Breakout New York Mayoral Contender Zohran Mamdani Wants To Spend $65 Million on Medical Gender Treatments for Minors and Adults

Zohran Mamdani, the Democratic Socialist candidate for New York City mayor, has quietly proposed channeling tens of millions of dollars in taxpayer funds to pay for medical gender-transition treatments for residents of all ages – including for minors. This city spending would counteract the sustained assault on these medical interventions – coming from the Trump administration and Congressional Republicans – which threatens treatment programs even within blue cities and states. The controversial method of providing puberty blockers, cross-sex hormones, and sometimes gender-transition surgeries — such as breast removal — to minors in particular is now at the apex of the culture wars. It has also become a flashpoint in Democrats’ battle to redefine themselves in the wake of their brutal losses in the November election.Mr. Mamdani, 33, of Queens, has emerged as the breakout candidate in the mayoral race. Political observers say he poses a serious challenge to Andrew Cuomo, 67, giving Mr. Mamdani a real chance of winning Tuesday’s Democratic primary. The race is being watched closely across the country as a bellwether of the far left’s staying power during the second Trump administration.In a little noticed spending proposal in Mr. Mandami’s detailed policy platform, the young state assemblyman calls for spending $65 million to “expand and protect gender affirming care citywide … for both transgender youth and adults.” Zohran Mamdani attends a Trans Community Town Hall with activist Ceyenne Doroshow in May 2025. InstragramMr. Mandami cites “the Trump Administration’s proposed elimination of federal support” for what’s known as gender-affirming care, or GAC, as driving his proposal, which would seek to force private hospitals to continue providing gender treatments to minors even in the face of mounting counter-threats from the president.“The Mamdani administration,” the proposal says, “will also hold private hospital systems denying GAC accountable — hospitals that continue to deny trans youth access to gender affirming care are in violation of NYS Constitution, as well as multiple state and city laws. The Mamdani administration will coordinate with the NYS Attorney General and District Attorneys to investigate and hold public hearings on hospitals that deny trans youth their rightful healthcare and hold them accountable to the law.” Mr. Mamdani is responding to gender treatments coming under increasing fire from the Trump Administration and the likelihood that even in deep-blue New York City, minors and adults alike could increasingly lose access to gender-transition drugs and surgeries.The landmark ruling on transgender rights that the Supreme Court issued Wednesday—in which the conservative super-majority effectively gave its blessing to the more than 20 red states that have banned minors from receiving gender-transition drugs—is unlikely to impact blue states, including the many, like New York, that have passed sanctuary laws protecting such access. But the Trump administration has been waging an escalating campaign against what’s known as pediatric gender medicine. Much as it has done to bring elite universities to heel, the White House has used its control of research grants and also Medicaid funding – on which hospitals depend – to threaten gender-transition programs even in states firmly under Democratic control. Earlier this month, the privately operated Children’s Hospital of Los Angeles, which is particularly reliant on federal funding, said it saw “no path forward” but to shutter its pediatric gender clinic.Following his attendance at a Trans Community Town Hall with activist Ceyenne Doroshow in May 2025, Zohran Mamdani posted on Instagram a statement of support for the transgender community. InstragramMr. Trump is in part moving to reverse the impacts of sweeping policies put in place by Presidents Obama and Biden regarding gender identity. In its waning days in 2016, for example, the Obama Administration altered a key rule in the Affordable Care Act, stipulating that gender identity should also be considered in policies barring medical discrimination based on sex. Since then, gender-transition treatments and surgeries have become much more widely covered by public and private insurance, for both minors and adults.The recent political backlash isn’t just coming from the White House. The budget reconciliation bill passed by the House and currently before the Senate would bar Medicaid coverage for gender-transition drugs for minors and adults alike.A Marist poll published Wednesday depicts the New York City mayoral primary as a two-man race, with Mr. Cuomo leading Mr. Mamdani by about 10 points. But the younger candidate, whose base is young, college-educated city dwellers, has narrowed this gap during the lead up to the current early voting period. Furthermore, New York City’s ranked choice voting, in which voters rank candidates on the ballot, can lead to surprises. On Sunday, former president Bill Clinton endorsed Mr. Cuomo, who served in his