At least six major hospitals across the country have recently agreed to stop providing gender-transition treatment to adolescents to end a wide-ranging Justice Department investigation into potential legal violations related to billing practices and consumer fraud.
The wave of settlements includes hospitals in New York, Pennsylvania and Connecticut, states that have been supportive of access to the treatments. The hospitals have agreed to pay fines, and several will provide free medical care to former patients who wish to treat side effects or to “detransition.”
The agreements are a victory for the Trump administration, which has asserted that the potential harms of gender transition for young people outweigh any benefits and that hospitals have overbilled for transition treatments to make a profit. Since early 2025, the administration has applied an array of financial and legal pressures to health care providers to stop treatments in 24 states that permit them.
Many hospitals had already suspended the treatments, citing pressure from the administration. But legal experts and transgender advocates said the new deals with hospitals add a sense of finality.
In a statement on Friday, Attorney General Todd Blanche said the agreements show that “hospitals that target children in these practices and then fraudulently obtain payment for the procedures will be held to account.” He said the Justice Department was continuing to seek agreements with other hospitals.
Most of the agreements have not been made public. The hospitals that reached agreements as of May and as recently as last week are Texas Children’s Hospital, Cleveland Clinic, Connecticut Children’s Medical Center, Mount Sinai Health System, New York University Langone Hospital and the UPMC Children’s Hospital of Pittsburgh.
Representatives for some of the hospitals said they had reached settlements in order to avoid long legal battles with the federal government, as well as to avoid revealing personal data the government has sought about their patients.
Some critics have argued that the Justice Department was acting in bad faith, raising financial questions to intimidate hospitals into ending services that are permitted in their states and to carry out the Trump administration’s policy goals. The Department of Health and Human Services has proposed a rule that would prevent any federal funding from going to hospitals that provide gender treatments to adolescents, though the rule has yet to take effect.
Others have criticized the hospitals, comparing them to law firms and universities that agreed to Trump administration demands at the expense of patients. One advocacy group, Gender Liberation Movement, has organized protests in recent weeks at Mount Sinai and NYU Langone, two New York City hospitals that have reached agreements with the Justice Department.
“It’s devastating to watch, one by one, health care institutions that once cared for trans youth turn their backs on them,” said Raquel Willis, the organization’s executive director.
Several Connecticut families have filed a legal challenge against Connecticut Children’s Medical Center for ending medical care for transgender adolescents last year. The hospital agreed in August that it would keep its gender clinic closed for a decade, pay the government $60,000 and provide $500,000 for patients under the age of 19 who wish to reverse the effects of the treatment, according to a copy of the settlement obtained by The New York Times.
“By agreeing to this settlement, the hospital has doubled down,” Hannah Hussey, a lawyer for the parents, said in a statement. “Not only on that breach of faith with parents and patients, but on its attempt to thwart its obligation under Connecticut law to provide medical care without discrimination.”
A spokeswoman for Connecticut Children’s declined to comment on details of the agreement, but defended it as necessary. “We have reached a resolution that allows our organization to remain focused on our mission of improving the health and well-being of children,” the hospital said in a statement.
Most major medical associations in the United States endorse gender-transition medication for adolescents who experience a mismatch between their sex and their sense of their own gender, known as gender dysphoria. Young people with the diagnosis are at higher risk of depression, anxiety and self-harm as their peers, research shows.
But there are some known risks, including fertility loss and regret, and several reviews by health experts have concluded that the treatments have not been studied well enough to establish whether they are beneficial. The Trump administration has said it is acting on the behalf of young patients and families, which it has portrayed as misled or unequipped to fully consent.
The treatment often includes puberty-delaying medication followed by hormones that align physical traits like body hair and voice range with an adolescent’s gender identity. In rarer cases, it can include surgery.
The Justice Department has said its investigations focus on potential violations of the Food, Drug and Cosmetic Act, the False Claims Act and other federal health care laws. A Health and Human Services report last month suggested that hospitals had incorrectly billed insurers for gender-transition treatment to obtain bigger reimbursements from federal health care programs and private insurers.
But in statements, several hospitals denied any wrongdoing, and legal experts said providing transition care for youths remains legal in about half of U.S. 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.
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