Two More Major Hospitals Reach Settlements With DOJ To Keep Youth Gender Clinics Shuttered

Two of the nation’s largest hospitals have newly reached settlements with the Department of Justice to keep their pediatric gender clinics shuttered. This development amounts to yet another victory for the Trump administration as it wages a whole-of-government campaign to destroy what remains of the beleaguered field of pediatric gender medicine.Facing accusations of potential violations of federal law that appear to include billing fraud, University of Pittsburgh Medical Center—the largest medical provider in Pennsylvania — and NYU Langone each agreed to cease providing gender-transition interventions to minors, according to a Justice Department news release issued Friday. NYU Langone will pay an $8.5 million penalty and UPMC will pay $950,000.“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 said in the release, referring to medical interventions for youths identifying as transgender. “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.”According to the Justice Department, both hospitals cooperated with an investigation into their practices in caring for gender-distressed youths, including into potential violations of federal law.Steve Ritea, a spokesperson for NYU Langone, said that the Justice Department “has agreed to resolve its investigations, removing the threat that NYU Langone would have to provide the confidential information previously demanded about patients under 18 who received gender-affirming care at our institution.” This despite the fact that a recent court order prevented the Justice Department from obtaining such records via subpoena from New York City hospitals. And in August, the Justice Department withdrew from its efforts to obtain patient records from UPMC via a subpoena issued last year. Mr. Ritea asserted that NYU Langone had “remained committed to protecting patient privacy and supporting our providers.” The settlement, he indicated, only impacted patients under age 18. A UPMC spokesperson said: “The agreement includes important privacy, confidentiality, and non-prosecution protections for patients, legal guardians, providers, and employees.”New York’s Mt. Sinai earlier this month reached a similar settlement to keep its pediatric gender clinic closed, joining a roster of hospitals to have capitulated in the face of the Trump administration’s threats to this field that includes Texas Children’s Hospital, the Cleveland Clinic and Connecticut Children’s Medical Center. Mt. Sinai agreed to put $2 million toward patients who have been harmed by gender-transition interventions they received as minors.The Justice Department made no mention in its release of UPMC or NYU Langone being compelled to provide treatment to such patients.The Justice Department emphasized that it is continuing to target other major hospitals, suggesting that more such settlements may be on the horizon.These settlements have infuriated and dismayed transgender activists and provoked rebukes from at least some Democratic politicians, who between them have accused these hospitals of betraying their duty to care for a vulnerable minority group even in the face of overwhelming threats from the Trump administration. Just over a majority of U.S. states have banned providing puberty blockers, cross-sex hormones and gender-transition surgeries to treat gender-related distress in minors. These bans received the effective blessing of the Supreme Court last year. This has rendered a patchwork legal system in which states controlled by Republicans, by and large, forbid these practices. But the Trump administration has sought to leverage the power of multiple federal agencies, as well as executive orders, to end pediatric gender medicine outright.The Justice Department, for one, has slapped numerous hospitals with aggressive subpoenas seeking detailed records of minors treated for gender dysphoria. And yet lawsuits to thwart the Trump administration’s efforts on this front, including suits impacting NYU Langone and UPMC, have had broad success thus far.But these suits do not protect health care providers from potential indictments for billing fraud. The Trump administration has leveraged multiple federal agencies to target the field of pediatric gender medicine for using billing codes unrelated to gender identity when submitting insurance claims for treating gender dysphoria.Use of alternative billing codes, such as “endocrine disorder, unspecified,” is widespread in pediatric gender medicine, according to a recent scathing report put out by the U.S. Department of Health and Human Services. Videos of presentations at conferences held by a major transgender activist-medical group obtained by The Sun back up this assertion. In a statement issued after its settlement with the Justice Department went public, a spokesperson for Mt. Sinai said that the hospital entered the agreement, in part, in service of “protecting our clinicians.”Mr. Ritea emphasized that “NYU Langone has not entered into this settlement because of any wrongdoing and has affirmatively denied any wrongdoing or liability in the agreement. We believe this resolution is in the best interests of our patients and their families, protecting them as well as our providers and the institution from prolonged litigation.”The UPMC spokesperson similarly said the agreement “expressly includes no admission of wrongdoing, fault, or liability.”Immediately after re-entering the White House, President Donald Trump issued an executive order threatening to cut off Medicare and Medicaid funding to hospitals that provided gender-transition interventions to patients under age 19. Shortly afterward, NYU Langone stopped accepting new patients to its pediatric gender clinic and began canceling existing appointments. UPMC started dialing back its