New York Hospitals Pay Millions to Stop DOJ Investigation into Gender Affirming Care for Trans Youth

Last week, NYU Langone Health (a hospital system affiliated with New York University) reached a settlement with the Department of Justice concerning its provision of gender-affirming care to trans youth. Mount Sinai Health System reached a similar agreement earlier this month. Despite these hospitals’ claims to care for LGBTQ+ patients, they’ve buckled in the face of federal attacks on trans care, prioritizing money over patients even in violation of state human rights laws.

Shortly after Trump’s second inauguration, the Trump administration threatened to withhold all federal funding from medical institutions providing youth gender-affirming care. NYU Langone, Mount Sinai, and other New York City hospitals were rumored to begin cancelling patient appointments and refusing to accept new trans youth patients. In response, several NYU labor unions and student groups rallied alongside Democratic Socialists of America (DSA), ACT-UP, and other progressive groups to protest NYU in February 2025. Later in the week, a coalition of various LGBTQ+ community organizations organized another protest against all of the hospital systems, with roughly 1,000 people in attendance.

NYU Langone formally announced the end of all gender-affirming care for trans minors a year later, in February 2026. The following May, the Department of Justice issued a grand jury subpoena (currently paused by a judicial injunction) seeking the medical records of trans youth who had received gender-affirming care at the hospital. At a subsequent hearing, the government’s lawyers hinted at the possibility of parents being prosecuted for helping their children seek medical care.

NYU Langone is now claiming the hospital agreed to the settlement in part to protect patients and their families, yet the settlement seemingly does not resolve the question of whether the hospital will be required to provide the medical records. How are trans patients and their families being protected, if their identities could still be revealed to a hostile government?

The settlement does mean the hospital systems will make multimillion dollar payments to the Trump administration and pledge to continue their halt on any gender-affirming care in exchange for the DOJ dropping the lawsuit. Mount Sinai also agreed to donate $2 million toward detransition medical care.

Queer community groups in New York City and their allies once again rallied outside NYU Langone Tuesday afternoon to protest the settlement. The New York Civil Liberties Union and other allied groups have pledged to continue defending the patients and their families, pointing out that the decision to cancel gender-affirming youth care violates state human rights law, which the hospitals are obliged to uphold regardless of executive orders from the President. Having laws to protect trans rights at the state level is good, but it’s clear that such laws are inadequate when hospitals are willing to capitulate to federal legal harassment and what essentially amounts to extortion.

The LGBTQ+ community and its allies should continue to organize against these attacks across the country, and healthcare workers — particularly nurses, with their large unions — should organize to both protect their patients and expand access to gender-affirming care to all who want it. School teachers, most famously the Chicago Teachers Union, have successfully won protections for LGBTQ+ students and teachers in their contract strikes in the past, and healthcare workers’ unions can organize for patient protections and the right to do their jobs and provide appropriate medical care, including gender-affirming care to their trans patients.