AT least six major hospitals across the United States have agreed to stop providing gender-transition treatment to adolescents as part of settlements reached with the US Department of Justice over investigations into alleged violations of federal law, including healthcare billing and consumer-fraud regulations.
The agreements involve hospitals in New York, Pennsylvania, Connecticut, Ohio and Texas, including Texas Children’s Hospital, Cleveland Clinic, Connecticut Children’s Medical Center, Mount Sinai Health System, New York University Langone Hospital and UPMC Children’s Hospital of Pittsburgh.
Under the settlements, the hospitals have agreed to pay fines, while some have also committed to providing medical care to former patients seeking treatment for complications or wishing to reverse some effects of previous treatment.
The agreements represent a significant development in the Trump administration’s campaign against gender-transition treatment for minors. The administration has argued that the potential risks of such treatment outweigh the benefits and has accused some healthcare providers of improperly billing insurers for the procedures.
Since early 2025, the administration has applied financial and legal pressure on healthcare providers in states where such treatments had remained available.
In a statement, US Attorney General Todd Blanche said the settlements demonstrated that hospitals providing such treatments to children and allegedly obtaining payments through fraudulent billing practices would be held accountable.
He added that the Justice Department was continuing to pursue agreements with other healthcare institutions.
However, several hospitals involved in the settlements have denied wrongdoing, saying they agreed to settle in order to avoid prolonged legal battles with the federal government and to prevent the disclosure of sensitive patient information sought during the investigations.
Most of the agreements have not been made public.
The settlements have also drawn criticism from transgender rights advocates, who argue that the Justice Department is using financial and legal investigations to pressure hospitals into ending services that remain legal under state law.
Raquel Willis, executive director of the Gender Liberation Movement, criticised the decisions by hospitals to end the services.
“It’s devastating to watch, one by one, health care institutions that once cared for trans youth turn their backs on them,” she said.
The organisation has held protests outside Mount Sinai and NYU Langone in New York following their agreements with the federal government.
In Connecticut, several families have also launched a legal challenge against Connecticut Children’s Medical Center over its decision to end medical care for transgender adolescents.
According to a settlement obtained by The New York Times, the hospital agreed in August to keep its gender clinic closed for 10 years, pay the federal government $60,000 and establish $500,000 in support for patients under 19 who seek treatment to reverse effects of previous care.
Hannah Hussey, a lawyer representing the parents, accused the hospital of failing its obligations to patients under Connecticut law.
Connecticut Children’s declined to discuss the details of the settlement but defended the agreement, saying it would allow the organisation to remain focused on children’s health and wellbeing.
The controversy comes amid an ongoing debate in the US medical community over gender-transition treatment for adolescents.
Major US medical associations have generally supported the use of gender-affirming medication for adolescents diagnosed with gender dysphoria, although questions remain about the evidence base, potential risks and long-term outcomes.
Treatment can include medication to delay puberty and, in some cases, hormone treatment intended to develop physical characteristics consistent with a young person’s gender identity. Surgery is less common.
Medical reviews have identified potential risks, including effects on fertility, while researchers and health authorities have differed over the strength of evidence regarding the benefits and long-term outcomes of some treatments.
The Justice Department said its investigations focus on possible violations of federal laws, including the Food, Drug and Cosmetic Act and the False Claims Act.
A recent report by the US Department of Health and Human Services alleged that some hospitals had improperly billed insurers for gender-transition treatment in ways that resulted in higher reimbursements from federal healthcare programmes and private insurers.
The hospitals involved have disputed allegations of wrongdoing.
Legal experts have also noted that providing gender-transition care to adolescents remains legal in a number of US states.
“There has been no determination that offering this care, including to young people, violates any federal law,” said Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University Law Center.
The settlements are therefore likely to remain part of a wider legal and political dispute over the regulation of gender-transition treatment for minors in the United States.
Source: The New York Times
