internal quotation marks omitted). QueerDoc contended that because DOJ issued the subpoena to implement § 8(c) of EO 14,187, it had issued the subpoena to achieve the same goal as the Administration: to “end” the provision of gender- affirming care. Id. at 4, 8. Because “[e]nding gender affirming care” was not a “valid” purpose of a HIPAA subpoena, QueerDoc argued, this subpoena should be quashed. Id. at 6–9. QueerDoc did not contend that any of DOJ’s investigators harbored illicit motives. Rather, QueerDoc asserted that the Administration’s directives and public statements themselves were sufficient proof of improper purpose. Id. at 8–9 (“The Court can—and should—find improper purpose and bad faith from [the Administration’s] statements alone.”). DOJ filed a response arguing that the Administration’s “position as to gender-related medical treatments for minors” was not a valid reason to quash the subpoena. DOJ emphasized that a court’s duty in a subpoena-enforcement proceeding is to ensure that the investigating agency has acted pursuant to statutory authority. Because it was undisputed that HIPAA authorized DOJ to issue the subpoena, DOJ argued that the district court should enforce it. See 18 U.S.C. § 3486(c). Two months after filing its response, and one month before the district court issued its order quashing the 18 QUEERDOC, PLLC V. USDOJ subpoena, DOJ tried to supplement the record with a declaration from Allan Gordus, the Assistant Director of the Consumer Protection Branch (the “Gordus Declaration”). The Gordus Declaration explained DOJ’s reasons for believing that QueerDoc may be engaged in the “misbranding” of puberty blockers and cross-sex hormones through false or misleading labeling. DOJ attempted to file the Gordus Declaration pursuant to a local rule that permits a party to “add an additional document in support of a previous filing.” W.D. Wash. Loc. Civ. R. 7(m). 3 On October 27, 2025, the district court quashed the subpoena in its entirety on the ground that DOJ had issued it for an “improper purpose.” QueerDoc, PLLC v. U.S. Dep’t of Just., 807 F. Supp. 3d 1295, 1301–04 (W.D. Wash. 2025). The district court first analyzed the Administration’s general policy on “gender-affirming care.” See id. at 1302–03. Based on EO 14,168, EO 14,187, the Bondi Memo, the Shumate Memo, and public statements from the Administration, the district court found that “the Administration’s explicit agenda” was to “downsize or eliminate all gender-affirming care.” Id. at 1303 (internal quotation marks omitted). The district court concluded that this “agenda” was improper because its objective—“the elimination of medical care that Washington and other states explicitly protect”—was one that “the Administration cannot accomplish . . . .” Id. at 1301. The district court then imputed that improper purpose to DOJ’s investigation of QueerDoc: Because DOJ “implemented [the Administration’s] directives through [the issuance of] administrative subpoenas,” the district court concluded that DOJ issued the subpoena to QueerDoc for an “improper purpose.” Id. at 1302–04.  QUEERDOC, PLLC V. USDOJ 19 The district court also noted that the “mismatch” between QueerDoc’s business activities and the stated purpose of the investigation demonstrated the subpoena’s “pretextual nature.” Id. at 1303. While acknowledging that “the government need not justify its decision to open an investigation” in the typical case, the district court subjected DOJ’s reasoning to a “more muscular review.” Id. at 1302. Turning to the sufficiency of DOJ’s explanation, the district court found that DOJ’s “inability to articulate why it is investigating QueerDoc” “confirm[ed]” that the subpoena was issued for the improper purpose of ending “gender- affirming care.” Id. at 1303. Because the district court quashed the subpoena in its entirety on improper purpose grounds, it did not reach QueerDoc’s arguments regarding overbreadth and undue burden. Id. at 1304. The district court also suggested that DOJ had issued the subpoena under its valid HIPAA authority, although QueerDoc had not raised the issue of statutory authority in its motion to