DINMAG

Two major American health systems have agreed to stop providing puberty blockers, hormones and gender-affirming surgeries to patients under 19 as part of settlements with the U.S. Department of Justice.

NYU Langone Hospitals will pay the federal government $8.5 million, while the University of Pittsburgh Medical Center will pay $950,000. Both institutions denied the government’s allegations, and the settlements contain no determination that either hospital violated the law.

At least six health systems have now settled

The agreements follow similar deals involving Mount Sinai, Texas Children’s Hospital, Cleveland Clinic and Connecticut Children’s Hospital.

The Justice Department says its investigations concern possible violations of federal drug, fraud and health-care laws. Its September 18 announcement used politically charged language to describe gender-affirming care and said investigations of other providers remain underway.

Independent reporting adds important context: several affected institutions had already stopped providing some or all of the care because of state restrictions or earlier federal pressure.

Patient records were part of the pressure

The dispute was not limited to which services hospitals could offer. Federal subpoenas sought information about minors who had received gender-affirming care, including identifying information.

NYU Langone said its settlement removed the threat that it would have to provide confidential patient information requested by the government. Courts have blocked several similar demands, although a recent federal appeals ruling strengthened the government’s position in one subpoena dispute.

For LGBTQ families, that raises concerns extending beyond a single treatment decision. Confidentiality is central to medical care, particularly when patients belong to a politically targeted group.

Medical policy and federal policy remain in conflict

The administration has promoted therapy without puberty blockers or hormones for transgender minors. Major professional organizations, including the American Medical Association and American Academy of Pediatrics, continue to support access to individualized, evidence-based care through clinical decision-making involving patients, families and physicians.

Gender-affirming surgery among minors is rare. Puberty blockers and hormones are more common, but availability now depends increasingly on geography, institutional policy and a family’s ability to travel.

The settlements therefore do more than close two programs. They demonstrate how federal investigations can reshape health-care access even without a nationwide act of Congress prohibiting the treatment.