DOJ Secures Agreements with NYU Langone and UPMC to End Pediatric Gender-Affirming Care

While Attorney General Todd Blanche characterized the $9.45 million settlements with NYU Langone and UPMC as a necessary measure against hospitals that "target children" and "fraudulently obtain payment," the agreements themselves contain no admission of wrongdoing or liability from either institution. The September 18, 2026, resolutions instead mark a strategic retreat by two of the nation's largest health systems, which opted to close their pediatric gender clinics rather than face prolonged federal litigation and the exposure of sensitive patient records.[1][5][6]

Under the terms of the agreements, both NYU Langone and the University of Pittsburgh Medical Center will cease providing puberty blockers, cross-sex hormones, and surgical procedures to patients under the age of 18. NYU Langone agreed to pay an $8.5 million penalty, while UPMC will pay $950,000 to resolve the federal probes into their billing practices.[1][6]

The settlements stem from a nationwide investigation launched by the Justice Department's Civil Division following a 2025 directive from President Donald Trump. The probe examined potential violations of the False Claims Act and the Food, Drug, and Cosmetic Act, specifically alleging that providers used inaccurate diagnosis codes to bill federal health care programs and private insurers for gender-transition interventions.[1][7]

Both hospital systems firmly denied the government's allegations of fraudulent billing. In a public statement, NYU Langone asserted that the resolution "removes the threat that NYU Langone would have to provide the confidential information previously demanded about patients under 18." The hospital emphasized that the settlement allows them to protect providers and patients from the exposure of sensitive health records, noting that the resolution does not impact pediatric mental health programs or care for adults.[4][6]

UPMC echoed that rationale, stating the agreement "expressly includes no admission of wrongdoing, fault, or liability by anyone involved." A spokesperson for the Pennsylvania-based system noted that UPMC chose to resolve the matter to "avoid prolonged litigation, protect patients and families from unnecessary disclosure of sensitive personal and health information, protect employees, and remain focused on patient care."[2][5]

The DOJ's pursuit of patient records had previously sparked intense legal battles. In July 2025, the Justice Department subpoenaed UPMC and more than 20 other clinics nationwide for identifying information regarding minors who had received gender-affirming care since 2020. While the DOJ later narrowed its request to anonymized records in some jurisdictions after facing court challenges, the pressure campaign successfully prompted several institutions to dial back their services.[4][5]

The agreements drew immediate condemnation from LGBTQ+ advocates and local officials. New York City Mayor Zohran Mamdani issued a statement calling NYU Langone's decision "yet another alarming example of a private institution caving to pressure from the federal government." In Pittsburgh, members of the advocacy group TransYOUniting protested the UPMC settlement. "It sounds more like medical abandonment than protection to me," said TransYOUniting board member Kian White.[2][4][7]

NYU Langone and UPMC are now the fifth and sixth major hospital systems to reach such resolutions with the federal government, joining Mount Sinai Health System, Texas Children's Hospital, and Connecticut Children's Medical Center. The DOJ noted that both NYU and UPMC received credit for cooperating with the investigation and will continue to assist with probes into other entities. "Our efforts and investigations into other providers are ongoing," Assistant Attorney General Brett Shumate warned.[1][3][5]