Two Major Hospital Systems Agree to End Gender Transition Procedures for Minors, Pay $9.45 Million

Two major hospital systems have agreed to stop providing puberty blockers, cross-sex hormones and surgical procedures for gender transition to minors under agreements announced Sept. 18 by the U.S. Department of Justice.

NYU Langone Hospitals will pay $8.5 million, while the University of Pittsburgh Medical Center, known as UPMC, will pay $950,000. The agreements resolve investigations into potential violations of federal law connected to the hospitals’ provision of care to minors and how that care was billed. Neither hospital admitted wrongdoing. The DOJ said its claims are allegations and that there has been no determination of liability.

The settlements are part of a nationwide investigation the department launched after President Donald Trump directed it in 2025 to prioritize enforcement involving gender transition procedures for children. According to the DOJ, investigators are examining potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act and other federal health care laws. The department said its inquiry includes whether providers used false diagnosis codes to obtain payment from federal health care programs or private insurers. It did not establish in its announcement that NYU Langone or UPMC had committed those violations.

Attorney General Todd Blanche said the department intends to pursue hospitals that provide the treatments and fraudulently seek payment for them. Assistant Attorney General Brett Shumate said investigations into other providers remain underway. The department also credited NYU Langone and UPMC for cooperating with investigators, including in inquiries involving other entities.

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NYU Langone offered a different explanation for its decision to settle. In a statement, the hospital said the agreement removes the threat that it would have to provide confidential information about patients under 18 who previously received gender transition care there. It said it denied wrongdoing and considered the resolution in the best interests of patients and families because it would protect their privacy and avoid prolonged litigation. NYU Langone said its pediatric mental health programs and care for patients 18 and older will continue.

UPMC states on its patient resources page that, because of recent federal directives, it cannot provide gender transition medications or surgeries to people under 19. Its website lists hormone therapy and gender transition surgery as services for people over 19.

The DOJ said the agreements follow similar resolutions with Mount Sinai Health System, Texas Children’s Hospital, Cleveland Clinic and Connecticut Children’s Hospital. The NYU Langone and UPMC investigations involved the DOJ’s Civil Division and the U.S. Attorney’s Office for the Northern District of Texas, working with the Department of Health and Human Services’ inspector general and the Food and Drug Administration’s Office of Criminal Investigations. The department said it will continue investigating other providers.