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<p><span style="font-weight:400">The Trump administration has secured agreements with at least six major hospital systems to end the provision of puberty blockers, cross-sex hormones, and surgeries to minors, marking a major development in the administration’s nationwide effort to shut down pediatric gender-transition treatment.</span></p>
<p><span style="font-weight:400">The Justice Department announced the latest deal last week, in which New York University Langone Hospitals and the University of Pittsburgh Medical Center agreed to stop providing sex-rejecting procedures to minors. The agreements also require NYU to pay $8.5 million and UPMC to pay $950,000 to resolve federal investigations into potential violations of federal law.</span></p>
<p><span style="font-weight:400">The agreements follow similar deals with Mount Sinai Health System, Texas Children’s Hospital, Cleveland Clinic, and Connecticut Children’s Hospital since May; according to the </span><a href="https://www.nytimes.com/2026/09/22/us/trangender-youths-hospital-settlements.html?campaign_id=60&;emc=edit_na_20260922&;instance_id=182382&;nl=breaking-news&;regi_id=184333330&;segment_id=226916&;user_id=b7576b5ea94bcf643b255c285396f858" target="_blank" rel="noopener"><span style="font-weight:400">New York Times</span></a><span style="font-weight:400">, not all deals have been made public. The Justice Department says its nationwide investigation into the providers is ongoing. </span></p>
<p><span style="font-weight:400">Attorney General Todd Blanche said in a <a href="https://www.justice.gov/opa/pr/doj-secures-agreements-nyu-and-upmc-end-pediatric-gender-affirming-care" target="_blank" rel="noopener">statement on Friday</a> that the “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.” </span></p>
<p><span style="font-weight:400">Taken together, the agreements show the scope of the administration’s effort. Rather than relying solely on state restrictions or federal funding policy, the Justice Department has used investigations into potential violations of federal law to pressure individual hospital systems to end the treatments themselves.</span></p>
<p><span style="font-weight:400">The Justice Department launched its nationwide investigation after President Donald Trump directed the department in 2025 to prioritize potential violations of federal law involving gender-transition treatment for children. DOJ says the investigation examines possible violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including allegations that providers used false diagnosis codes to obtain payments from federal health programs and private insurers.</span></p>
<p><span style="font-weight:400">The department emphasizes that the allegations resolved through the settlements remain allegations and that there has been no determination of liability. NYU and UPMC have denied the allegations.</span></p>
<p><span style="font-weight:400">But the administration’s strategy has now produced agreements with at least six major hospital systems, including some of the country’s largest and best-known medical institutions. The latest agreements make clear that DOJ does not view the first wave of settlements as the end of the effort.</span></p>
<p><span style="font-weight:400">The settlements have also included provisions for children and young adults who want medical treatment related to previous gender-transition interventions.</span></p>
<p><span style="font-weight:400">Mount Sinai </span><a href="https://www.nytimes.com/2026/09/04/nyregion/adolescent-trans-care-mount-sinai-trump.html" target="_blank" rel="noopener"><span style="font-weight:400">agreed</span></a><span style="font-weight:400"> to dedicate $2 million toward free medical care for people suffering what the Justice Department describes as harmful consequences of sex-rejecting procedures they received as children. Connecticut Children’s </span><a href="https://www.justice.gov/opa/pr/justice-department-secures-agreement-connecticut-childrens-end-pediatric-gender-affirming" target="_blank" rel="noopener"><span style="font-weight:400">agreed</span></a><span style="font-weight:400"> to put $500,000 toward medical care for individuals living with consequences of the treatment.</span></p>
<p><span style="font-weight:400">Texas Children’s Hospital, meanwhile, </span><a href="https://www.justice.gov/opa/pr/justice-department-secures-landmark-resolution-end-pediatric-gender-affirming-care-and" target="_blank" rel="noopener"><span style="font-weight:400">agreed</span></a><span style="font-weight:400"> in May to pay $10 million to resolve allegations involving false billings and to establish a clinic providing restorative care for people who have undergone gender-transition treatment.</span></p>
<p><span style="font-weight:400">The hospitals have generally not admitted wrongdoing. The </span><a href="https://apnews.com/article/transgender-genderaffirming-hospitals-trump-justice-agreement-34faeeab4575b81160ae6531254584cb" target="_blank" rel="noopener"><span style="font-weight:400">Associated Press</span></a><span style="font-weight:400"> reported that several had already stopped providing the treatments because of state laws or earlier pressure from the Trump administration.</span></p>
<p><span style="font-weight:400">That distinction is significant: the DOJ settlements did not cause every hospital involved to stop providing the treatments in the first place. Texas Children’s and Cleveland Clinic, for example, had already stopped providing pediatric gender-transition treatment before reaching their agreements with the federal government. Mount Sinai was the only one of the six institutions that had not previously announced that it was ending the care, according to AP.</span></p>
<p><span style="font-weight:400">For some hospitals, the DOJ agreements also resolved disputes over federal demands for patient information. The administration had </span><a href="https://apnews.com/article/gender-affirming-care-personal-information-justice-51b2dad661a3cc3d9e3649f9ee95eda2" target="_blank" rel="noopener"><span style="font-weight:400">subpoenaed</span></a><span style="font-weight:400"> hospitals for information about pediatric gender-transition treatment, including patient names. NYU said its agreement protects patients and families from the possibility that the hospital would have to turn over confidential information about patients under 18.</span></p>
<p><span style="font-weight:400">The legal pressure has come alongside broader administration action against pediatric gender-transition treatment. Trump signed an </span><a href="https://www.whitehouse.gov/presidential-actions/2025/01/protecting-children-from-chemical-and-surgical-mutilation/" target="_blank" rel="noopener"><span style="font-weight:400">executive order</span></a><span style="font-weight:400"> in January 2025 directing the federal government to restrict support for gender transitions for people under 19, and the administration has also barred federal Medicaid dollars from covering the treatment.</span></p>
<p><span style="font-weight:400">The Justice Department says the hospitals’ agreements are part of a continuing investigation rather than the end of the effort. “Our efforts and investigations into other providers are ongoing,” Brett Shumate, assistant attorney general for the Civil Division, said. “Those that have broken the law and not resolved their potential liability will be prosecuted to the fullest extent possible.”</span></p>
<p><span style="font-weight:400">The agreements do not mean pediatric gender-transition procedures have ended nationwide. According to the Associated Press, 27 states have laws protecting minors from the “treatment,” while the procedures remain available at hospitals, clinics, and individual physicians in other states.</span></p>
<p><span style="font-weight:400">Major medical organizations, including the </span><a href="https://www.ama-assn.org/public-health/population-health/advocating-lgbtq-community" target="_blank" rel="noopener"><span style="font-weight:400">American Medical Association</span></a><span style="font-weight:400"> and </span><a href="https://publications.aap.org/aapnews/news/25340/AAP-reaffirms-gender-affirming-care-policy?autologincheck=redirected" target="_blank" rel="noopener"><span style="font-weight:400">American Academy of Pediatrics</span></a><span style="font-weight:400">, continue to support keeping “gender-affirming care” available to youth.</span></p>
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Trump DOJ Pressures Six Major Hospitals To End Child Sex-Change Procedures