quash. See QueerDoc, 807 F. Supp. 3d at 1301 n.1. Finally, the district court struck the Gordus Declaration on the ground that it did not comply with Local Civil Rule 7(m). See id. at 1303 n.2. The district court noted that it would have quashed the subpoena even if it had considered the Gordus Declaration, which, in the court’s view, “further demonstrate[d] the pretextual nature of the subpoena.” Id. This appeal followed. II We have jurisdiction pursuant to 28 U.S.C. § 1291. In re Subpoena Duces Tecum, 228 F.3d 341, 346–47 (4th Cir. 2000) (orders enforcing or quashing administrative subpoenas are “final” because “there is no ongoing judicial 20 QUEERDOC, PLLC V. USDOJ proceeding that would be delayed by an appeal.”); see Cobbledick v. United States, 309 U.S. 323, 330 (1940) (proceedings to enforce administrative subpoenas are “self- contained, so far as the judiciary is concerned[.]”). We review the district court’s order quashing an administrative subpoena for abuse of discretion. McLane Co. v. EEOC, 581 U.S. 72, 75 (2017). We will uphold the district court’s findings of fact unless they are “illogical, implausible, or without support in inferences that may be drawn from the record.” United States v. Hinkson, 585 F.3d 1247, 1263 (9th Cir. 2009) (en banc). However, “the District Court’s latitude does not extend to legal issues about what counts as an illicit motive,” United States v. Clarke, 573 U.S. 248, 256 (2014), and we review such legal issues de novo. Hinkson, 585 F.3d at 1261–62. III We begin by describing a federal court’s authority to enforce or quash an administrative subpoena before explaining why the district court exceeded its authority in this case. A An administrative agency’s authority to issue subpoenas is created by statute. Peters v. United States, 853 F.2d 692, 696 (9th Cir. 1988). Just as Congress delegated to agencies the power to execute federal law in particular domains, Congress delegated to certain agencies the “power[] of original inquiry” to fulfill their statutory mandates. United States v. Morton Salt Co., 338 U.S. 632, 642 (1950). As part of this scheme, Congress made federal courts the exclusive bodies that could enforce, modify, or quash administrative subpoenas. In re Nat’l Sec. Letter, 33 F.4th 1058, 1063 (9th  QUEERDOC, PLLC V. USDOJ 21 Cir. 2022) (“[W]hile an agency may issue a subpoena without prior judicial approval, it must invoke the aid of a federal court to enforce it.”). The scope of a court’s inquiry during a subpoena-enforcement proceeding, however, is “strictly limited.” FTC v. Texaco, Inc., 555 F.2d 862, 871– 72 (D.C. Cir. 1977) (en banc). If enforcing a subpoena entailed rigorous, trial-like proceedings, “the investigative process [w]ould be completely disrupted,” agencies would be “diverted from their legitimate duties,” and the “injection of collateral issues . . . would make the investigation interminable.” Hannah v. Larche, 363 U.S. 420, 443 (1960). Hence, these proceedings are “summary in nature.” United States v. Stuart, 489 U.S. 353, 369 (1989). The court’s primary role is to ensure that the agency does not act “arbitrarily or in excess of [its] statutory authority.” Okla. Press Publ’g Co. v. Walling, 327 U.S. 186, 216 (1946). The agency bears the initial burden of showing that (1) Congress empowered the agency to issue investigatory subpoenas; (2) the agency followed applicable procedures; and (3) the subpoena sought evidence that could be relevant and material to a statutorily authorized investigation. United States v. Golden Valley Elec. Ass’n, 689 F.3d 1108, 1113 (9th Cir. 2012). An affidavit in which the investigating official declares a legitimate basis for the subpoena is sufficient to establish the agency’s prima facie case for enforcement. FDIC v. Garner, 126 F.3d 1138, 1143 (9th Cir. 1997). Once the agency has established its prima facie case, the recipient is left with “few defenses” against enforcement. United States v. Derr, 968 F.2d 943, 945 (9th Cir. 1992). One defense is that enforcement of the subpoena would be an “abusive use of the court’s process” because, although the subpoena was authorized by statute, the agency