The Trump administration’s Justice Department encountered significant resistance as federal judges across the country repeatedly rejected its requests for hospitals to disclose internal records regarding transgender medical care provided to minors.
By late April, federal judges in Boston, Philadelphia, Pittsburgh, Los Angeles, and Seattle had either dismissed or significantly limited the administration’s demands for hospitals to submit patient records to federal authorities.
Rather than abandoning the effort, the administration shifted its approach in April, directing the case to the Fort Worth courthouse in the Northern District of Texas, where virtually all matters are assigned to either Chief Judge Reed O’Connor or Judge Mark T. Pittman, a Trump appointee.
Notably, no Texas hospitals were involved in the transgender care controversy—Texas lawmakers had prohibited gender-affirming care for minors in 2023. Nevertheless, the Justice Department petitioned the Texas court to enforce a subpoena against Rhode Island Hospital, maintaining that its nationwide investigation fell within the Northern District of Texas’s jurisdiction.
Judge O’Connor, appointed by President George W. Bush and elevated to chief judge last August, accepted this reasoning. He has cultivated a reputation as a reliable conservative voice on the federal bench.
He granted the motion, permitting the hospital to release sensitive personal information, including the names and Social Security numbers of minor patients.
“The subpoena’s demands are reasonable,” he wrote.
Most of the nation’s 94 district courts distribute cases randomly among their judges.
The Northern District of Texas operates differently. Case assignments are based on the courthouse where a lawsuit is initially filed. Several courthouses are staffed by only one or two judges, enabling litigants to engage in strategic “judge shopping”—filing cases in specific locations to virtually guarantee which judge will preside.
In four of the Northern District’s seven courthouses, a single Trump appointee hears all cases. A fifth courthouse routes all matters to Judge O’Connor. In the sixth—Fort Worth—approximately 90 percent of cases are divided between Judge O’Connor and Judge Pittman.
Of the district’s nine active judges, eight were appointed by Republican presidents, with six appointed by Trump. While other districts may have higher concentrations of Trump appointees, few employ the case-assignment practices characteristic of Northern Texas. Additionally, most fall outside the jurisdiction of the U.S. Court of Appeals for the Fifth Circuit—the nation’s most conservative appellate court, which reviews appeals from Texas, Louisiana, and Mississippi.
For years, conservative advocacy groups and the Texas attorney general’s office have filed lawsuits in Northern Texas, leveraging the district’s distinctive case-assignment system. With Trump’s return to office, Judge O’Connor’s district has become an increasingly favored venue for the Justice Department.
A Justice Department spokesperson declined to comment on the practice. Judge O’Connor did not respond to interview requests.
This year, Judge O’Connor has rapidly issued rulings striking down Biden-era regulations on ghost guns and immigration courts. He has also quickly approved sweeping settlements with opponents who appeared to share the administration’s ideological positions.
Legal scholars have long noted that Democratic administrations and states have similarly utilized districts with concentrations of more liberal judges. However, many distinguish between the widespread practice of “forum shopping”—filing in regions with generally favorable judicial attitudes—and effectively selecting a specific individual judge.
Kevin Wagner, a political science professor at Florida Atlantic University, observed that the precision of venue selection in Texas is remarkable, allowing litigants to secure not merely a “favorable” jurisdiction but a “predictable” one.
The administration’s strategy of placing consequential nationwide cases before Judge O’Connor occurs simultaneously with its criticism of other judges for exceeding their authority.
Justice Department officials and Republican lawmakers have characterized trial judges exercising broad unilateral power as “rogue judges.” However, such critiques about judicial overreach rarely target judges whose sweeping decisions advance the administration’s agenda.
Assigning significant cases by geography rather than random selection “undermines the appearance of impartiality,” said Nancy Gertner, a retired federal judge and Harvard Law School lecturer, who has been critical of the Trump administration. She noted that recent attacks on judicial credibility from political branches make it “all the more important that the standards for case assignment are fair.”
