Hospitals Strike Deals with Trump Administration to Halt Care for Transgender Minors

At least six major hospitals have agreed to refuse gender-affirming hormones and surgery for transgender young people, according to deals with the Department of Justice. These agreements also include provisions for hospitals to make payments to the federal government for patients seeking to reverse gender transitions.

The most recent agreements were finalized last week, with the Department of Justice stating that some providers will also assist in covering medical costs for children to “detransition.” The hospitals involved have not admitted to any wrongdoing.

The Justice Department announced settlements last week with New York University Langone Hospitals and the University of Pittsburgh Medical Centers. Under these agreements, the institutions will cease providing puberty blockers, hormones, or gender-affirming surgery for patients under 19. U.S. Attorney General Todd Blanche stated that the department is "fighting to protect our nation’s children" and seeking agreements to end such care for minors.

NYU agreed to pay the federal government $8.5 million, and UPMC agreed to pay $950,000. These settlements follow similar agreements reached since May with Cleveland Clinic, Connecticut Children’s Hospital, Mount Sinai Health System in New York, and Texas Children's Hospital. The hospitals involved have indicated that these deals will not affect their pediatric mental healthcare programs for transgender children.

Many of these hospitals had already stopped offering such treatments due to state bans or pressure during Donald Trump’s previous administration. The Trump administration had published a review urging only therapy, not broader gender-affirming care, for youth. Despite this, most major medical organizations, including the American Medical Association and the American Academy of Pediatrics, support the availability of these treatments.

Mount Sinai is the only one of the six institutions to reach a deal without having previously announced its decision to stop care. The hospitals in Texas and Ohio had already halted treatments under state bans. The others announced their policy changes after Trump returned to office in January 2025, a period marked by executive actions targeting gender-affirming care, including an order to cut federal support and barring federal Medicaid dollars from covering such treatments for those under 19.

The Trump administration had subpoenaed hospitals beginning in July 2025, requesting information on gender-affirming care for children, including patient names. NYU Langone stated that its settlement protects patients and families by removing the threat of being forced to provide confidential information about minors who received care.

Several hospitals had sought court injunctions to prevent the disclosure of patient records, with most prevailing in lower courts. However, a ruling last month from the San Francisco-based 9th U.S. Circuit Court of Appeals gave the administration’s case momentum, finding that its objective of ending gender-affirming care for youth was not improper, thus not a basis to block the subpoenas.

Nationwide, at least 27 states have enacted laws restricting or banning gender-affirming care for minors. Furthermore, more than two dozen hospitals, health systems, and clinics in states without bans have ceased offering the care since last year. A coalition of Democratic state officials has filed a lawsuit against the Trump administration, alleging that its actions unlawfully intimidate medical providers.

While gender transition surgery for individuals under 18 is uncommon, many transgender youth receive hormone therapy to block puberty or to develop sex-linked characteristics aligned with their gender identity. According to Eliel Cruz, a cofounder of the Gender Liberation Movement, some families have relocated to other states seeking treatment, only to find services curtailed there, and some have reportedly left the country.