Full Breakdown
UPMC Settles DOJ Investigation, Halting Gender-Affirming Care for Minors
By Drooid · · How we work
Core Settlement and Immediate Impact
On September 18, the U.S. Department of Justice announced that the University of Pittsburgh Medical Center (UPMC) would pay $950,000 to resolve a federal investigation into alleged billing practices tied to gender-affirming care for minors. The settlement requires UPMC to cease providing gender-affirming medical services to patients under 19 years of age for ten years. In exchange, the agreement adds privacy, confidentiality and non-prosecution protections for patients, legal guardians, providers and employees, and contains no admission of wrongdoing.
Background & Context
Gender-affirming care—including puberty blockers and hormone therapy—remains legal in Pennsylvania. UPMC stopped offering certain treatments to patients under 19 in June 2025, citing risk of federal prosecution. The September settlement follows a similar agreement reached earlier with New York University Langone Hospitals, which paid $8.5 million.
Data & Statistics
- Settlement payment: $950,000 (UPMC).
- Comparable NYU Langone payment: $8.5 million.
- Six complaints filed with the Pennsylvania Human Relations Commission on behalf of transgender children and 18-year-olds denied care.
- The DOJ alleges UPMC billed insurers using gender-dysphoria diagnosis codes that the government contends were inaccurate, potentially affecting about 15 categories of information previously sought in a subpoena.
Official Statements & Responses
The hospital said it chose the agreement to avoid prolonged litigation and to stay focused on its core mission of patient care.
Criticism & Opposition
Activists argue the settlement will end life-saving treatment for transgender youth. Attorney Elizabeth Lester-Abdalla of the Women’s Law Project noted the agreements allow UPMC to resume treatment if a Pennsylvania or U.S. Supreme Court ruling finds the halt unlawful.
On-the-Ground Reports
In late September, more than 30 members of the transgender community and allies, organized by ACT UP Pittsburgh, picketed outside UPMC Children’s Hospital in Lawrenceville.
Conflicting Reports & Gaps
The two publicly posted agreements contain contradictory language about the age cutoff. One document references “individuals under 18,” while another defines the covered conduct as applying to “an individual under 19.” UPMC has not clarified how 18-year-old patients—legally adults in Pennsylvania—will be treated under the settlement. The Human Relations Commission has not issued a ruling on the six pending complaints; if no decision is rendered by the end of the month, complainants could pursue civil action.
Verbatim Quotes
- “The Department of Justice is fighting to protect our nation’s children and working tirelessly to reach agreements with hospitals to end so-called ‘gender affirming care’ for minors,” — Attorney General Todd Blanche.
- “Today’s resolutions send a clear message: hospitals that target children in these practices and then fraudulently obtain payment for the procedures will be held to account.” — The Justice Department
What’s Next
The settlement includes a clause that terminates UPMC’s obligations if a final ruling by the Pennsylvania Supreme Court or the United States Supreme Court determines that the cessation of care violates federal or state law. The Human Relations Commission is expected to issue a decision on the pending discrimination complaints by the end of the month; a failure to do so could trigger lawsuits from the families involved.
