Hospitals Settle with DOJ to End Gender-Affirming Care for Minors

At least six major hospitals—including New York University Langone Health, the University of Pittsburgh Medical Center, Cleveland Clinic, Connecticut Children’s Hospital, Mount Sinai Health System, and Texas Children’s Hospital—have entered settlements with the U.S. Department of Justice that prohibit the provision of puberty blockers, hormone therapy, or gender-affirming surgery to patients under 19. The agreements also require the hospitals to make payments to the federal government for “detransition” costs: NYU agreed to pay $8.5 million and UPMC $950,000. In return, the DOJ will drop investigations into prior care and halt subpoenas seeking patient records. The hospitals assert the deals do not affect their pediatric mental-health services for transgender youth.

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The settlements follow a series of federal actions launched after President Donald Trump returned to office in January 2025. An executive order that month called for cutting federal support for gender transitions in minors, and Medicaid coverage for such care was barred. In July 2025 the Justice Department began issuing subpoenas to hospitals for names of patients receiving gender-affirming treatment. Several institutions successfully blocked the record-turnover demands in district courts, but a 2-1 decision by the 9th U.S. Circuit Court of Appeals last month upheld the administration’s authority to pursue the subpoenas, stating the goal of ending the care is not “improper.” At least 27 states now have laws restricting or prohibiting gender-affirming care for minors, and more than two dozen hospitals in states without bans have also stopped offering the services.

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U.S. NYU Langone issued a statement that the settlement “protects patients and their families” by removing the threat of having to disclose confidential information about minors who received such care. The Justice Department noted that some providers have also agreed to help fund medical costs for children who choose to “detransition.” Major medical organizations—including the American Medical Association and the American Academy of Pediatrics—continue to support the availability of gender-affirming treatment for youth.

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• “It’s a really dangerous precedent when the federal government is allowed to politicize any one group of people’s care and end it,” — Eliel Cruz, a cofounder of the Gender Liberation Movement

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