Several major hospitals across the country have agreed to close their youth gender clinics and stop providing puberty blockers, cross-sex hormones, and surgeries to patients under 19 as part of settlements with the Department of Justice.

Under the terms, the hospitals must end all such treatments for minors and, in some cases, provide funding for patients seeking to address side effects or detransition. The Justice Department framed the actions as necessary to protect children from procedures the administration describes as harmful and based on overbilling practices.

The latest agreements, reached last week, involve New York University Langone Hospitals and the University of Pittsburgh Medical Center Children’s Hospital. NYU Langone will pay $8.5 million, while UPMC agreed to pay $950,000. These deals follow similar resolutions with Mount Sinai Health System, Texas Children’s Hospital, Cleveland Clinic, and Connecticut Children’s Medical Center.

These settlements build on executive actions and regulatory pressures initiated early in President Trump’s second term. Federal authorities threatened to withhold Medicare and Medicaid funding from noncompliant providers and launched investigations into billing and consumer fraud related to the treatments. Multiple hospitals had already paused or ended services in response to state laws and federal warnings before finalizing the DOJ agreements.

Administration officials, including Attorney General Todd Blanche, stated that the resolutions send a clear message holding hospitals accountable for targeting children with these interventions. The efforts have resulted in the closure of gender clinics at prominent institutions in both red and blue states.

Critics of the treatments argue they expose vulnerable youth to irreversible effects without sufficient evidence of long-term benefits. The Trump administration has prioritized ending federal support for the practices nationwide through a combination of legal and financial measures.

The Department of Justice continues to pursue additional agreements with other providers. Most settlements remain private, though details from several have emerged through public reporting.