Two of the country’s largest health systems have agreed to stop providing gender-affirming medical care to minors following investigations by the Trump administration’s Department of Justice.
NYU Langone Hospitals and the University of Pittsburgh Medical Center (UPMC) entered into separate agreements with the DOJ on September 18, ending federal investigations into their pediatric gender-affirming care programs. Under the settlements, both healthcare systems agreed to stop providing puberty blockers, hormone therapy, and gender-affirming surgeries to patients under 18.
NYU Langone also agreed to pay $8.5 million, while UPMC will pay $950,000. The DOJ said the payments resolve allegations connected to federal healthcare laws and billing practices. Neither healthcare system admitted wrongdoing, and the DOJ acknowledged that the allegations resolved through the agreements had not resulted in a determination of liability.
UPMC said its agreement includes protections for patients, guardians, healthcare providers, and employees while preserving the confidentiality of sensitive medical information.
“UPMC chose to resolve the matter to avoid prolonged litigation, protect patients and families from unnecessary disclosure of sensitive personal and health information, protect employees, and remain focused on patient care and advancing its core mission,” the healthcare system says in a statement reported by WTAE.
NYU Langone similarly said resolving the investigation would allow the healthcare system to avoid prolonged litigation and continue focusing on patient care, medical research, and physician education.
The settlements are part of a broader federal effort targeting gender-affirming healthcare for transgender minors.
President Donald Trump directed the Justice Department in 2025 to prioritize investigations involving gender-affirming medical treatment for young people. The DOJ subsequently launched a nationwide investigation examining potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal healthcare laws. The department has also alleged that some providers may have used improper diagnosis codes or billing practices when seeking reimbursement for treatment.
Those remain allegations. NYU Langone and UPMC expressly denied the DOJ’s claims.
The federal investigations have included subpoenas seeking medical information connected to transgender patients who received gender-affirming care as minors. Some patients and healthcare institutions have challenged those demands in federal court, raising concerns about medical privacy and the scope of the government’s investigations.
The agreements with NYU Langone and UPMC follow similar settlements involving other major healthcare systems. Earlier in September, Mount Sinai Health System reached an agreement with the DOJ requiring it to end gender-affirming medical treatment for minors.
Other healthcare systems that have reached federal agreements include Texas Children’s Hospital, Cleveland Clinic, and Connecticut Children’s Hospital. At least six major hospital systems have now entered agreements with the Trump administration restricting gender-affirming treatment for minors, according to the Associated Press.
The settlements come as access to gender-affirming healthcare for transgender youth continues to shrink across the United States through a combination of state restrictions, federal actions, hospital policy changes, and litigation.
Major medical organizations have historically supported access to individualized gender-affirming healthcare for transgender adolescents, while the Trump administration has challenged the use of puberty blockers, hormones, and surgeries for minors and sought to restrict federal support for those treatments.
Graphic courtesy of NYU Langone Health