Balls and Strikes
Judge O’Connor, a 61-year-old former federal prosecutor who served as a congressional aide before his 2007 judicial nomination, has established himself as a consistent skeptic of federal actions conflicting with conservative principles. In 2015, he issued orders blocking paid family leave for gay couples and invalidating a 1960s-era prohibition on interstate handgun sales.
In 2016, he struck down Obama administration guidance requiring schools to permit transgender students to use restrooms matching their gender identity. In blocking the rule nationwide, he determined that any government guidance defining “sex” to include gender identity was unlawful.
A Texas native, Judge O’Connor earned his undergraduate degree from the University of Houston and his law degree from South Texas College of Law Houston in 1989.
He served nearly a decade as an assistant U.S. attorney in the Northern District of Texas and was detailed by the Justice Department to serve as counsel to the Senate Judiciary Committee in 2003, advising Senator Orrin Hatch, Republican of Utah and the panel’s chairman. In 2005, he worked with an immigration-related subcommittee under Senator John Cornyn, Republican of Texas.
“Throughout his legal career and time on the federal bench, Judge O’Connor has called balls and strikes to help preserve our independent judiciary and uphold our Constitution, and Texas is better off for it,” Senator Cornyn said in a statement.
During Judge O’Connor’s 2007 confirmation hearing, Senator Sheldon Whitehouse of Rhode Island expressed concern about judicial nominees he perceived as feigning independence while delivering rulings aligned with their “political orthodoxy.”
In response, Judge O’Connor stated he would follow the example of judges “loyal only to the Constitution” who “call the cases as they see them.”
A Familiar Bench
Judge O’Connor’s recent prominence stems from the Northern District of Texas’s case-assignment practices.
Judge O’Connor now serves as the sole federal judge in Wichita Falls, Texas, presiding over every case filed in that division. He also handles matters in the Fort Worth division, where he was once the only judge.
All cases filed in the Abilene, Lubbock, and San Angelo divisions are heard by Judge James Wesley Hendrix, another Trump appointee. Another Trump appointee—Judge Matthew J. Kacsmaryk—handles every case in the Amarillo division. In 2023, Judge Kacsmaryk issued a widely noted ruling against the legality of mifepristone, an abortion medication, after an anti-abortion group incorporated in his district just months before filing suit there.
Miles T. Armaly, an associate professor of political science at the University of Mississippi who co-authored a study on judge shopping in May, said the district’s influence stems from its position within the Fifth Circuit, which has upheld several of Judge O’Connor’s most disputed rulings.
Nevertheless, the circuit has at times moved faster than the Supreme Court in scrutinizing other decisions, including rulings on Biden-era pistol brace regulations and a dispute between Elon Musk’s social media platform X and the liberal watchdog organization Media Matters.
Even after the Supreme Court’s decision last year limiting the authority of individual judges to block federal policies nationwide, Mr. Armaly noted, single-judge divisions remain a significant tool for litigants pursuing political objectives beyond the district.
The new restrictions on nationwide injunctions removed “one of the tools out of the tool kit,” he said, “but the construction project is still the same.”
Particularly under the second Trump administration, the Fifth Circuit has become a conduit for contested decisions that the Supreme Court has increasingly been called upon to resolve. It also stands out as the most frequently reversed appeals court.
Alexander Gouzoules, an associate professor at the University of Missouri School of Law, said the combination of factors in Texas that permits litigants to select judges with known views and survive appeal has increasingly encouraged those seeking “outlier results” to file there over the past decade.
“Any one of these problems might be solvable on its own,” he observed. “But when they’re combined with each other, there is a sort of exponential effect on the kind of destabilizing outcomes it produces.”
Single-judge divisions have drawn criticism from both parties.
In 2021, a report on patent litigation noted that litigants were directing 20 percent of all patent lawsuits nationwide to a single judge in the Western District of Texas. The study prompted Senator Thom Tillis, Republican of North Carolina, and Senator Patrick Leahy, Democrat of Vermont, to request a review; their concerns were subsequently cited by Chief Justice John G. Roberts Jr.
