MFIA Wins Challenge to Removal of Medical Commentary Noting LGBTQ Health Risks

The Media Freedom and Information Access (MFIA) clinic — alongside the national ACLU and ACLU Massachusetts — is representing two Harvard Medical School physicians in a First Amendment challenge to the removal of their scholarship from a government website.

Dr. Gordon Schiff and Dr. Celeste Royce each had an article taken down from Patient Safety Net (PSNet) — a resource of the Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) — for their alleged violation of President Trump’s Executive Order 14168.

The order, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” directs that “[a]gencies shall remove all statements, policies, regulations, forms, communications, or other internal and external messages that promote or otherwise inculcate gender ideology.” 

The Office of Personnel Management (OPM) issued guidance directing agencies to comply with the executive order. In response, AHRQ removed Schiff and Royce’s commentaries because both happen to reference the existence of transgender individuals, using the terms “LGBTQ” and “transgender,” according to the clinic.

Schiff’s co-authored commentary is titled “Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings.” His advice to the medical community details that the evidence-based indicators of high risk for teen suicide “include male sex, being young, veterans, Indigenous tribes, lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ).” AHRQ informed Schiff that using the “T” in “LGBTQ” violated the executive order and removed his publication, according to the clinic.

Royce’s co-authored commentary is titled “Endometriosis: A Common and Commonly Missed and Delayed Diagnosis.” Endometriosis is a condition where tissue similar to uterus lining grows outside the uterus, which can cause severe pain. Royce’s commentary states that “it is important to note that endometriosis can occur in trans and non-gender-conforming people and lack of understanding this fact could make diagnosis in these populations even more challenging.” AHRQ informed Royce that referencing the existence of transgender individuals was no longer allowed and removed her publication, according to the complaint.

MFIA and co-counsel filed suit in the U.S. District Court for the District of Massachusetts. The complaint claims that the removals constitute “censorship [that] violates the First Amendment by imposing a viewpoint-based and unreasonable restriction on Plaintiffs’ speech.” 

The complaint further asserts violations of the Administrative Procedure Act, which authorizes the judiciary to hold unlawful agency action found to be “arbitrary [or] capricious.”

MFIA and co-counsel seek declaratory and injunctive relief that would set aside OMP’s guidance and require AHRQ to restore — in addition to Schiff’s and Royce’s commentaries — all scholarship taken down from PSNet pursuant to Executive Order 14168. The complaint contends that the suit combats wider “unlawful and dangerous suppression of doctors’ speech about how to better diagnose patients.”

The Media Freedom and Information Access clinic at Yale Law School is dedicated to increasing government transparency, defending the essential work of news gatherers, and protecting freedom of expression through impact litigation, direct legal services, and policy work.

Updated 5/23/25:

On May 23, the district court entered a preliminary injunction, requiring the government to repost every article removed from PSNet pursuant to President Trump’s executive order, including Schiff and Royce’s commentaries. 

The injunction followed a May 21 hearing at which Ben Menke ’25 argued along with ACLU co-counsel Scarlet Kim ’11. The Court held that the government actions were “a flagrant violation” of the First Amendment, based on the plaintiffs’ “powerful showing of viewpoint discrimination.” The Court suggested that the government’s actions also may have violated the Administrative Procedure Act, “undermin[ing] patient safety” on a website created to protect patient safety.