administration.Zohran Mamdani’s policy positions clearly state his support for publicly funded medical gender treatments. InstagramMr. Cuomo was once lauded by LGBTQ political groups for ushering in same-sex marriage to the state as governor in 2011, four years before the Supreme Court legalized the practice nationally. But while Mr. Mamdani has offered a detailed LGBTQ policy platform, the centrist former governor has established no such proposals of his own. In fact, Mr. Cuomo has almost entirely eschewed currying favor with gay and transgender constituencies as he pushes for a return to the public life he lost when he resigned the governship under pressure due to multiple women accusing him of sexual harassment. Joseph Jourdan, president of Lambda Independent Democrats of Brooklyn, an influential LGBTQ political club, expressed a lack of faith in Mr. Cuomo’s ability to deliver on the club’s priorities. “We’re going to need people that we know will fight really hard in court to protect that funding” for gender-care services, Mr. Jourdan said. “It’s something we don’t necessarily see in former Governor Cuomo.”Mr. Jourdan, who said that Mr. Mamdani was the club’s second pick, behind city comptroller Brad Lander, in the ranked-choice voting scheme, noted his dismay that Mr. Cuomo was the only major Democratic candidate for mayor to skip all the LGBTQ-focused political forums.But Mr. Cuomo’s tight-lipped approach to transgender issues hardly cuts against the grain among leading Democrats as the national party suffers from an identity crisis with Republicans holding the Washington trifecta. In recent months, many Democratic lawmakers nationwide have shrunk from expressing support, in particular, for children’s access to gender-transition drugs. Response to last week’s Supreme Court ruling among liberal leaders was notedly muted. A mayoral candidate and state assemblyman, Zohran Mamdani, rides the subway on March 24, 2025 at New York City. Michael M. Santiago/Getty ImagesPolling has suggested that many of the leading causes that have lately animated the transgender-rights movement—including promoting pediatric gender medicine and supporting trans women playing in women’s sports, using women’s locker rooms and being incarcerated in women’s prisons – have collectively become an albatross for Democrats.This rude awakening was forced upon the party, in particular, when at the close of the 2024 campaign Republicans poured over $200 million into an ad campaign on behalf of Trump’s re-election, widely considered wildly impactful, that showed Mr. Harris on tape promising taxpayer-funded gender treatments for prisoners. Many transgender advocates have expressed concern that Democrats are intending to offload them as a political priority.Mr. Mamdani, whose star is likely to continue rising regardless of the outcome of Tuesday’s Democratic primary, is among those on the far left who have remained vocal and steadfast in supporting what many progressives continue to advocate as a fundamental right. His gender-care proposal would likely face a difficult path to enactment given the city’s finances. But if carried out, the plan would buttress New York City’s position as a haven for minors who, amid a fierce legal, legislative and cultural backlash against such medical practices, seek to undergo treatments to develop sex characteristics of the opposite sex. “It is not only the law in New York for people of all ages to be able to access gender-affirming care easily and safely, but it is our moral obligation,” Mr. Mamdani wrote in response to a candidate survey provided by the Jim Owles Liberal Democratic Club, a local LGBTQ-focused group. Democratic mayoral candidates Andrew Cuomo, left, Zohran Mamdani, center, and Whitney Tilson, right, after participating in a primary debate, June 4, 2025, in New York. AP/Yuki Iwamura, Pool)In an interview, the club’s director, longtime progressive gay activist Allen Roskoff, criticized the swath of local Democratic gay politicos who support Mr. Cuomo. He argued they have abandoned the liberal principles on which gay liberation was founded. “A true commitment to LGBTQ rights mandates recognition of the struggle of the trans community and 100 percent support and advocacy,” Mr. Roskoff said, saying that this necessarily included backing gender-transition treatment for minors. The policy memo on Mr. Mamdani’s campaign website outlining his plan to spend $65 million in city funds to support access to gender-transition treatment for New Yorkers states that the city would direct $57 million “to public hospitals, community clinics, federally qualified health centers, and nonprofits” that provide gender-transition treatment. An additional $8 million would develop and support virtual and telehealth services by community health providers; add gender-transition treatment to the existing virtual services provided by the public New York Health + Hospitals system; create a hub to help connect people to providers who could prescribe these medications; and support programs like one run by the LGBTQ-focused Callen-Lorde community health clinic for caring for transgender sex workers.The