Here's a detailed analysis of the court order from the U.S. District Court, District of Massachusetts, dated May 23, 2025, regarding the case Gordon Schiff and Celeste Royce v. U.S. Office of Personnel Management et al. You can read the full text of the order by clicking here.

This order addresses a motion for a preliminary injunction filed by two physician-professors, Drs. Schiff and Royce, challenging the removal of their authored articles from a federally-hosted online patient-safety resource called PSNet. The removals stemmed from implementation of an Executive Order (EO) on "gender ideology" signed by the President in January 2025.

Key Points and Context:

  • PSNet Background: PSNet is a government-run patient safety knowledge portal operated under the Agency for Healthcare Research and Quality (AHRQ). It publishes expert commentaries and case studies on patient safety, helping medical professionals learn from diagnostic errors and improve care.

  • Plaintiffs and Their Content: Drs. Schiff and Royce had published commentaries with content referencing transgender and LGBTQ topics as part of medical discussions relevant to patient safety.

  • The Executive Order and Its Implementation: The EO directed federal agencies to recognize binary biological sex and to remove all materials that "promote or inculcate gender ideology." The Office of Personnel Management (OPM) issued a memo instructing agencies to remove outward-facing government media that promote gender ideology, interpreted by AHRQ as requiring removal of articles containing words like "transgender" or "LGBTQ."

  • Content Removal and Aftermath: The plaintiffs' articles were removed from PSNet without prior notice, based solely on word searches for prohibited terms. Attempts to repost them were conditioned on removing certain phrases related to transgender identities, which the plaintiffs refused, citing censorship and inaccuracy.

  • Legal Claims: The plaintiffs allege violations of their First Amendment free speech rights and the Administrative Procedure Act (APA), claiming the agencies acted arbitrarily, capriciously, and beyond their authority.

Court's Analysis:

  1. Standing and Jurisdiction:
    The court finds that the plaintiffs have standing because they allege direct harm to their own speech rights, not just third parties'. Arguments that the site’s technical limitations prevent redress were rejected, as standing is judged based on facts at the time the lawsuit was filed.

  2. Likelihood of Success on the Merits: 

    • The court confirms PSNet is a limited public forum. Restrictions on speech must be both reasonable and viewpoint-neutral. 
    • The government admitted to viewpoint discrimination by removing content solely because it expressed views inconsistent with the EO's stance on gender ideology. This is unconstitutional. 
    • The defendants failed to show that the restrictions were reasonable or consistent with the forum's purpose (patient safety). 
    • The plaintiffs are very likely to succeed on their First Amendment claim.

  3. Irreparable Harm: 

    • Loss of First Amendment freedoms, even temporarily, is irreparable harm. 
    • The court presumes irreparable harm due to the constitutional violation.

  4. Balance of Harms and Public Interest: 

    • The harms to plaintiffs and the public (loss of important patient safety information) outweigh any claimed administrative burden on the agencies. 
    • The court found no evidence supporting the claimed burden.

  5. APA Claims: 

    • The court preliminarily agrees the agency actions were final and likely arbitrary and capricious. 
    • OPM acted beyond its statutory authority by issuing the broad "Takedown Directive." 
    • However, no ongoing agency action was shown to justify prospective relief under the APA.

  6. Scope of Relief: 

    • The court grants an injunction requiring the defendants to restore the plaintiffs' commentaries and all other content removed by the same procedure on PSNet. 
    • The injunction is narrowly tailored to this case and does not extend to future submissions or other government forums. 
    • Broader administrative stays on future EO implementation are denied for lack of evidence of ongoing harm.

Conclusion:

The court granted the preliminary injunction in part, ordering the government to restore the plaintiffs' and similarly removed patient-safety content to PSNet, recognizing that the removal constituted unconstitutional viewpoint discrimination. The ruling emphasizes that government agencies must operate within constitutional and legal bounds even when implementing presidential directives.

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