NYU Langone Hospitals and the University of Pittsburgh Medical Center have agreed to stop providing puberty blockers, cross-sex hormones, and gender-related surgery to minors and to pay a combined $9.45 million, the Justice Department announced on September 18. NYU agreed to pay $8.5 million and UPMC $950,000, bringing to at least six the number of major hospitals that have signed similar deals.
The earlier agreements involved Mount Sinai Health System in New York, Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's. Most of the hospitals had already stopped offering the treatments because of state bans or earlier federal pressure. NYU Langone, for example, ended its program for transgender patients under 18 in February.
For families of transgender teens in New York, Pittsburgh, and other affected areas, the deals formalize changes many had already felt. They also raise practical questions about where ongoing care will come from, what happens to medical records, and which services remain available.
The Terms Hospitals Accepted
Under the NYU and UPMC agreements, both systems will stop providing puberty blockers, cross-sex hormones, and surgical procedures to minors. The Justice Department said both hospitals earned credit for cooperating, including ongoing cooperation in its investigation of other providers.
The deals resolve allegations only. The Justice Department states that there has been no determination of liability, and both hospitals denied the allegations. They said the agreements protect the confidentiality of patients, parents, and providers whose records had been sought through grand jury subpoenas, and that pediatric mental health services and care for adults 18 and older will continue.
"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 spokesperson Steve Ritea said. UPMC said it settled to avoid extended litigation and protect private patient information, The Advocate reported.
Some earlier deals went further. Under its September 4 agreement, Mount Sinai agreed to pay an undisclosed monetary penalty and to dedicate $2 million to free medical care for people the department says were harmed by treatments they received as minors. Texas Children's agreed to open a clinic for patients seeking to reverse a transition.
The Federal Case and the Pushback
The Justice Department says it is investigating potential violations of the Food, Drug, and Cosmetic Act and the False Claims Act, including whether providers used false diagnoses or billing codes to obtain payment from government health programs and private insurers. "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," Attorney General Todd Blanche said.
The effort grows out of a January 2025 executive order directing federal agencies to restrict gender transition treatments for minors, including through Justice Department enforcement. Last year, the department sent subpoenas seeking patient records to more than 20 providers, and several of those demands have been challenged in court.
Families, advocates, and major medical groups see the deals differently. The American Academy of Pediatrics and other medical organizations have supported access to this care for adolescents, while the administration argues the evidence behind it is weak.
MedicalDaily previously reported on HHS referrals of hospitals and pharmacies to federal investigators over youth gender care billing codes. Since then, Mount Sinai, NYU, and UPMC have signed on, and NYU's $8.5 million is the largest payment disclosed so far.
Families Weighing Next Steps
The most immediate effect falls on transgender adolescents already in treatment and their parents. Families whose care has been interrupted should ask the hospital for a written plan covering referrals, copies of medical records, and continued mental health support. Stopping hormone treatment abruptly can have physical and emotional effects, so any change should be discussed with a clinician rather than made on a family's own.
Access now depends heavily on where a family lives, and some families have traveled to other states for care only to see providers there stop as well. Teens facing a disruption in care may also experience stress, anxiety, or low mood. Parents who notice signs of a mental health crisis can call or text 988 to reach the 988 Suicide and Crisis Lifeline at any hour.
Privacy is a separate concern for many parents. Both hospitals said the agreements protect patient confidentiality, a point families had pressed after subpoenas sought detailed records.
Several questions remain open. The full text of the NYU and UPMC agreements has not been widely published, and the department has not said how many other providers remain under investigation. MedicalDaily will report on new agreements, court rulings, and any published settlement terms.
Key Questions Answered
Which hospitals have signed agreements with the Justice Department? NYU Langone, UPMC, Mount Sinai, Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's.
How much are the hospitals paying? NYU agreed to pay $8.5 million and UPMC $950,000. Mount Sinai agreed to an undisclosed penalty plus $2 million for free medical care.
Did the hospitals admit wrongdoing? No. The Justice Department says the claims are allegations only, with no determination of liability, and the hospitals denied the allegations.
Which treatments are affected? Puberty blockers, cross-sex hormones, and gender-related surgery for minors. Pediatric mental health care and care for adults continue, according to NYU and UPMC.
What should families in treatment do now? Ask the hospital for referrals and copies of records, and talk with a clinician before stopping any medication.
Are more agreements expected? The Justice Department says its investigation of other providers is ongoing.
Published by Medicaldaily.com