Children’s Hospital of Los Angeles is pulling the plug on its gender care program for minors. CHLAJoseph Figliolia, a policy analyst who studies pediatric gender medicine at the conservative think tank The Manhattan Institute, took issue with Mr. Mamdani’s framing of the purported benefits and necessity of gender-transition treatment for minors in particular. “As much as I’m a libertarian on adults accessing gender medicine and transitioning, I still don’t think it should be paid for with taxpayer dollars based on the asserted premise that its ‘necessary lifesaving healthcare for trans youth,’ which remains a highly contested claim,” Mr. Figliolia, quoting Mr. Mamdani’s policy document, said in an email.Multiple systematic literature reviews—the gold standard of scientific evidence—have found the research backing pediatric gender-transition treatment wanting and inconclusive. However, a wide swatch of U.S. medical associations have maintained their support for the field.Brad Hoylman-Sigal, a Democratic state senator running for Manhattan borough president, has introduced a bill that would use state funds to fill in the gap in Medicaid funding should Congress bar federal dollars from covering gender-transition treatment. Zohran Mamdani advocates for New York City to be a ‘sanctuary city’ for the transgender community. InstagramsDr. Jeffrey Birnbaum, a pediatrician who provides gender-care services at the state-run University Hospital of Brooklyn, said that, given that Medicaid is administered by the state, he believed that Albany rather than City Hall would be a more logical hub for shoring up Medicaid coverage for gender-care services.Of the city taxpayer funds that Mr. Mandani proposes spending on gender-transition treatment, the proportion that would go specifically to adolescents is unclear.Do No Harm, a nonprofit that advocates against medicalized gender transitions for minors, recently conducted an analysis of nationwide medical-claims data for such interventions, covering 2019 to 2023. The organization found evidence of 1,151 minors in New York state receiving gender-transition drugs, surgeries or both during that five-year period. For these services, health care providers billed $19 million, or an average of just under $4 million annually. (The dollar amount for which the providers were actually reimbursed is likely lower.) These figures, however, are likely incomplete. They are otherwise not city-specific. But Do Not Harm’s accounting indicates that nearly $12 million of the billing came from just two New York City hospital powerhouses: NYU Langone and Mt. Sinai.It also remains unclear whether Mr. Mamdani’s proposed spending would cover gender-transition surgeries or just medications. His campaign did not respond to requests from the Sun for comment, nor did Mr. Cuomo’s.U.S. Rep. Marjorie Taylor Greene (R-GA) speaks outside the U.S. Supreme Court during a rally as the high court heard arguments in a case on transgender health rights on December 04, 2024 in Washington, DC. Kevin Dietsch/Getty ImagesMr. Mamdani has pushed for curbing city tax breaks to large private institutions, including universities and hospitals, and redirecting the funds to their public counterparts. In his gender-care policy memo, he directs particular ire toward NYU Langone, one of the country’s wealthiest hospitals. In late January, the Trump administration issued an executive order that threatened to withhold federal funds from hospitals that provided gender-transition interventions to patients under age 19. Soon after, The New York Times reported that NYU Langone was among the New York City hospitals that had at least paused their provision of such medical interventions to this age group. Transgender advocates and their allies—among them Mr. Mamdani—rose up in an outcry, with many denouncing the hospital as a traitor to what they characterized bedrock principles of equitable health-care access. New York State Attorney General Letitia James, a Democrat, joined the backlash, issuing a sharp warning to local health care providers that if they withheld treatment for transgender patients, they would be in violation of state anti-discrimination statutes. The president’s executive order has since been at least temporarily blocked by two federal judges. But that legal reprieve may be short lived pending the appeals process, and has not necessarily resulted in an all-clear effect on New York hospitals.A young person cheers as supporters of transgender rights rally by the Supreme Court, December 4, 2024. AP/Jacquelyn MartinA New York–Presbyterian representative said in an emailed statement: “We continue to work through this evolving situation to comply with applicable state and federal laws and regulations. As always, our priority is to serve all our patients in a compassionate and responsible way.”A source close to the hospital, speaking anonymously because they were not at liberty to disclose such information, said that its pediatric gender program was indeed maintaining gender-transition treatment for current patients under age 19, but was only considering new patients in this age bracket for behavioral-health