Another result of the Department's nationwide investigation into hospitals performing sex-rejecting procedures on minors
The Department of Justice announced agreements with two of the nation’s largest health care systems—New York University Langone Hospitals (“NYU”) and University of Pittsburgh Medical Center (“UPMC”)—that resolve investigations into potential violations of federal law arising from their provision of sex-rejecting procedures on children, often euphemistically referred to as “gender-affirming care.” Under the agreements, NYU and UPMC will cease providing these dangerous interventions to minors, which include administering puberty blockers and cross-sex hormones and performing surgical procedures. Each hospital will also pay a monetary amount as part of the resolutions, with NYU agreeing to pay $8.5 million and UPMC $950,000.
“The Department of Justice is fighting to protect our nation’s children and working tirelessly to reach agreements with hospitals to end so-called ‘gender affirming care’ for minors,” said Attorney General Todd Blanche. “This resolutions send a clear message: hospitals that target children in these practices and then fraudulently obtain payment for the procedures will be held to account.”
This announcement follows similar agreements with Mount Sinai Health System in New York, Texas Children’s Hospital, the Cleveland Clinic Foundation, and Connecticut Children’s Hospital. In working towards these resolutions, the United States acknowledged that both NYU and UPMC took significant steps entitling them to credit for cooperation with the Department in its investigation, including ongoing cooperation in the Department’s investigation of other entities potentially violating federal law in connection with the provision of sex-rejecting procedures to minors. At all times during the investigation, NYU and UPMC remained cooperative and solutions-driven.
“We appreciate that some of the nation’s largest and most prestigious hospital systems have agreed to cease harming minors under the guise of ‘gender-affirming care’ and agreed to pay for potential violations of federal law when they did so,” said Brett Shumate, Assistant Attorney General for the Civil Division. “But I want to be clear: our efforts and investigations into other providers are ongoing. Those that have broken the law and not resolved their potential liability will be prosecuted to the fullest extent possible.”
“My office’s foremost priority is protecting children. The resolutions announced today reflect the close collaboration across the Department of Justice and our continued commitment to ensuring that minors are safeguarded,” said Ryan Raybould, US Attorney for the Northern District of Texas. “These investigations are ongoing, and my office will continue to follow the evidence, act decisively when the well-being of minors is at stake, and fully pursue wrongdoers who have broken federal law.”
The resolutions obtained in this matter were the result of a coordinated effort between the Civil Division’s Enforcement and Affirmative Litigation Branch and the Commercial Litigation Branch, Fraud Section, the U.S. Attorney’s Office for the Northern District of Texas, the U.S. Department of Health and Human Services, Office of Inspector General, and the Food and Drug Administration Office of Criminal Investigations.
In 2025, President Trump directed the Department of Justice to prioritize investigations and enforcement actions involving violations of federal law in the provision of so-called “gender-affirming care” to children. Acting on that directive, the Civil Division launched a nationwide investigation into the child gender-transition industry. The investigation examines potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers. These schemes compound the harm inflicted on vulnerable children by fraudulently shifting the cost of potentially unlawful medical interventions to taxpayers and insurers. Today’s agreements are the results of that nationwide investigation. The Civil Division’s Enforcement & Affirmative Litigation Branch and Commercial Litigation Branch will continue to pursue these cases across the country, stop unlawful conduct, recover funds obtained through fraud, and hold accountable those who profit by violating federal law at children’s expense.
The claims resolved by the United States in these agreements are allegations only, and there has been no determination of liability. NYU and UPMC have expressly denied all allegations.
