At least six hospitals have reached agreements with the Trump administration to stop offering gender-affirming treatment for transgender minors. These agreements, reached through the Department of Justice, require the hospitals to refuse gender-affirming hormones and surgery for young transgender patients and instead pay the federal government for patients seeking to reverse their gender transitions. The most recent deals were finalized last week. Most of the hospitals had already stopped offering the treatments due to state laws or previous pressure from the administration. These agreements end investigations into past care and prevent the possibility of hospitals being forced to share patient records. The Justice Department says some providers have also agreed to help pay medical costs for children who want to "detransition." The hospitals have not admitted to wrongdoing. The Trump administration recently announced settlements with New York University Langone Hospitals and the University of Pittsburgh Medical Centers. These hospitals agreed not to provide puberty blockers, hormones, or gender-affirming surgery for patients under 19. NYU agreed to pay the federal government $8.5 million, and UPMC agreed to pay $950,000. These deals followed similar agreements reached since May with other major hospitals, including Cleveland Clinic, Connecticut Children’s Hospital, and Texas Children's Hospital. The hospitals have stated that these agreements will not affect how their pediatric mental health programs treat transgender children. The Trump administration issued a review last year suggesting that only therapy, not broader gender-affirming care, should be offered to youth. However, most major medical organizations, including the American Medical Association and the American Academy of Pediatrics, support the availability of such treatment. Mount Sinai is the only one of the six hospitals to strike a deal that had not previously announced its decision. Hospitals in Texas and Ohio had already stopped offering the care due to state bans. Others had changed their policies since Trump returned to office in January 2025, following a series of actions targeting gender-affirming care. He signed an executive order in January 2025 to cut federal support for gender transitions for those under 19 and barred federal Medicaid from covering the treatment. Gender-affirming care is still available at many hospitals, clinics, and through individual physicians. These agreements end federal investigations into the hospitals. One key action from the administration was to subpoena hospitals, starting in July 2025, for information on gender-affirming care for children, including patient names. NYU Langone stated in a statement that the settlement protects patients and their families by removing the threat of having to provide confidential information about patients under 18 who received gender-affirming care. Several hospitals have asked courts to block them from being forced to turn over records, and most won in district courts. However, a recent 2-1 ruling from the 9th U.S. Circuit Court of Appeals in San Francisco supported the government's case, stating that the administration's goal of ending gender-affirming care for youth is not improper and cannot be used to block the subpoenas. Access to gender-affirming care for youth has become more difficult. At least 27 states have laws restricting or banning such care for minors. Additionally, over two dozen hospitals, health systems, and clinics in states without such bans have stopped offering the care since last year—including some in states with legal protections for it. A group of Democratic state officials has sued the Trump administration, arguing that its efforts unlawfully intimidate medical providers. While transition surgery for those under 18 is rare, many transgender youth receive hormones to block puberty or trigger the development of sex-linked characteristics that align with their gender identity. Eliel Cruz, a cofounder of the Gender Liberation Movement, said some families have moved to other states for access to treatment, only to find that providers have stopped offering it there. Some have even left the country. He said the agreements with the Trump administration show “who has the courage to do what their calling and education calls them to do—which is do no harm—and those (who do) not.”