care. The status of pediatric gender-care services at Mt. Sinai, which is reported to have limited such medical interventions in the wake of Trump’s executive order, and NYU Langone remains unclear. Neither hospital returned requests for comment.Dr. Birnbaum was quoted in The New York Times in February saying he was willing to go to jail rather than abandon providing gender-care services to his young patients. He told the Sun that he later asked Ms. James’ office whether it would protect him in the event he wound up in legal peril. The attorney general’s office, he said, replied that it would indeed defend him. President Trump speaks before signing an executive order barring transgender female athletes from competing in women’s or girls’ sporting events, in the East Room of the White House, February 5, 2025. AP/Alex Brandon“I’m going to keep doing this until they carry me out in handcuffs,” Dr. Birnbaum reiterated to the Sun, specifying that he was speaking as an individual and not on behalf of his employer. Dr. Birnbaum said that while he appreciated the intention behind Mr. Mamdani’s plan to pay for gender-care services, “I’m concerned about the ability for him to push forward such an ambitious plan.” He also said he was grateful for Mr. Cuomo’s forthright support for dramatically increased HIV funding during his tenure as governor, which has directly benefitted Dr. Birnbaum’s clinic. Amid an onslaught from the right, threats of litigation from Ms. James – and possibly a Mamdani administration – on the left could leave hospitals that provide pediatric gender care in a pickle. And even if the city or state government replaced lost Medicaid funds for gender-transition treatments, this would not protect city hospitals from the Trump administration withholding Medicaid funding for any and all health care services, as well as blocking federal research grants.Furthermore, the White House is flexing more than just its financial muscles in its unyielding effort to end pediatric gender medicine. The Justice Department has warned doctors in this field that they could be subject to investigations and the FBI has issued a call for tips about the provision of gender-transition surgeries to youth, even as it remains legal in 23 states. The Centers for Medicare and Medicaid Services has subjected health care providers to newly strict monitoring of pediatric-gender-medicine practices. And the Department of Health and Human Services has directed providers to begin observing the principles of a major report that the department commissioned, published last month, that has characterized pediatric gender-transition treatments as too risky to even study in clinical trials.Lawyer and transgender rights activist Chase Strangio and ACLU Deputy Executive Director AJ Hikes leave the Supreme Court after Strangio argued a transgender rights case before the high court on December 04, 2024 at Washington, DC. Kevin Dietsch/Getty ImagesChildren’s Hospital Los Angeles has been the first major blue-state health care provider to buckle under this mounting political pressure. In an apparent harbinger of the stark choices similar clinics in Democratic-led states might increasingly face, the CHLA hospital leadership said they were reluctantly closing the gender clinic because they lacked the financial reserves to withstand what amounted to an existential threat of losing all its Medicaid funding. Regardless of whether the Trump administration’s efforts to pull such health-care purse strings would withstand legal challenges, his administration has broadly proved that it does not make idle threats of withholding huge sums of federal money from major institutions. His administration has, after all, frozen billions of dollars in federal grants to top universities such as Columbia and Harvard in the president’s ongoing effort to get them to bend to his political will, unleashing a financial cataclysm across the Ivy League and beyond.Mr. Jourdan, however, expressed optimism that an aggressive legal defense could thwart such efforts by the Trump administration to cripple the local field of pediatric gender medicine. “They’ve shown consistently that when you do stand up to them, they do back down,” he said. “That’s how bullies are.”

Breakout New York Mayoral Contender Zohran Mamdani Wants To Spend $65 Million on Medical Gender Treatments for Minors and Adults

More from the New York Sun

The War Over War Powers

Antisemitism Is the Root of Mamdani Socialism, and It’s Destroying New York City

Why Rod Stewart Mattered So Much to a Teen Boy in Care

More from the New York Sun

The War Over War Powers

Antisemitism Is the Root of Mamdani Socialism, and It’s Destroying New York City

Why Rod Stewart Mattered So Much to a Teen Boy in Care

France’s Greens Propose Paid Days Off Instead of Air Conditioning To Respond to Heat Waves

Musk Loses Trillionaire Title as SpaceX Shares Tumble

Chevalier Wins, Democrats Panic, and Letitia James Fears Mamdani Has Given Party Its MAGA Moment

James Comey Builds All-Star Legal Team To Thwart Renewed Effort by Trump DOJ To Convict Him

Rubio Tries To Ease Gulf Allies’ Fears of Capitulation to Tehran