gender-care services for adolescents.According to 2019 to 2023 billing data compiled by the advocacy nonprofit Do No Harm, which opposes pediatric gender medicine, NYU Langone was second in New York state to Mt. Sinai in billings for gender-transition interventions for minors—at a respective $4.5 million and over $8 million. These figures may not be complete, however, and represent the amount billed to insurers, not the amount actually reimbursed. The pullback in services by these major hospitals triggered waves of protests against them by transgender activists and their allies and impacted families.Such capitulation also provoked a sharp rebuke from New York’s attorney general, Letitia James, who warned New York hospitals that denying transgender patients services put them in conflict with state anti-discrimination law.In April 2025, Pittsburgh Mayor Ed Gainey joined over a dozen other officials in writing a letter to UPMC demanding the full restoration of its pediatric gender clinic—to no avail.Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, then sent letters to several major hospitals, including UPMC, demanding a tranche of medical and billing data from their pediatric gender clinics.UPMC fully shuttered its pediatric gender clinic in June 2025. This did not stop the Justice Department from issuing a subpoena the next month seeking patient records. The subpoena, which was among a collection that targeted about 20 hospitals nationwide, sought each patient’s name, date of birth, Social Security number and address and information about their parents. Despite broad losses in the courts over its efforts to gain such sweeping access to sensitive patient records—including a federal judge quashing the UPMC subpoena—the Justice Department has continued to press its case against these clinics. But the losses suggest that the leverage it held over hospitals that have reached settlements is more related to accusations of billing fraud than to concerns about patient privacy.NYU Langone did ultimately resume services in its youth gender clinic, but only temporarily. In December, the U.S. Department of Health and Human Services proposed a new rule that would codify the executive order barring Medicaid and Medicare funding for hospitals providing gender-transition interventions to adolescents. Mt. Sinai and NYU Langone each subsequently shuttered their pediatric gender clinics. NYU Langone cited the departure of the clinic’s medical director “coupled with the current regulatory environment.”Ms. James ordered NYU Langone to resume services, but the hospital apparently did not comply. A protest outside an NYU Langone clinic in Manhattan on March 1 included a speech by Brad Lander, New York City’s former comptroller, who in June beat the incumbent Rep. Dan Goldman in the Democratic primary for the state’s 10th congressional district. Mr. Lander said that the Trump administration’s attacks on pediatric gender medicine were emblematic of “advancing fascism.”Lambasting NYU Langone, Mr. Lander said: “How could you be an institution that believed in the Hippocratic oath and decided that bending the knee with Donald Trump is more important than taking care of kids in New York City?”In May, a grand jury out of the Northern District of Texas issued a new, criminal subpoena to NYU Langone, seeking detailed patient records from its pediatric gender clinic as well as related internal communications. Mt. Sinai received a similar subpoena in June. Any effort to quash those subpoenas would likely have gone before Judge Reed O’Connor. Mr. O’Connor has become famous for providing friendly rulings to the Trump administration and to Republicans more broadly.The ACLU joined others in filing a class action lawsuit in June against the Trump administration and NYU Langone in the Southern District of New York over the Justice Department’s efforts to obtain medical records from New York City pediatric gender clinics. The following month, a federal judge issued a preliminary injunction preventing the Justice Department from obtaining such records via subpoena at any hospitals in the city. An appeals court rejected the Justice Department’s bid for a stay last month.New York City Mayor Zohran Mamdani pledged during his campaign to spend $65 million on providing gender-transition interventions to New Yorkers, including for minors. But given the daunting legal blockade the Trump administration has erected around pediatric gender clinics, the city has effectively kowtowed. In June, the city announced a $15 million, two-year plan to provide such services—but only to patients age 19 and older. HHS last month finalized a rule that bans Medicaid and Children’s Health Insurance Program funding for gender-transition interventions for minors. That rule is set to go into effect October 13. A swath of Democratic state attorneys general, plus Gov. Josh Shapiro of Pennsylvania, have sued to block it from going into effect.In the meantime, dozens of pediatric gender clinics have closed their doors or dialed back services since the onset of the second Trump administration. And the Justice Department appears poised to enter more agreements that would padlock the doors of more major clinics by the force of law.Brett Shumate, assistant attorney general for the Justice Department’s civil division said in Friday’s news release that “our efforts and investigations into other providers are ongoing.” In an apparent reference to accusations of billing fraud, he continued: “Those that have broken the law and not resolved their potential liability will be prosecuted to the fullest extent possible.”

Two More Major Hospitals Reach Settlements With DOJ To Keep Youth Gender Clinics Shuttered

Two More Major Hospitals Reach Settlements With DOJ To Keep Youth Gender Clinics Shuttered

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