In a sweeping shift that touches families from the Bronx to the Bay Area, six major U.S. hospitals have formally agreed to stop offering gender-affirming treatments to patients under 19. The agreements, signed with the Department of Justice, mark the latest turn in a federal campaign that has redrawn the boundaries of pediatric healthcare.
Among the institutions are NYU Langone Health in New York City and the University of Pittsburgh Medical Center (UPMC) in Pennsylvania. Both have paid multimillion-dollar fines to close federal investigations into their previous practices. Mount Sinai Health System, also in New York, went a step further: it agreed to fund medical care for individuals seeking to reverse treatments they received as minors.
A new legal landscape for hospitals and families
For years, these hospitals offered puberty blockers, hormones, and surgical procedures as part of gender-affirming care for minors. But under pressure from the federal government, they have now committed to ending those services entirely. The Justice Department has framed the agreements as a necessary safeguard for child welfare, warning that any institution that defies the rules will face severe consequences.
“These agreements are about protecting children,” a DOJ spokesperson said in a statement. “We will not hesitate to act against any hospital that puts ideology above the well-being of minors.”
The impact on families is immediate. Parents who had been navigating care for their transgender or nonbinary children now face a patchwork of options. Many of these hospitals had already suspended their programs before signing the agreements, leaving patients in limbo. Medical teams have scrambled to refer young patients to independent clinics, community health centers, or out-of-state providers.
For Latino families, who already face barriers to healthcare—from language access to immigration concerns—this disruption adds another layer of stress. In cities like New York and Pittsburgh, where Latino communities are growing, the closure of these programs means longer waits, higher costs, and fewer culturally competent providers.
“We’re seeing families who are desperate,” said Dr. Elena Ramírez, a pediatric endocrinologist in Queens who has worked with transgender youth. “They don’t know where to turn. Some are considering moving to states with more protections, but that’s not an option for everyone.”
The agreements also include provisions for mental health services. Pediatric psychiatry and counseling remain available at these hospitals, which officials say will help cushion the emotional toll on families. But the future of specialized care is uncertain.
Federal appellate courts have largely upheld the administration’s restrictions, but legal challenges continue. Meanwhile, the medical community is adapting to a new reality where the definition of pediatric care has narrowed.
For families, the road ahead is unclear. Some are turning to community resources to find support. Others are exploring legal options. But for now, the six hospitals—once beacons of comprehensive care—have closed their doors to this type of treatment.
As the landscape shifts, one thing is certain: the debate over gender-affirming care is far from over. And for the families caught in the middle, the stakes couldn’t be higher.
