Two of the country's biggest hospital systems will stop treating transgender kids — not because a court ruled against them, and not because their states banned the care, but because Trump's Justice Department pressured them into it.
On Friday, September 18, the Justice Department announced deals with the University of Pittsburgh Medical Center and New York University Langone Hospitals. Under them, both will stop giving puberty blockers, hormones and surgery to minors. NYU Langone will pay $8.5 million and UPMC will pay $950,000.
Neither hospital admitted doing anything wrong. Both denied the government's allegations, and the Justice Department's own announcement says no liability was determined.
The care is legal where these hospitals are
Gender-affirming care for minors is legal in Pennsylvania and in New York — where the state has gone further and passed shield-law protections for the people who provide and receive it.
"Gender-affirming care is legal in Pennsylvania, and gender-related discrimination is not," Mimi McKenzie, legal director of the Public Interest Law Center, which represented families of UPMC patients, said Friday, the Pennsylvania Capital-Star reported. "This type of care can be life-saving for trans youth."
So how does the federal government get a hospital to stop providing a legal treatment? It investigates until the hospital decides a deal is cheaper than a fight.
A year of chasing children's records
These deals are the end of a campaign that started when President Trump directed the Justice Department to go after providers of gender-affirming care.
- UPMC was one of more than 20 hospitals that got subpoenas last year demanding the patient records of children who received gender-affirming care, the Capital-Star reported.
- Families fought back — and won. In March, a federal judge denied the Justice Department's demand for UPMC patients' records, finding the records couldn't be stripped of details that would identify the children. The department appealed, then dropped the appeal in August.
- At NYU Langone, prosecutors tried again with a grand jury. In May, a federal prosecutor demanded details "sufficient to identify" patients who had received gender-affirming care since 2020, NYU's student paper, Washington Square News, reported. Trans patients sued to stop it, and a federal judge in Manhattan temporarily blocked the subpoena on June 24. The Justice Department's appeal is still pending. NYU Langone had already shut down its Transgender Youth Health Program in February.
At both hospitals, the government has so far lost in court over the records. It won the fight over the care anyway.
UPMC said it settled "to avoid prolonged litigation" and to "protect patients and families from unnecessary disclosure of sensitive personal and health information." NYU Langone said much the same. The records stay private. The price was the care.
Who's next
The Justice Department is not done. Brett Shumate, the assistant attorney general who runs its civil division, said investigations into other providers are ongoing, and that "those that have broken the law and not resolved their potential liability will be prosecuted to the fullest extent possible."
The department said UPMC and NYU Langone earned credit in part because they are cooperating with its investigations of other providers.
They aren't the first. The department said the deals follow similar agreements with Mount Sinai Health System in New York, Texas Children's Hospital, the Cleveland Clinic and Connecticut Children's Hospital.
Lawyers for NYU Langone patients called the deal "beyond shameful." "The Trump administration has strong-armed NYU and Mount Sinai into striking a deal that betrays transgender young people in New York," they said.
Part of a wider squeeze
The hospital deals are one piece of a broader push to cut trans kids off from care. Trump's Medicare and Medicaid agency has cut off Medicaid coverage for trans kids' care starting October 13. In Texas, Ken Paxton took $10 million from a children's hospital and ordered it to open a clinic, then forced out the doctors best equipped to staff it.
For a family in Pittsburgh or New York, the result is the same either way: care their state allows is no longer available at these hospitals.
The facts, in short
Under deals announced September 18, Trump's Justice Department got UPMC and NYU Langone to stop providing gender-affirming care to minors and pay $9.45 million combined, even though both denied wrongdoing, no liability was found, and the care is legal in Pennsylvania and New York. The deals came after the department spent more than a year demanding trans children's identifiable medical records and losing in federal court. Four other hospital systems have already signed similar deals, and the department says more investigations are underway.
Sources
This post is based on the Justice Department's announcement and reporting by the Pennsylvania Capital-Star and Washington Square News. Photo: Jessica Kourkounis for the Pennsylvania Capital-Star.
