Six US hospitals agree to halt gender-affirming care for minors in DOJ deals

At least six major hospitals in the United States have reached agreements with the Department of Justice to stop providing gender-affirming hormones and surgery to transgender minors, and to make payments to the federal government for patients seeking to reverse gender transitions. The most recent settlements were announced last week.

The agreements end federal investigations into care the hospitals previously provided and remove the threat of being compelled to hand over patient records. The Justice Department has said some providers also agreed to help cover medical costs for children who wish to detransition. The hospitals have not admitted to any wrongdoing.

Last week, the department announced settlements with NYU Langone Hospitals and the University of Pittsburgh Medical Centers. Under the deals, the hospitals agreed not to provide puberty blockers, hormones or gender-affirming surgery — which the administration refers to as "sex-rejecting procedures" — to patients under 19. NYU agreed to pay $8.5 million and UPMC $950,000.

These followed similar settlements reached since May with the Cleveland Clinic, Connecticut Children's Hospital, Mount Sinai Health System in New York and Texas Children's Hospital. Mount Sinai is the only one of the six that had not previously announced its decision to stop offering the care.

Most of the hospitals had already halted the treatments because of state bans or earlier pressure from the administration. The hospitals in Texas and Ohio stopped care under state bans, while others announced policy changes after President Donald Trump returned to office in January 2025 and began a series of steps targeting the care. He signed an executive order that month calling for cuts to federal support for gender transitions for those under 19, and the administration has barred federal Medicaid dollars from covering the treatment.

The hospitals have said the agreements will not affect how their pediatric mental healthcare programs treat transgender children. NYU Langone said the settlement protects patients and families by removing the threat that it would have to provide confidential information previously demanded about patients under 18 who received gender-affirming care at the institution.

A key administration action was subpoenaing hospitals, first announced in July 2025, seeking information on gender-affirming care for children, including patients' names. Several hospitals asked courts to block the records demands, and most prevailed in district courts. But a ruling last month from the San Francisco-based 9th U.S. Circuit Court of Appeals gave the government's case a boost. A 2-1 ruling found that the administration's goal of ending gender-affirming care for youth is not improper and cannot be used as an argument to stop the subpoenas.

At least 27 states have laws restricting or barring gender-affirming care for minors. More than two dozen hospitals, health systems and clinics in states without bans have stopped offering the care since last year, including some in states with specific legal protections for it. A group of Democratic state officials has sued the administration over those efforts, saying they unlawfully intimidate medical providers.

Transition surgery for people under 18 is rare, but many transgender youth receive hormones to block puberty or to trigger development of sex-linked characteristics consistent with their gender identity. The care remains available at a variety of hospitals, clinics and through individual physicians.

Eliel Cruz, a cofounder of the Gender Liberation Movement, criticised the agreements. "It's a really dangerous precedent when the federal government is allowed to politicize any one group of people's care and end it," he said. Cruz said some families have moved to other states for access to treatment, only to find providers stop it there, and some have left the country. His group has protested hospitals that ended the care.

Most major medical organizations, including the American Medical Association and the American Academy of Pediatrics, support keeping treatment available. The administration last year published a review urging only therapy and not broader gender-affirming care for youth.