Several major hospital systems across the United States have agreed to stop providing gender-affirming medical care for minors and pay substantial settlements to the US Department of Justice (DoJ). These agreements stem from a nationwide DoJ probe that began in 2025.
NYU Langone and Other Hospitals Settle with DoJ
NYU Langone, a prominent hospital network serving thousands of patients across New York City, Long Island, and Westchester County, reached a settlement on Friday to end transgender medical care for minors. The network has agreed to pay the US Department of Justice $8.5 million, as reported by the New York Post. NYU Langone had been subpoenaed by the Trump administration in May 2025 for medical records on minors who received trans care, but the agreement now spares the hospital from handing over those records.
Despite the settlement, NYU Langone spokesman Steve Ritea stated that the hospital has not entered into the agreement because of any wrongdoing and has “affirmatively denied any wrongdoing or liability.” Ritea added, “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.”
NYU Langone is not the only hospital system to reach such an agreement. Mount Sinai Health System in New York entered a similar settlement earlier in the month. Other institutions that have struck deals to end gender-affirming care for youth patients and pay the federal government include the University of Pittsburgh Medical Center (UPMC), which will pay $950,000, Texas Children’s Hospital, the Cleveland Clinic, and Connecticut Children’s Hospital.
US Attorney General Todd Blanche stated that 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.” US Assistant Attorney General Brett Shumate further commented, “We appreciate that some of the nation’s largest and most prestigious hospital systems have agreed to cease harming minors under the guise of ‘gender-affirming care’ and agreed to pay for potential violations of federal law when they did so.”
DoJ’s Strategy and Public Reaction to US Hospital Transgender Care Stance
The DoJ’s approach in these cases has increasingly leveraged fraud and billing law, focusing on potential violations of federal law and alleged fraudulent billing practices, particularly under the False Claims Act. According to ICLG, these investigations centre on claims where healthcare providers are said to use false diagnosis codes to obtain payments from private insurers and federal healthcare programmes.
This intensified scrutiny follows a January 2025 executive order from the Trump administration titled ‘Protecting Children from Chemical and Surgical Mutilation’. An April 2025 memorandum from then-Attorney General Pam Bondi also warned healthcare providers that falsely billing the government “for the chemical or surgical mutilation of a child is a violation of the False Claims Act and is subject to treble damages and severe penalties.”
The settlements have drawn criticism. New York City Mayor Zohran Mamdani promptly condemned both NYU Langone’s decision and the DoJ’s probe, describing it as “another alarming example of a private institution caving to pressure from the federal government that will have real and serious consequences for young trans and gender nonconforming New Yorkers.” Mamdani asserted that the settlement “politicizes families’ most private medical decisions, vilifies lifesaving care, and undermines professional medical judgment.”
A joint statement by Lambda Legal, the New York Civil Liberties Union, the American Civil Liberties Union, and counsel for the class in Coe v Blanche, a class action filed to block the DoJ from seizing sensitive health information, denounced the DoJ’s actions. They stated it was “beyond shameful that the Trump administration has strong-armed NYU and Mount Sinai into striking a deal that betrays transgender young people in New York.” The New York attorney general’s office is currently reviewing the settlement.
The DoJ has confirmed that efforts to “stop unlawful conduct, recover funds obtained through fraud, and hold accountable those who profit by violating federal law at children’s expense” remain a key priority. Attorney General Todd Blanche indicated the settlements should serve as a “clear message” to the industry.
