The structural question

Let me set aside, for a moment, the specific controversy over gender-related medical care for young people. That debate is genuine and contested, and reasonable people land in different places. I have my own views about parental authority and the proper limits of medical licensing boards. But none of that is the first question raised by this story. The first question is simpler and older: may the federal executive demand the private medical files of individual patients — including minors — and the names of their doctors?

The burden of proof is on the government

I spent my career arguing that the burden of proof in any expansion of government power must rest with the government, not with the citizen. That principle is not ideological decoration. It is the load-bearing wall of a free society. [Inference, not recollection: if the DOJ is seeking these records outside a specific criminal proceeding with individualized probable cause, the burden it must meet is very high indeed.] A general demand for clinic files and staff rosters looks less like targeted law enforcement and more like an instrument of pressure — against patients, against families, and against physicians.

What economic freedom taught us about political freedom

I argued in Capitalism and Freedom that economic freedom and political freedom are inseparable. You cannot confiscate a person's livelihood, their contracts, their professional records, without also threatening their civil standing. Medical privacy is part of that same fabric. A government that can reach into a clinic and extract the names of patients — whatever the stated justification — has acquired a tool that history suggests will not stay narrowly used.

California's resistance is not an ideological quirk

Some will frame California's legal resistance as partisan obstruction. I would frame it differently. Federalism was designed precisely for moments like this one: to give states the standing to act as a check on federal overreach. I was not, in my lifetime, a defender of every use to which states put their autonomy. But the existence of that check — the ability of a state to say "show us your legal authority" — is worth defending regardless of which party is in Washington.

The counsel that follows

Whatever the courts ultimately decide on the merits here, the episode carries a lesson that transcends this particular controversy. Governments acquire the habit of surveillance gradually, and they rarely surrender it voluntarily. The right response — for legislators, for courts, and for citizens — is to insist on precise legal authority, narrow scope, and genuine individualized cause before any executive agency may open a medical file. That standard should apply equally regardless of which administration is asking, and regardless of what it claims to be looking for.