issued it 22 QUEERDOC, PLLC V. USDOJ for an “improper purpose” or in bad faith. United States v. Powell, 379 U.S. 48, 51, 58 (1964). An “abuse of process” would occur if a court enforced an administrative subpoena that the agency had “issued for an improper purpose, such as to harass [the recipient] or to put pressure on him to settle a collateral dispute, or for any other purpose reflecting on the good faith of the particular investigation.” Id. at 58. A party that seeks to quash a subpoena on this basis bears a “heavy” burden to produce “specific facts and evidence to support his allegations of bad faith or improper purpose.” United States v. Jose, 131 F.3d 1325, 1328 (9th Cir. 1997) (en banc) (citation and internal quotation marks omitted). A federal court has the inherent power to ensure that its process is not abused by a government that acts from illicit motives. See Powell, 379 U.S. at 58 (“It is the court’s process which is invoked to enforce the [subpoena], and a court may not permit its process to be abused.”). The authority to quash an administrative subpoena when its enforcement would abuse the court’s process derives from this inherent power. SEC v. ESM Gov’t Sec., Inc., 645 F.2d 310, 317 (5th Cir. Unit A 1981) (“The equitable powers of the courts of the United States . . . over their own process, to prevent abuse, oppression and injustice, are inherent. . . . The Supreme Court’s directive[] in Powell . . . leave[s] no doubt that this power may be properly invoked in cases involving the enforcement of administrative subpoenas.”); see also Chapman v. Maren Elwood Coll., 225 F.2d 230, 234 (9th Cir. 1955) (explaining that a subpoena-enforcement proceeding is “equitable in character”). The prohibition against bad-faith subpoenas is also grounded in the Fourth Amendment’s requirement that a subpoena be reasonable. Golden Valley, 689 F.3d at 1113. Whether the authority  QUEERDOC, PLLC V. USDOJ 23 rests on our inherent equitable power or on the Fourth Amendment, the inquiry remains the same. The doctrine of “improper purpose” arose from the use of civil tax summonses by the Internal Revenue Service (IRS). In the term before it decided United States v. Powell, the Supreme Court noted that the recipient of an IRS civil tax summons could raise the defense that the IRS had issued the summons “for the improper purpose of obtaining evidence for use in a criminal prosecution.” Reisman v. Caplin, 375 U.S. 440, 449 (1964). This defense came from the text of the Internal Revenue Code, which enumerated four valid purposes of a civil tax summons. See id. at 442 n.1. Moreover, there was a separate concern that if the IRS used its civil summons authority to obtain information to be used later in a criminal investigation, it would circumvent rules of criminal procedure intended to protect the rights of defendants. See United States v. LaSalle Nat’l Bank, 437 U.S. 298, 312 (1978). Therefore, the Supreme Court held that the IRS could not issue a civil summons if there was a “pending criminal charge” or if the IRS was conducting “an investigation solely for criminal purposes.” Donaldson v. United States, 400 U.S. 517, 533 (1971). The Supreme Court later added that the IRS could not use its civil summons authority in “bad faith,” which would occur if the IRS issued a summons to investigate potential tax violations after the IRS had referred those violations to DOJ for criminal prosecution. LaSalle, 437 U.S. at 311–13, 316. Although the leading cases on “improper purpose” and “bad faith” involve the use of IRS civil tax summonses in connection with criminal investigations, the doctrine also applies to extreme cases of official misconduct. For example, it is improper to issue a subpoena solely for the benefit of a private party, rather than for a public-regarding 24 QUEERDOC, PLLC V. USDOJ purpose. See United States v. Cortese, 614 F.2d 914, 921 (3d Cir. 1980) (if a private informant was “pursuing its own business purpose by giving the IRS data,” and the “entire motivation” for the IRS investigation was this private party’s information, an improper purpose may exist). An agency investigator may not issue a