Mounting complaints led the Judicial Conference of the United States—the federal judiciary’s administrative and policy-making body—to adopt new nonbinding guidance in March 2024, advising judicial districts to randomly assign cases when major federal policies with nationwide implications were involved.
“The random case-assignment policy deters judge shopping,” said Judge Robert J. Conrad Jr., who heads the federal courts’ Administrative Office, in an announcement. “It promotes the impartiality of proceedings and bolsters public confidence in the federal judiciary.”
The proposed changes faced resistance in Texas.
Two weeks later, the Northern District’s then-chief judge, David C. Godbey, announced that the district’s judges had met and decided against adopting the change.
Judge O’Connor added his perspective later that year, characterizing the Judicial Conference’s recommendation as an attack on his district in a speech to the conservative Federalist Society.
He criticized the conference’s remarks as hypocritical, characterizing the Justice Department under President Joseph R. Biden Jr. as “a frequent forum shopper.” He also lamented the Judicial Conference’s decision as yielding to “external political criticism” from “so-called commentators and elected political officials” he said were determined to “undermine the judiciary.”
“Make no mistake about it: This pressure remains,” he said. “It remains a constant source of pressure and will not ease up any time soon.”
One-Day Orders
With Trump’s return to the White House, the administration has repeatedly filed significant matters in Judge O’Connor’s divisions.
Last summer, the Justice Department sued Texas in Wichita Falls, where Judge O’Connor handles all cases. The lawsuit challenged a first-of-its-kind Texas law providing in-state tuition to undocumented students. Texas legislators had unsuccessfully attempted to repeal the statute in recent years, despite its bipartisan adoption in 2011.
Rather than defending the law, Republican Texas Attorney General Ken Paxton—a close Trump ally—collaborated with the Justice Department to craft a hasty legal agreement to strike it down. Outside groups argued the proposed agreement constituted abuse of the court system, as the federal government and Texas shared the same ideological position.
Judge O’Connor approved the settlement the same day, accepting the contested position that the two-decade-old law was “invalid.” The Fifth Circuit declined to block the settlement last year but has not yet issued a final ruling on an appeal filed by a group of individuals and nonprofit organizations.
The parties exchanged positions this year when Mr. Paxton, who is campaigning for Senate in Texas with Trump’s endorsement, sued the federal government in Wichita Falls in June over a 2024 Biden-era rule permitting immigration judges to suspend certain deportation proceedings. America First Legal, a group co-founded by Stephen Miller—a senior White House adviser and architect of much of Trump’s immigration policy—assisted in representing Texas.
Once again, the two sides were ideologically aligned but formally opposed in the lawsuit. Together, they proposed an agreement eliminating immigration judges’ discretion to block deportations under certain circumstances. On the same day the lawsuit was filed, Judge O’Connor approved the settlement with a brief order.
“Dirty Pool”
In the hospital subpoena case, a Rhode Island state agency filed a new lawsuit requesting the federal court in Rhode Island to halt the out-of-state demands from Texas.
After reviewing the sequence of events, Judge Mary McElroy, a federal district judge in Rhode Island, reprimanded the Justice Department, accusing its lawyers of a “crusade to obtain transgender children’s medical records” and of abandoning her court “in favor of a distant forum that D.O.J. deems friendly to its political positions.”
During a hearing, she characterized the tactic of “shopping” the case to Texas as “dirty pool” and granted a motion to quash the subpoenas.
The Justice Department maintained it had legitimate grounds to base the investigation in North Texas. In May, Judge O’Connor ruled it was “necessary and prudent” for Rhode Island Hospital to submit the documents to him personally, should the Justice Department ultimately prevail in the complex litigation.
A Rhode Island appeals court has deferred to Judge O’Connor for now. Oral arguments in the appellate case are scheduled for October. In the interim, the hospital has begun producing records, noting the process would require “a period of months.”
In Judge McElroy’s assessment, engineering this outcome explains why the Justice Department brought the case to Northern Texas in the first place.
“You chose Judge O’Connor in Texas,” she told a Justice Department attorney in court in May. “Let’s just admit that.”