WASHINGTON, D.C. — Under the settlements, NYU Langone Hospitals agreed to pay the federal government $8.5 million. Under the settlements, the University of Pittsburgh Medical Centers agreed to pay the federal government $950,000. The settlements prevent the hospitals from being forced to turn over patient records to the federal government.

NYU Langone Hospitals stated it did not enter the settlement due to any wrongdoing and denied liability. The hospitals stated the deals will not impact how their pediatric mental healthcare programs treat transgender children. U.S. Attorney General Todd Blanche said in a statement, "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."

Eliel Cruz, a cofounder of the Gender Liberation Movement, said, "It’s a really dangerous precedent when the federal government is allowed to politicize any one group of people’s care and end it." Cruz said the agreements show "who has the courage to do what their calling and education calls them to do — which is do no harm — and those (who do) not." The Department of Justice stated that some providers agreed to help pay medical costs for children to detransition.

The 9th U.S. Circuit Court of Appeals issued a 2-1 ruling last month finding that the administration’s goal of ending gender-affirming care for youth is not improper and cannot be used as an argument to stop 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 gender-affirming care for minors since last year.

A group of Democratic state officials sued the Trump administration, alleging its efforts unlawfully intimidate medical providers. The American Medical Association and the American Academy of Pediatrics support keeping gender-affirming treatment available for youth. The New York attorney general’s office is reviewing the settlement between NYU Langone and the Department of Justice.

Why It Matters

The settlements represent a continuation of federal enforcement actions initiated in 2025 under the direction of President Trump, who prioritized investigations into the provision of gender-affirming care to minors. These agreements follow similar resolutions with other major health systems, indicating a broader pattern of regulatory pressure on medical providers across multiple states. The financial penalties and operational restrictions imposed on NYU Langone and UPMC total nearly $9.45 million and establish a precedent for how federal authorities may intervene in pediatric healthcare decisions.

The response from local officials and advocacy groups shows the tension between federal enforcement and local medical practices. While the Department of Justice frames the settlements as protective measures for children, critics argue they constitute political interference in healthcare. The ongoing legal challenges by Democratic state officials and the review by the New York attorney general suggest that the conflict over jurisdiction and medical authority remains unresolved, with potential implications for healthcare providers in states without existing bans on such care.

Timeline

On June 22, 2011, the Department of Justice issued a clarification on guidance titled Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans With Disabilities Act and Olmstead v. L.C. In January 2025, President Donald Trump signed an executive order calling to cut federal support for gender transitions for individuals under 19. Also in January 2025, the Trump administration published a review urging only therapy and not broader gender-affirming care for youth. The settlements resolve Department of Justice investigations that began in 2025 into the hospitals' provision of gender-affirming care to minors.

In July 2025, the Department of Justice announced subpoenas to hospitals requesting information on gender-affirming care for children, including patients' names. On September 22, 2026, the Justice Department published a notice titled Agency Information Collection Activities; Proposed Collection; Comments Requested; Title-Supplemental Information on Water Quality Considerations-ATF Form 5400.30.

What's New

U.S. Assistant Attorney General Brett Shumate said, "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."

New York City Mayor Mamdani said in a statement, "Today’s decision by NYU Langone to enter into a settlement with the U.S. Department of Justice is yet 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 also said the settlement politicizes families’ private medical decisions, vilifies lifesaving care, and undermines professional medical judgment. The Justice Department published a notice titled Agency Information Collection Activities; Proposed Collection; Comments Requested; Title-Supplemental Information on Water Quality Considerations-ATF Form 5400.30 on September 22, 2026.

How Sources Differ

Sources differ on the characterization and scope of affirming care restrictions. The Department of Justice settlement agreements state that the Department reached settlements with New York University Langone Hospitals and the University of Pittsburgh Medical Centers to end federal investigations into gender-affirming care for minors.

The Department of Justice investigation records state that the settlements resolve investigations that began in 2025 into the hospitals' provision of gender-affirming care to minors, while state legislation records indicate that at least 27 states have laws restricting or barring such care.